The Challenge That is AIDS

It is no doubt that these days anti -AIDS campaigns are huge photo opportunities more than anything else. From high ranking politicians and beauty queens, film stars and social workers, everybody jostles for space on the podium, shouting themselves hoarse about safe sex, dignity to those who suffer from AIDS, the care and acceptance they need…and many other things besides. It is another matter how many of these clichés are actually translated into action, especially in countries which have taken the worst beating of the AIDS epidemic. Since the identification of the first HIV + case in Senegal in 1986, there has been no end of research and activism done, but not much good seems to have come out of it.

It is a glaring fact that today, almost 38 million people are infected with AIDS across the world, and there seems to be nothing much actually done to retard the increase in numbers. Awareness campaigns only serve to frighten those who already have it…since being a carrier means social ostracism, they can no longer be anonymous in their state. In developing and poor countries of Afro-Asian region, AIDS is a REAL threat, not something whose initial infection can be kept at bay with drugs.

The fight has now acquired political overtones in most poor countries since celebrity endorsements to the cause seem to have started the roll in of money. But who gives the money calls the shots, and in this case, US is the single greatest contributor, with various donors. The contributions from PEPFAR (President’s Emergency Plan for AIDS Relief), are directed mainly towards the 15 worst hit Sub Saharan countries (which account for almost 66% of all the AIDS cases in the world), but there is still a political agenda on the board. The Congress had asked for at least 33% of the prevention part of this money be spent on focusing on sexual abstinence….a part of the program. It does not work that way in real life. An equal, if not greater emphasis is needed on the concept of safe sex…the use of condoms, but this faces a hurdle, in the form of religious objections (even the Church does not encourage the use of condoms). Supplying American drugs to the patients is another issue while the plan allocation is an important issue in some countries.

Probably activists across the world hoped these problems will resolve themselves over time. But the spending, plans and all efforts are based on the assumption that these will be required only till a cure is found. There seems to be none in sight, and so, for an indefinite period of time, the people of these countries, suffering from AIDS, will have no option but live off the taxpayers of affluent countries. Political memory is very short and it may well happen that some policy rethinks bring about a change in this situation before the cure can be fund. Is it then proper to have the fates of such a large number of people hanging in the balance?

The fight against AIDS in Africa seems to be a losing battle. The workers who have been there for decades, fighting, educating, struggling, have finally come to terms with the fact that nothing is helping. Socio-economic structures will ensure the disease lives on, and nowhere more than these starving countries. The reasons are many, exploitation of the people, especially women. Messages such as abstinence and fidelity have not worked, and will not work either, simply because they are unrealistic expectations. The main hurdle has been that till now the problem of AIDS has been seen in an international context. The strategy should have been, to see the problem in the socio-economic and cultural context. So looking for solutions in the African context could have told the workers that its roots are essentially not medical, but socio-economic and steps have to be taken accordingly. Similarly in India, the root is again socio-economic, social acceptance of promiscuousness of men, helplessness of their wives at home, and economic compulsions of women who end up being the multiple partners…understanding these issues could well have set the AIDS workers on the path to the solution by now. The solution unfortunately lies only party in rehabilitation and drugs and vaccines. Most of it lies in the poverty and illiteracy factor. Women, even if they know and understand their rights, do not always have the power to exercise them, and certainly never, when it comes to right over sexual relations.

Making prostitution legal or illegal will also not solve anything, since laws like these are meant to be broken. As long as there are starving women and exploiting men, prostitution will flourish in one form or another. War zones suffer from their own set of problems, and the solution does not lie in visits from dignitaries and some right noises made by them. The involvement of local agencies must be emphasized, but unfortunately, it is only now that these things are being understood. Prevention has to be the priority, rather than taking care.

In developing countries like India that have growing economies, it is usually social reasons that stump any efforts to fight AIDS. Between 2001 and 2002, the number of HIV + people rose from 3.97 million to 4.6 million in India alone, and given this rate of growth, this will soon be in the same proportion as the African countries (almost 5.2 million). The Bill and Melinda Gates foundation has been contributing generously to control the disease in India but the onslaught, like in Africa, continues. The only saving grace is that the aware medical fraternity in India started taking steps to combat AIDS just when it was identified first, so today, almost 18 years later, we are not yet in the midst of an epidemic. Of course, India’s pitfall is the burgeoning population, and it is difficult to control a disease like AIDS in this kind of a teeming crowd. Another problem is the social stigma associated with the disease, which discourages open discussions, not to mention taking medication. The biggest hurdle could be the fact that sex is a taboo subject in India, even though Indians have one of the highest rates of multiplying in the world…but diseases cannot be controlled by behind- the- closet discussions.

The disease in India has reached non-high risk behavior persons, faithful housewives, infants…mainly through married, promiscuous males. Today 1% of all pregnant women test positive, while 26% of all reported cases are of females, even though the Indian society does not allow women multiple sexual partners (not openly anyways).

Shocking statistics n terms of awareness are coming to light, about 90% of urban Indians have heard of AIDS (where have the rest 10% been all this while????), only 72% of the rural population knows about it. In less educated states, almost 75% of the women have never heard of AIDS. Their husbands, migrant workers to metros, will probably give it to them before these women get to hear about AIDS from anyone else.

AIDS is a real threat, that will not go away by Charity balls and celebrity podia…it is a grassroots problem that needs to be handled at that level. It cannot be seen as an opportunity to "help the world", or even "help the poor". Photo shoots will not help, nor will speeches,…the day the activist will realize this, the first step towards eradication or at least prevention will have been taken.