Denialists’ harvest—the AIDS body count in South Africa

As a physician, few things frustrate and sadden me as much as preventable deaths. I see it all the time—the guy who kept putting off his colonoscopy and was later diagnosed with metastatic colon cancer, the woman who put off coming to the doctor with her breast lump until it broke through her skin, the heart patient who couldn’t stop smoking. They all haunt me. But what if the ghosts were numbered in the hundreds of thousands rather than dozens?

That’s what it must be like to be Thabo Mbeki, that is if he has a conscience. It may (or may not) be bad “framing” to call someone a “denialist” but a new study seems to say that whatever you call it, denialism kills. When government leaders allow themselves to be duped by denialists murderers non-acceptors of truth sickfuckdenialistbastards….Damn it, I’m sticking with “denialist”. When government leaders allow denialists to guide their public health policies, people die, apparently in large numbers. I’ll have to leave it to my epidemiology colleagues to evaluate the quality of the study (which on my read looks OK), but even if it’s off by one order of magnitude, the results are horrifying.

What can possibly be done when government leaders are enthralled by denialists? The challenge of global warming has be left out of effective public policy for the last eight years. Who knows what effect that will have on lives lost? Science will always be politicized to some extent, but we must—MUST—speak out, and forcefully, when denialists take over an issue critical to the public well-being.

These issues have very real consequences. Take “abstinence-only” programs—please. They don’t work. At all. And the same thinking that brought you these programs affects our overseas health policies vis-a-vis condoms, abortion, birth control, and other important public health measures. What if we had a president who bought the infections disease promotion anti-vaccine lie? Imagine the impact that could have on public health. This is not an area where we can all just get along.

There is room in debates for all kinds of voices. Some people may take a meet-you-half-way conciliatory approach. Others may be more in-your-face. Denialism isn’t some gimmick, some bloggy thing—it is a real world phenomenon with real world effects. I can’t meet an AIDS-denialist half way. They are wrong, and my tone indicates just how wrong I think they are. I know some will be turned off by certain types of discourse and language (Hi, Mom!), but there are times when only an F-bomb will do.

The tragedy of AIDS in South Africa (especially when contrasted with successes in places like Botswana) highlights the need for vigilance in science and medicine. When unscientific and denialist thinking pops up, grab the mallet—there’s enough of these folks to keep us playing whack-a-mole for a long time to come.