Pre-Exposure Prophylaxis or PrEP

Pre-exposure prophylaxis (PrEP) involves putting HIV negative people on antiretroviral drugs (ARV) with the aim of protecting them from HIV infection. This blog looks at some of the pros and cons of PrEP.

Thursday, October 21, 2010

Gates Foundation Spends Billions on Potemkin Villages

Bill and Melinda Gates seem to think people have a downer on development aid, if their recent attempts to present us with 'success stories' is anything to go by. One of problems with Gates and Co is that they have a lot of say in how the development agenda is set because they have the money to blow on whatever they feel like. So if they feel like blowing their money on puffing their own projects and interests, they'll do it. And if they feel like hyping PrEP, genetically modified organisms and numerous other purely technical quick fixes, they'll do that.

In recent years, questions have been raised about the way things have been done in development up to now. Perhaps that was going nowhere and things will just continue to benefit the donors more than people living in developing countries. But what the Gates Foundation is doing tends to obscure what is going on, to paint a colorful picture when what we need is an accurate picture. Worse still, because they get to set the agenda, issues that have been ignored in the past will stay in the dark and issues that these over paid bureaucrats like will be even more hyped than before.

Nothing I read about Gates and his cronies makes me think that he understands poverty or any other issue in development. I don't even think he cares very much about such things. I have no idea what motivates him but I don't see him engaging with anything but opportunities to force unneeded and possibly harmful technologies on people who are too disempowered to object. The foundation's work risks undermining other work that is going on in development and unless they can learn to cooperate and even take their lead from people who know what they are doing, who know what they are talking about, development will be stifled.

For example, PrEP is not going to reduce the risks that HIV negative people face to any great extent. People who face sexual risks can take other measures and if they can't, it's hard to see how some pills with help. For those who face non-sexual risks, the pills may work, but their availability is not a reason for allowing unsafe medical and other practices to continue. PrEP is in danger of sweeping the real problems under the carpet, but without reducing the risks appreciably.

Genetically modified organisms and other technical quick fixes are similarly distracting from the real issues that give rise to poverty, food insecurity, contaminated water and poor sanitation, inequalities of various kinds and any other development problems. Technical solutions are in the hands of technocrats like Gates and they will always remain in the hands of the rich and powerful. People don't die for want of pills for, say, cholera, they die for want of fresh water. Cure cholera and a handful of other water borne diseases and people will die of something else, probably also water borne.

The majority world is not a sand-pit for Gates and recipients of his largesse to play in, it is reality for most of the world's population. Big 'philanthropy' needs to be answerable to the public before it does irreparable damage, if it hasn't done so already.


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