A Critical Analysis of Biomedicine in the Context of HIV

Both Impure Science and When AIDS Began: San Francisco and the Making of an Epidemic address that HIV, not only, challenges the constructs of biomedicine in terms of its manifestation but it also serves to highlight the intrinsic weakness within the systems of biomedicine.

Biomedicine often seeks a “magic bullet” when it comes to addressing a particular disease. Because there is no universal solution to HIV, as it socio-culturally manifests itself in diverse ways within various societies, such a “magic bullet” is not a viable solution in relation to this epidemic. Even if a “magic” vaccine were discovered, this would not address the social, cultural and economic ramifications of the disease.

This particular epidemic can illustrate the inadequacies within the constructs of biomedicine in various ways. Firstly, when HIV initially manifested itself among male homosexuals, homosexuality, itself, became a concept which was largely medicalized and pathologized. Furthermore, biomedicine over accounted for the role of sexual transmission in the spread of HIV. Hence, even when the data set enlisted that a number of homosexuals were also intravenous drug users, research scientists chose to assign sexual behavior as the primary risk factor. Secondly, the dangers of arrogance in research can be felt time and time again in regards to HIV. Biomedicine desperately tries to separate itself from society in order to invest in research with a scientific base, yet it is not able to protect itself from the shortcomings of the researcher himself. This downfall is especially illustrated by Gallo’s fixation with attempting to prove the relation of HIV with a specific type of cancer. Additionally, biomedicine is largely governed by systems of power and legitimacy which are more concerned with the competition within the biomedical research arena rather than a larger altruistic good. Therefore, the cults of credibility formed by an elitist group of scientists not only dictate knowledge as they see fit, but also serve to mostly hinder any other alternative hypothesis in regards to the disease. Lastly, HIV research mainly still ignores socio-cultural and economic factors. In the process of being “scientific,” biomedical research fails to capture the essence of who HIV impacts and why it impacts them. It is scary to believe that researchers sincerely did not and still do not see relations between the prevalence of HIV and its relations to socio-cultural and economic factors.

Moreover, much of HIV research which was conducted principally excluded marginalized populations such as women and intravenous drug users. Therefore, one cannot help but wonder who this research is helping. This curiosity is highly relevant as one considers how biomedicine prefers to be rather fixated with attempting to find an unlikely vaccine to magically cure HIV rather than invest in alternative treatments which show more promise as noted by Michelle Cochrane.

HIV primarily impacts marginalized populations internationally; however, much of HIV research is being done in the western world. This poses three primary concerns. Firstly, it leads to questioning the intentions of the western world in regards to addressing HIV. Because most individuals affected are marginalized populations around the world, why is the western world so thoroughly invested in this disease? Secondly, because the prevention and intervention measures are often being planned in the western world, this further hinders cultural sensitivity and adaptability. For instance, prevention and intervention methods which may have been successful in Ghana may produce drastically different results in Delhi. Thus, the predominant research being done in the western world is of concern as it may undermine cultural factors. Lastly, western researchers may have preconceived notions about countries in which HIV is prevalent. The erroneous beliefs of the manifestation of HIV in Africa being a result of “culture” and Africa’s perceived “incompetence” to implement change both largely hinders biomedicine as highlighted by Cochrane.

Even though HIV is a fairly young virus, it has certainly led to the questioning of biomedical systems of legitimacy and power which reign havoc on disease prevention and intervention measures. Furthermore, its handicap lies in its vested interest in power and money, rather than on genuinely attempting to seek solutions which promise results. HIV especially challenges the notion of “one size fits all” solution yet this does not prevent researchers to attempt to seek this solution. These two books therefore go beyond HIV in the sense that they illustrate how systems of biomedicine which claim to be largely “scientific” are actually laden with political and personal agendas which have more to do with power and funding relations and less to do with addressing the disease. Furthermore, one cannot help but wonder why the field of biomedicine itself is so afraid of looking at larger context which keeps in mind socio-cultural and economic factors. In essence, is biomedicine afraid to do this because this may actually force them into reflecting on their own shortcomings in regards to disease?