Where I'm at

I am at the Social and Behavioral Sciences Network Meeting of the Centers for AIDS Research, which are NIH-funded research centers around the country and which, as you may already have guessed, have a social and behavioral sciences network.

David Bangsberg this morning told us something rather interesting. You may remember that many people -- including high officials of the previous administration such as Andrew Natsios -- insisted that there was no sense in providing antiretroviral treatment to people in Africa because they are incapable of following drug regimens. As Natsios memorably said, they don't even have clocks.

As it turns out, the percentage of people in Africa who stick to their HIV drug regimens is a lot higher than the percentage of people here in the U.S. And that's true even though for many of them, it costs 30% of their monthly income just to travel to the clinic every month to pick up their pills, not to mention a whole day away from the fields or whatever their source of sustenance may be.

How do they do it? They draw on social capital -- family members and neighbors give them the money, watch their kids and tend their fields while they are gone. Why? Not only because the people live in close-knit communities, but also becauase, before they got the drugs, they were sick and could not work. Others had to take care of them, while they couldn't pull their own weight economically. Now they are up and around again, working, helping take care of their neighbors' kids, giving back. And so the community depends on them to take the pills, because that's what keeps them a productive, giving part of the whole.

Think how different that is from the context of antiretroviral treatment here in the U.S. And also think about what it tells us about our prejudices and our limited and downright foolish view of the rest of the world.