Sunday, November 2, 2008

The balance between protecting individual rights and the health of the public

While Cuba's approach to HIV/AIDS containment was definitely a violation on human rights, they have managed to maintain the lowest prevalence of HIV in the Americas. I think we can be somewhat forgiving of their approach because at the time, the etiology of the disease was not fully understood. From what I've read up on this, the first case was not detected from a gay male, but from a heterosexual volunteer returning from Africa, therefore, there was very little stigma attached to the disease initially (http://www.medicc.org/ns/assets/documents/Cuban%20HIV%20Strategy.pdf). It was understood to be a sexually transmitted disease that could infect the population regardless of sexual practices. Therefore, the HIV approach taken by Cuba was made based on epidemiological evidence, and did not involve them targeting certain populations and isolating them. While debate arrived when Cuban health officials implemented a sanatorium policy for people diagnosed with HIV or AIDS,they defended their actions by arguing that they were able to provide patients with the most effective mechanism for providing comprehensive biological, psychological,and social care patients required.

I don't believe quarantining HIV patients is morally the right approach to address the HIV epidemic, but it did prove effective. Public health professionals are faced with the arduous task of balancing and protecting the rights of individuals with the health of the public. Which raises the million dollar question, at what cost do we compromise individual rights in order to protect the public? This reminds me the case of Andrew Speaker and the CDC in May 2007. Speaker was infected with a drug-resistant form of TB and decided to travel to Europe, exposing many people to the disease. The CDC made the decision to order him back and quarantined him. Unfortunately for the CDC, Speaker was a lawyer and was able to highlight his victimization and win over the American public. In my opinion, certain cases do call for the government to take action and compromise individual rights for the greater good.

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