Global AIDS: Myths and Facts

Reviewed by William W. Rankin

The destruction of the poorest people in the poorest countries because of AIDS is the event of our time. Over 22 million have died since HIV/AIDS was first named and characterized a few decades ago — most of these in resource-poor areas. Today 42 million more are living with HIV around the world, and 30 million of these are in the countries south of the Sahara Desert.

This disease has no historic precedent. Most of the countries are still in denial. The funds being made available to combat HIV/AIDS are pitifully inadequate and, most disturbing of all, what we are now seeing is only the beginning.

Global AIDS is produced by the Institute for Health and Social Justice — these are smart, dedicated, and well-informed people on this wrenching topic. Paul Farmer is a brilliant physician with much experience in third world contexts, and Zackie Achmat is the brave head of the Treatment Action Campaign to force the South African government to distribute antiretroviral drugs to people living with HIV/AIDS.

The book succeeds very well as a primer on all major aspects of the global AIDS epidemic. It presents ten myths and then systematically debunks these in well-researched, smoothly written terms.

Myth Four: HIV prevention in poor countries is more important than providing treatment. Nope. Myth Five: The complexity of treating HIV/AIDS in impoverished countries makes treatment infeasible. Wrong again.

• Myth One: AIDS is primarily an African problem for Africans to solve. It is not.
• Myth Two: People living with HIV/AIDS are solely to blame for their predicament. Not so.
• Myth Three: Corruption in resource-poor countries is sufficient justification for not trying to help. Wrong.
• Myth Four: HIV prevention in poor countries is more important than providing treatment. Nope.
• Myth Five: The complexity of treating HIV/AIDS in impoverished countries makes treatment infeasible. Wrong again.
• Myth Six: Vaccines will soon be available and they will solve the global problem. No to each assertion.
• Myth Seven: Pressuring the pharmaceutical industry for cheaper drugs is futile. It isn’t.
• Myth Eight: Insufficient health funding in poor countries means that allocations for HIV treatment will benefit the privileged few and harm the majority of others. Not so, again.
• Myth Nine: Wealthy countries have nothing to gain by fighting AIDS in poor countries. Again wrong.
• Myth Ten: There is nothing we can do anyway. Reminds me of the person who said, "Don’t you think what’s killing us is ignorance and apathy?" and the other said, "I don’t know and I don’t care."

Here are a few zingers from the book to whet your appetite — each of these being buttressed by carefully researched facts:

• "The long history of violence and injustice inflicted on the African continent by colonialism and neoliberal economic and trade policies shaped the socioeconomic context in which HIV proliferates."
• "In fueling the spread of HIV and other sexually transmitted infections, systemic discrimination against women is one of the deadliest forms of inequality."
• "Without access to treatment, people may have much to lose by knowing their [HIV] status and very little to gain."
• "The best arguments for American involvement in international AIDS work are moral."

In circumstances of lethal extremity for other people, the "issue" becomes larger than the fate of the victims. It broadens to include the by-standers: Who are we and what have we become?

The cruel irony is that the disease is transmitted in the one act of intimacy holding the greatest potential for expressing love between two people, and through the wonder of birth. But the illness is fed, as an epidemiologist colleague says, by "all that is worst in society": poverty, racism, xenophobia, homophobia, sexism, ignorance and indifference on the part of so many around the world who could still wake up and help.

Assuming that the U.S. spends $4 billion each month to maintain its forces in Iraq, about two and a half months of this would provide the UN Global Fund with all it has asked from the entire world to fight AIDS for a year.

Assuming that the U.S. spends $4 billion each month to maintain its forces in Iraq, about two and a half months of this would provide the UN Global Fund with all it has asked from the entire world to fight AIDS for a year.

The authors of Global AIDS conclude, "By the choices we make with respect to AIDS, we are defining our moral selves, and determining the ethical character of the world we will inhabit and leave to future generations."

And that is why the global AIDS catastrophe is an urgent summons to the world’s religious communities, custodians as they are of the great moral heritages of humankind.

The Rev. Dr. William W. Rankin is president of the Global AIDS Interfaith Alliance (GAIA) in San Francisco, California. He previously served as vice-president of the United Religions Initiative, also in San Francisco, and as dean of the Episcopal Divinity School in Cambridge, Mass. Bill may be reached by email at wrankin@thegaia.org

FOR MORE COVERAGE OF THIS ISSUE:

• AIDS in a Global Age, the January/February 2003 issue of The Witness magazine. Writers from South Africa, India, and El Salvador are featured along with coverage of the church’s international response to this worldwide crisis.
• AIDS’ Troubling Gender Factor by Irene Monroe
• The Death of an AIDS Baby by Linda Van Duuren and Rachel Mash, writing from Cape Town, South Africa