VOA英语2010年-AIDS: The Lazarus Effect

Researchers call it the Lazarus effect – the dramatic beneficial changes that antiretroviral drugs – ARVs - can bring to HIV/AIDS patients and their families. The drugs are changing lives.

In the biblical story, Jesus is said to have raised Lazarus from the dead. Now, in rural western Kenya, HIV/AIDS patients and their families, in a sense, are being brought back to life.

Researchers say that not only do AIDS drugs restore the health of those who are very ill, but their families respond as well.

University of California at San Diego Associate Professor Joshua Graff-Zivin, co-author of the study, "The Lazarus effect is I think an effect that's been coined by the medical professionals to describe this sort of pulling individuals from the jaws¹ of death – (an) experience associated with giving ARV treatment to those who have HIV/AIDS. We borrowed the phrase from the medical types to say that there's an economic Lazarus effect, as well."

A brighter future

Without treatment, people living with HIV/AIDS usually see their immune systems collapse², which is closely followed by opportunistic infections. The ability to earn a living and provide for their family is lost.

 

University of California at San Diego
Joshua Graff-Zivin
"So when you provide this treatment to the individual and make them healthy, then you have this phoenix-like, Lazarus-like effect on the rest of the family where they're no longer covering for a sick individual and the economic productivity of the household goes up. Investment behavior of the household goes up and they get put on a better economic path," he says.

Those positive economic effects usually occur within six months of the start of antiretroviral treatment.

"What the evidence suggests," he says, "is that folks are making more long-term investments. So that is they are managing their farms in a more long term manner. So using more fallow cycles so that they can rejuvenate³ the fertility of their soil. That means growing a little bit less in the current term in order to have higher productivity in the future, which is consistent with the idea that they would be more future oriented once they recognize that they're going to be around to reap those benefits."

Families make other long term investments as well, as the full-effects of the antiretroviral drugs are seen.

He says, "We also see small increases in investments in assets, in particular, livestock⁴. So, clearly, you're not going to invest in a cow and tie up all that cash now if you're not going to be around to see the fruits of that investment. And we see some modest evidence of changes in at least preferences for fertility in terms of how many children one wants. But that I think is a more complicated story that we haven't fully⁵ understood yet."

Cost / benefit ratio

The health and economic benefits seen by the Kenyan families following ARV treatment could enter into the debate over when to start treatment. There's growing evidence that beginning treatment well before a person's immune system collapses⁶ can bring greater health benefits. But that means governments would need to buy more medicine at a time when the economic crisis has resulted in tighter budgets.

UNAIDS says more than 5 million people in developing countries are now receiving ARV treatment. However, it adds another 10 million should be receiving treatment now.

"I wouldn't want to take a position on sort of what is clinically indicated. But I would suggest that if the clinical evidence suggests that there's value in putting people on treatment earlier, then I think what we'd find on the economic side is that we would avert⁷ some of this economic downturn within the household. Now, our evidence suggests that economic downturn can be recovered once put on treatment, but it certainly seems to me it would be better to avoid that downturn altogether," he says.

Stuckler says you cannot separate the welfare of one generation from another when it comes to HIV/AIDS. He says if an adult in the household falls ill and is untreated it has a "profound impact" on the welfare of the other family members. Children, he says, are especially affected⁸.

"When we think about those linkages⁹ and we think about the case for intervention¹⁰ – and it is certainly true that it is expensive to intervene – what we need to recognize is not only are we providing health benefits for the patient, but we're providing a broad set of economic benefits for that patient, as well as the rest of their household. And presumably those impacts on the household spill over onto the larger economy," says Graff-Zivin.

One of the key partners in the study was the AMPATH program in Eldoret. It's a partnership¹¹ between Indiana University in the U.S. and Kenya's Moi University. Other partners include USAID, the World Bank and the University of North Carolina.

1 jaws   

n.口部；嘴

参考例句：

• The antelope could not escape the crocodile's gaping jaws. 那只羚羊无法从鱷鱼张开的大口中逃脱。
• The scored jaws of a vise help it bite the work. 台钳上有刻痕的虎钳牙帮助它紧咬住工件。

2 collapse   

vi.累倒；昏倒；倒塌；塌陷

参考例句：

• The country's economy is on the verge of collapse.国家的经济已到了崩溃的边缘。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做了一次彻底的调查分析。

3 rejuvenate   

v.(使)返老还童；(使)恢复活力

参考例句：

• The mountain air will rejuvenate you.山里的空气会使你恢复活力。
• Exercise is perhaps the most effective way to rejuvenate your skin.锻炼可能是使皮肤恢复活力的最好手段。

4 livestock   

n.家畜，牲畜

参考例句：

• Both men and livestock are flourishing.人畜两旺。
• The heavy rains and flooding killed scores of livestock.暴雨和大水淹死了许多牲口。

5 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

6 collapses   

折叠( collapse的第三人称单数 )； 倒塌； 崩溃； （尤指工作劳累后）坐下

参考例句：

• This bridge table collapses. 这张桥牌桌子能折叠。
• Once Russia collapses, the last chance to stop Hitler will be gone. 一旦俄国垮台，抑止希特勒的最后机会就没有了。

7 avert   

v.防止，避免；转移(目光、注意力等)

参考例句：

• He managed to avert suspicion.他设法避嫌。
• I would do what I could to avert it.我会尽力去避免发生这种情况。

8 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

9 linkages   

n.连接( linkage的名词复数 )；结合；联系；联动装置

参考例句：

• Only the thermosetting resins provide a strong cohesive forces; this is due to molecular cross linkages. 只有热固性树脂具有巨大的凝聚力，这是由于分子交错链所造成的。 来自辞典例句
• The linkages between the stable units must be as near as possible of equal stability. 稳定链节之间的键必须有尽可能接近的稳定性。 来自辞典例句

10 intervention   

n.介入，干涉，干预

参考例句：

• The government's intervention in this dispute will not help.政府对这场争论的干预不会起作用。
• Many people felt he would be hostile to the idea of foreign intervention.许多人觉得他会反对外来干预。

11 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。