This Week:

Quote of the Week

The International AIDS Conference 2004: Crucial Context

The AIDS Conference in the News

Greetings,

The old joke goes like this: Two guys come out of a restaurant, complaining to each other. One says, “Boy, the food in there was TERRIBLE!” The other guy nods and says, “Yeah, it was. And such small portions, too!”

Doing this week’s Nygaard Notes put me in mind of that old joke. As I looked at the lack of coverage of the recently-concluded International AIDS Conference, I was getting upset at the lack of news coverage. Then I looked closer and saw that the coverage that we did get was badly distorted. That’s food for thought – bad thought. And such small portions, too!

This is why we need more media activism. We need to put pressure on the media to do their job of helping our citizens become properly informed on important issues. But we also need to support the growing movement toward creating alternative news sources to ultimately replace the profit-oriented industry we have at the moment.

That’s a big job. This week I give some sense of how the mass media did on this particular issue. Next week I look at the real story, and give some ideas about how you, too, can learn to analyze the media effectively.

That’s it for now. Until next week,

Nygaard

"Quote" of the Week:

This week’s QOTW is from an excellent story that was unfortunately buried on page 17 of the June 30th New York Times. (But don’t get mad at the Times; no other newspaper in the country, to my knowledge, ran this news on ANY page.) The Times headline: “Investigators Say Drug Makers Repeatedly Overcharged.” I’ll quote it at length.

“Federal investigators said Tuesday that drug companies had repeatedly overcharged public hospitals and clinics for low-income patients, making them pay more than the maximum prices allowed by federal law. Such taxpayer-supported hospitals, community health centers and clinics for people with AIDS are supposed to have access to the government's best prices for outpatient drugs.

“If the government detects evidence of overcharges, ‘it does not have the legislative, regulatory or contractual authority to effectively remedy the situation,’ George F. Grob, an assistant deputy inspector general, said. If the hospitals and clinics are not overcharged, Mr. Grob said, they could ‘serve more patients and improve the quality of service.’

“The Bush administration said that it ‘concurs with the overall findings in the report’ and would try to monitor drug prices more closely. But it said it did not want to ask Congress for authority to impose fines and other penalties on drug companies.”

The International AIDS Conference 2004: Crucial Context

Earlier this month, 17,000 people, including people living with HIV/AIDS, government officials, public health workers, AIDS activists, scientists, and others gathered in Bangkok, Thailand for the 15th International AIDS Conference. There was a real story here about one of the greatest public health crises of our times. Too bad the media missed it.

Statistics and Attitudes

When I say that the HIV/AIDS crisis is a huge one, here is part of what I am talking about: Nearly 40 million people worldwide are now infected with HIV and 16,000 new infections occur every day. Poor countries bear more than 90 percent of the global burden of HIV/AIDS these days, with sub-Saharan Africa alone being home to 28 million infected people. The AIDS activist group HealthGAP (Global Access Project) echoes many groups when it says,

“Countries [in Africa] are now facing not only immediate daunting challenges of caring for huge numbers of people affected by HIV/AIDS, but [are also facing] long-term catastrophic economic development impacts on labor forces, educational systems, communities and families. [Outside of Africa] the unchecked expansion of the AIDS epidemic could lead to similar catastrophic public health crises.”

After the problem of AIDS came to public consciousness in the early 1980s, the response for a number of years was to focus on prevention. But in the mid-1990s, especially in the world’s wealthy countries, the approach began to shift. Antiretroviral drugs (ARVs) for HIV and associated infections became standard treatment for HIV in Western Europe and North America, and we saw dramatic decreases in rates of death and illness among infected people in these countries. This shift mostly happened in the world’s rich countries, for a variety of reasons, which I’ll talk about next week.

In the poor countries it was a different story. Here is HealthGAP again:

“[In the poor countries] people with AIDS continued to suffer and die with no access to medicines and with grossly inadequate health care. [Although there was a major shift in the wealthy countries,] glaring global inequities in HIV disease burden were scarcely addressed in mainstream global AIDS policy discussions – neither by governments of wealthy donor nations nor by the multilateral institutions that they had created to lead the economic, political and public health development in the post-colonial global South. Rather, treatment delivery for the vast majority of the global population of people with AIDS was essentially dismissed as prohibitively expensive and logistically impossible. HIV prevention continued to be viewed as the only possible solution to the AIDS epidemic in the developing world.”

This is still the case for the most part, despite the fact that, as the group Doctors Without Borders says, “without the appropriate medicines, prevention efforts are severely limited and treatment is impossible.”

AIDS activists in the rich countries know that it was “social activism which catalyzed advances in science, medicine and health care delivery which led to the introduction of treatments and care for people with AIDS” in their countries.

It was in this context that this year’s International AIDS Conference occurred, coming together under the theme of “Access For All.” Now let’s look at how the U.S. media covered this major conference.

The AIDS Conference in the News

How was the just-concluded 15th International AIDS Conference covered in the Mainstream Corporate For-Profit Agenda-Setting Bound Media in the U.S.? To put it bluntly, the news of this important conference – and of the global public health crisis upon which it focused – was under-reported and distorted.

The Local Paper: Unreported

In assessing the performance of the mass media in covering this conference, I started by looking at my local newspaper, the Star Tribune, for the week of the conference, which ran from July 11th to the 16th. I was surprised to find not a single news article on the conference produced by this major regional newspaper! They did publish one editorial, on July 13th, saying that the rich countries need to give more money to the fight against HIV/AIDS, and that “the world community must double their efforts.” True enough, but what does that mean?

Normally, one might look to the news pages to get some hint of what the editorial was talking about, but there were no news articles on the conference in the Star Tribune. There were two articles that week about AIDS, and they mentioned the conference, but they were both reprints from other newspapers. One told of a medical breakthrough that now makes it possible to test and treat pregnant women and their newborns to prevent the virus being transmitted from mother to child. These tests “could further reduce the low U.S. rate of infant infection,” said the article from the LA Times.

The other article was from the NY Times, and focused on last week’s release of a report on the effect of AIDS in Africa by the United Nations Development Programme. The article pointed out that poverty in Africa, after “recent decades of progress,” is now worsening, at least in part due to the spread of AIDS.

The National Media: Misreported

I could see that the AIDS story was not much of an issue for the editors of the Star Trib. Maybe there wasn’t a story here? I next went and looked at the New York Times (“All The News That’s Fit To Print”) during the week of the conference to see how they covered it. They ran about 13 stories on the AIDS conference – or that at least prominently mentioned it – during that week. I looked for themes in the coverage. That is, what impression of the issues facing the global AIDS community would a faithful reader of the New York Times come away with after reading their coverage of the recent get-together?

Three of the articles concerned technical progress (“2 Cheap Drugs Combined Can Prevent H.I.V. in Newborns,” “Fixed-Dose Mixtures of Generic AIDS Drugs Prove Effective,” and “Tests to Begin on New Drugs to Protect Women From Contracting H.I.V.”). Three more were about South Africa (“AIDS Fills South Africa's Cemeteries,” “Mandela Appeals to AIDS Conference to Extend Fight to TB,” and “South Africa Rejects Use Of AIDS Drug For Women”). One was about Thailand (“Loans Help Thais With H.I.V. Get Back to Work”).

A July 12 article was about a proposed meeting of heads of state that never happened (“World Leaders Are Scarce as AIDS Conference Opens in Bangkok.”) One important point appeared in an article that was not really about AIDS, but about a shortage of nurses in Africa (“An Exodus of African Nurses Puts Infants and the Ill in Peril.”) One of the reasons that there is a shortage is that many nurses are themselves dying, the Times tells us, “mostly of AIDS and tuberculosis.” The Times adds, almost as an aside, that “Drugs for people with AIDS have been unaffordable up to now,” a crucial point to which I will return next week.

Two of the Times articles touched on issues that should be of major importance to a U.S. audience, as they discuss issues upon which U.S. policies have had a huge effect. The first – “H.I.V. Goal Still Possible, U.N. Health Unit Says” – refers to “obstacles that had severely limited the number [of people with HIV/AIDS] now under treatment,” but fails to examine U.S. responsibility for those “obstacles,” another serious omission to which I will return.

The second missed opportunity for the Times was their July 13th article headlined “Duplicated Efforts Are Hampering AIDS Fight, Conferees Say.” Although the article clearly states that “waste and inefficiency from the duplication of efforts by donors are a major obstacle” to dealing with the global AIDS crisis, there is no mention of the U.S. role in that “duplication of efforts,” although that role is clear to anyone who looks.

A July 14th article, “Early Tests for U.S. in Its Global Fight on AIDS,” was the single exception to the pattern of diverting attention from U.S. responsibility for problems with access to treatment for AIDS. This article – co-reported by three Times reporters – raised a number of important issues that were otherwise ignored by the Times, yet even here the tone was of the U.S. as the valiant philanthropist, alone and misunderstood. I’ll talk more about this article next week, but here’s a small example of the tone: After remarking that “The president's [anti-AIDS] program, a centerpiece of his compassionate conservativism [sic], has been a prime topic of conversation at the International AIDS Conference in Bangkok – and a magnet for some protests,” the Times lists a number of specific problems that “critics” of the U.S. have with Mr. Bush’s program. They then quote “the administration's global AIDS coordinator,” Randall Tobias, who drew loud protests when he addressed the conference. Tobias remarked that “I don't know why people spend so much time fighting each other.” This is typical for the Bush administration: if one criticizes a failed policy, one is being “pessimistic.” If one criticizes a misguided policy on AIDS, we’re “fighting each other.”

So, what are the main impressions that readers of the Times might come away with after the week’s coverage? I think they might include these impressions: AIDS is a big problem in the poor countries of the world, especially those in Africa; the U.S. is doing all it can; many countries don’t like the U.S. and are not grateful for our help, as usual; and HIV/AIDS is now, for the most part, a problem for “other” countries, except to the extent that they are objects of our charity.

All in all, pretty disappointing. Since the theme of the International AIDS conference was “Access For All,” one might have expected that the news reports on the conference in this country might focus on the issues related to access. Mightn’t one? Or at least explain what is meant by “access.” Access to what? Why don’t all have access? Or, if they do, how did the conference celebrate that? Yet, even in the best article in the Times, the word “access” was not to be found.

My database search of the nation’s newspapers indicates that the Times’ coverage for the week of the International AIDS Conference was fairly representative of that found elsewhere in this country. However, there were some noble exceptions – and some fascinating contrasts in the foreign press – that give a hint of the kind of news coverage that we could have had.

Next week I’ll spell out what I think is the real story that United Statesians should have gotten from the media about the AIDS Conference. I’ll also give some resources for learning more about HIV/AIDS, and I hope to spell out some of the tricks – er, scholarly methodologies – that I used to put this two-part series together.