These and Those

Musings from Students of the Pardes Institute of Jewish Studies in Jerusalem

A Dvar Torah from the European Aids Conference

Posted on October 24, 2015 by Zvi Henderson

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Pardesniks come from a variety of professional backgrounds; some from leadership roles in youth movements, some from the Jewish professional world, from finance, business and social work. My professional background is public health, and in particular sexual health and well-being. It’s as wide a field as you can imagine. Before making Aliyah from Scotland and ending up at Pardes, I managed a support service for people living with HIV, and worked on harm reduction policies for drug users and improving sexual health services for highly affected populations, in particular, men who have sex with men (MSM).

I skipped classes at Pardes this week in order to represent Israel at the European AIDS Conference in Barcelona. Even though I’m letting down my chevruta partners, I felt I had the opportunity to put a little Torah into action.

For me this work is the most Jewish thing I’ve ever done. It always feels like a David and Goliath battle, but I know who wins in that story. For one, the pharmaceutical industry is so powerful and its evil ways are so entrenched, it would take a force of biblical proportions to change their practices.

In 2008, The Centre for Research on Multinational Corporations produced a report detailing dozens of examples of highly unethical human drug trials which took advantage of people in the developing world. From children being given experimental treatments without their parents’ consent, to forged signatures, to misinformation and adverse effects not being reported, it is a litany of failings of the modern drug development industry.

India is one of the most affected countries; between 2008 and 2011, there were over 2,000 deaths that we know about from drug trials taking place in India.

“But if harm should occur, then you are to give life in place of life–eye in place of eye, tooth in place of tooth, hand in place of hand, foot in place of foot, burnt-scar in place of burnt-scar, wound in place of wound, bruise in place of bruise.” Exodus 21:23-25

‘Eye in place of eye’ actually means monetary compensation. The Rabbis divided the human body into 22 parts, corresponding to the 22 letters of the Hebrew alphabet, with each having a specific, monetary value attached to it. Perhaps if drug companies had to live by this halacha, they would take far more care in setting up their trials.

Even when a drug comes to market and can help people, the way it’s distributed is so unjust it would make the mayor of Sodom blush. I wrote recently about the Martin Shkreli scandal, the hedge fund manager who bought the license for an old drug used to treat infections in people with AIDS and jacked up the price by 5,000%. That story revealed many scandals still prevalent in our world, one being that anyone today even requires a drug to treat AIDS related infections.

One of the wonderful things about being at the European Aids Conference is the relentless positivity. Drug companies show off their shiny new side-effect free medicines on plasma screens, well dressed community advocates mingle with doctors, and the conference agenda is packed with sessions on “the cure.”

But this atmosphere, worlds apart from the unending depression of 20, 15 or even 10 years ago, belies the reality we live in. This year a milestone in the fight against AIDS was reached with 15 million people on treatment around the world… out of a global population of 35, 40, maybe even 50 million living with HIV.

We could literally end AIDS tomorrow, if we wanted to. The three magic numbers are 90, 90, 90, that’s 90% of people diagnosed, 90% on treatment and 90% virologically suppressed (their treatment works and they have the correct nutrition and social support to take it). This would prevent most new infections, stop most babies being born with HIV, and stop anyone else becoming sick or dying prematurely.

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Why should we care? As Jews, we are intimately involved in this system. As doctors and health care professionals, as business people and executives, as campaigners and activists, and just as people who see the needless suffering of other people as offensive to our basic humanity.

Israel isn’t immune to these problems either, nor are we anywhere close to being a world leader in an area that should really be our expertise. In Israel, the government won’t even think about licensing PrEP, a cheap drug that is 100% effective in preventing HIV transmission, even though it’s also incredibly cost effective. While Ethiopian Jews are fully eligible for HIV treatment through the Kupat Cholim (Israel Health Service), there are never-ending cases of discrimination against that community and a critical lack of information in Amharic. Another major challenge is an acute lack of appropriate services to tackle the growing phenomena of hard drug use among MSM that is now embedded in Tel Aviv, like in every major party city.

Despite missing a week of classes at Pardes (which no one should do–I have so much Mishna to catch up on!), I have been able to achieve a couple of things:

  1. A green light from the European Aids Treatment Group and Gilead Sciences to apply for funding for support and empowerment of people living with HIV from the Ethiopian community in Israel, including organizing gatherings, translating information into Amharic, and dealing with cases of discrimination in the courts.
  2. Commitment from specialists in London to work with us in developing a harm reduction center in Tel Aviv for men who have sex with men and use drugs.
  3. Airing some of the complex issues of Israeli society at an international forum and showing that the desire to save lives crosses borders and nationalities.

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If you’re walking in the desert and you have more than enough water, so much so that you are actually a water salesman and you are transporting it to market, and you come across an abandoned child, dying of thirst, are you not obligated to help the child? If you come to a village full of thirsty children, do you still set up your water stall and charge more than anyone can afford, just because you can?

To put it more bluntly, if you have a treatment for someone’s illness, and you intentionally withhold it from them, are you not culpable should they die? Maybe there’s a Dvar Torah on that; I’ll have to keep studying to be sure.