The blindness of AIDS ‘awareness’

AIDS is a terrible disease, that blights the lives of millions of people in the developing world, particularly Africa. And like any other terrible disease, it needs to be tackled with new research and a concerted distribution of the latest methods of prevention and treatment.

World AIDS Day on 1 December exhibited some very strange ways of trying to tackle a disease. Instead of investment in healthcare we saw pop concerts, vigils and parades to raise ‘awareness’; instead of research we heard emotional speeches and statements of ‘support’. The day showed how much the AIDS issue has become a way for the West to give the developing world moral lectures.

Campaigning against AIDS has become a way in which individuals in the West can demonstrate their worthiness. A new website launched on World AIDS day allowed viewers to post a red ribbon on a map of America: ‘In trying to fight this continuing epidemic’, informed the website, ‘LINCS designed AIDSribbons.com to give visitors a chance to show they care that HIV/AIDS is still among us and that people are still getting infected and are ultimately dying’ (1). The point here was to enable people to ‘show they care’ about AIDS deaths – rather than to do anything about these deaths. Pop diva Annie Lennox was shown staring sombrely through sunglasses, pulling open her coat to reveal a t-shirt with ’17 million AIDS dead’ plastered across it. The message of the t-shirt seemed to be more about the caring, aware character of the wearer than about the problem of AIDS itself.

Ex-South African president Nelson Mandela hosted a huge concert in Cape Town, featuring stars such as Bob Geldof, Bono, Andrea Corr and Ms Dynamite. Mandela compared his campaign against AIDS to the battle against apartheid (he has named the campaign ‘46664’, after the number he was given in Robben Island prison). AIDS is no longer just a disease, said Mandela, it is ‘a human rights issue’ (2). The fact that a fatal virus is being likened to a cruel and oppressive social system suggests that AIDS has become a symbol for all the world’s evils – as the American critic Susan Sontag put it, this is a case of ‘AIDS as metaphor’.

Meanwhile, UN head Kofi Annan’s statement about World AIDS day seemed as much a display of his own sensitivities as it was an attempt to galvanise efforts around a major public health threat. He told the BBC that he was saddened by the ‘incredible callousness’ of a world that was failing to treat AIDS sufferers: ‘I feel angry, I feel distressed, I feel helpless.’ The intimation seemed to be that the battle against AIDS was failing because others did not feel as strongly as him. ‘I’m not winning the war because I don’t think the leaders of the world are engaged enough’, he said (3).

All this is self-indulgent – and somewhat tasteless. But posturing popstars could be endured if they helped to deliver treatment to those who need it. The problem is that moralism infects the whole way in which AIDS is assessed, treated and tackled.

When people in the West talk about the challenge of AIDS in Africa today, they are not just talking about a virus. Instead, AIDS is seen in terms of sinful behaviour. It is seen as the result of individual irresponsibility, of people wantonly sleeping around and neglecting to practise safe sex. As US secretary of state Colin Powell put it, citing President Yoweri Museveni of Uganda: ‘[Museveni] says “This is what is causing it…irresponsible heterosexual sex.” It kind of jars when you hear it but that is the kind of leadership message that has to be given.’ Rather than focusing on practical remedies – such as improving health services in the developing world – the emphasis in campaigns against AIDS is often on changing people’s attitudes and behaviour.

The focus of campaigns is on raising AIDS ‘awareness’. If you scan the World AIDS Day website, the emphasis is on making people more aware of HIV and fighting ‘HIV prejudice’ (4). To mark World AIDS day, the USA sent a delegation to tour Africa. Rather than offering money or resources, this delegation, according to one report, ‘headed to hard-hit Africa to urge its leaders to increase awareness about the virus’ (5). In this context, raising awareness essentially means telling governments and people in the third world how they should talk and think about sex, and how they should behave. The Chinese government – which has long been criticised for refusing to talk about the AIDS threat – was recently praised for airing a condom advert and launching a documentary about a woman with AIDS (6).

This concerted attempt to moralise to people of the third world about their sexual behaviour has held back the understanding and tackling of the disease. On spiked, Dr Stuart Derbyshire reported on new research suggesting that dirty needles, rather than heterosex, was the main source of HIV transmission in Africa. ‘Consideration of the much more reasonable possibility that injection was the source of infection could have led to a focus on dirty needles, unsanitary conditions, and other problems associated with healthcare in third world countries’, wrote Derbyshire (see AIDS in Africa: sense at last).

When fighting AIDS is about ‘awareness’, it is not surprising that everybody from pop stars to cricketers believes that they could make a contribution to fighting AIDS. The manager of the Pakistan national cricket team said: ‘Through the players, who are role models across the world, we can create more awareness and all Pakistani players are keen to support the fight against AIDS.’ While all of us are concerned about AIDS, it takes more than demonstrations of concern to actually fight it.

In reality, AIDS can only be tackled by governments and medical authorities – as a health problem, rather than a political problem. The festivities of World AIDS Day did little to help the world, and little to tackle AIDS. If more people took off their morality-tinted spectacles, the AIDS problem could be seen a bit more clearly.

(1) AIDSribbons.com to Debut Today, PRNewswire, 30 October 2003

(2) Fight against Aids is like apartheid, says Mandela, The Times, 1 December 2003

(3) Annan: World losing war on AIDS CNN, 30 November 2003

(4) See the World AIDS Day website

(5) Vigils, seminars planned globally to mark World AIDS Day, AP, 1 December 2003

(6) Drugs plan offers hope on World Aids Day, 1 December 2003