After 25 years, there is a broad though sometimes superficial
awareness of state responses to HIV/AIDS in the global South, where
the spread of disease is said to be fueled by inept or failed states,
those so poor or whose officials are so indifferent that they lack public
health services or even a minimal health care infrastructure. But this
narrative ignores the failed responses among states struck in the first
wave of the pandemic in the early 1980s. In the long run, generally
between 1986 and 1990, the industrialized democracies where a new illness
was first identified did implement comprehensive disease prevention, blood
safety, and treatment and care regimes specifically targeting AIDS; in the
short run, these same countries struggled over—and more often then
not failed to implement—appropriate measures to stem the spread of
the epidemic. And in the long run, tens of thousands contracted HIV and
died.Michael J. Bosia, Assistant Professor
at Saint Michael's College in Vermont, has been an activist and
policymaker (mbosia@smcvt.edu). He thanks the Fulbright fellowship
program, a Blaine J. Yarrington Fellowship from Northwestern University,
and Saint Michael's College for financial support.