The AIDS conference in Vienna just rejected a resolution calling for harm reduction for injection drug users despite this being a proven good strategy. Most nations ignored it, with only one supporting it. Only one openly rejected it (hint: it starts with ‘C’ and borders the arctic).
But here is the really interesting thing: The great triumph announced at the conference is the invention of a vaginal gel that seems to reduce HIV transmission by about half. The reason that a method with such limited effectiveness is even needed is that because in many of the places with the worst epidemics, many men refuse to use condoms (which are much more effective), even if their partners want them to. So here we have a advocacy community that is fatalistic about getting people to use condoms to prevent rapid death at an early age, but they are not willing to embrace needle exchanges.
But at least they are half reality-based, which makes them more realistic than those who think we can eliminate smoking without THR. The AIDS activists recognize that people will just not do what they are told because rich or powerful people say it is best. If people will not even choose condoms, how sensible is it to assume that they will choose to become abstinent from nicotine. And remember, THR is not just about people rich enough to afford pharmaceuticals and counseling services. There are and will be hundreds of millions of people smoking in the same places where they are at highest risk for AIDS.
– Carl V. Phillips