Some 30 years after the 'discovery' of AIDS, this year's World AIDS Day theme is "Getting to zero: zero new HIV infections. Zero discrimination. Zero AIDS related deaths". The World Health Organisation's press office flags, in particular, the World AIDS Campaign's focus on "Zero AIDS related deaths" as a crucial call for a much needed push for access to treatment for all, for governments to honour promises made in the Abuja declaration and to be held to account on their targets for domestic spending on health and HIV.
But, as global funding for AIDS and other major diseases have flooded development support for health in the south, it has often displaced domestic funding and national leadership alike (as well as saved and improved many lives). We have seen a gradual re-medicalisation of HIV in the process and a broader de-politicisation along with that. That would be all well and good, if only it was working. Unfortunately, the medicalisation of HIV misses a crucial point: The denial of life-saving care and treatment is all about power and discrimination, as is reducing vulnerability and risk to prevent new infections amongst key marginalised groups.
This focus on the root of the problem was the central message of the late activist and leader, Robert Carr - "Getting to Zero Bullshit: Calling HIV-related stigma what it is: Racism, Classism, Misogyny, Homophobia, Elitism", which was also the title of the Robert Carr Memorial lecture at this year's AIDS Conference, in Washington DC in July. The AIDS conference had another typically all-embracing and vague theme, "turning the tide together", which left many delegates soul-searching for what's gone wrong. For example, despite a long history of sweeping references to 'gender inequality' as driving the epidemic - and 'mainstreaming women's empowerment' as the answer - we've seen precious little progress in the sector's understanding of the ways that gender actually interacts with HIV, which also intersects other axes of inequity in complex ways.
To challenge these simplistic and stereotyping approaches to gender in HIV, IDS and partners from Brazil, India, Kenya, South Africa and Uganda put on a Satellite Session on the opening day of the conference - "Gender and HIV: What Have Men Got to Do with It?". This highlighted not only men's importance to the response, but also that the role of men and masculinities in gender oppression and vulnerability is highly complex, institutionally embedded and bound up with homophobia, misogyny, racism and power. This damages men, women and transgendered people alike, and particularly so at the lower rungs of social pecking orders.
However, men's engagement in the response cannot be limited to a sense of 'having been left out' or 'neglected' and men certainly don't need to be given special spaces within women's feminist movements. The issue here is that, whilst many men indeed do also suffer from patriarchal oppression and our complex relationships to masculinities, we need to use the spaces in society which we already occupy and open them up to make them feminist spaces.
This issue of men's health and the role of masculinities recently got further attention on the International Men's Day (on 19th October) and in the run-up to this, the current class of IDS Masters students in Gender and Development joined me at the Second National Conference for Men and Boys in the UK. Whilst inspired by a diverse and growing sector, we also found ourselves confronted by a few rampant anti-feminists from the organisation 'Fathers for Justice', which left me thinking "man up and grow some balls, for Pete's sake!" Of course, that subtle equation between responsibility and masculinity itself reflects the presumptive nub of the problem: Despite the human male's advantage - over millennia - of enjoying socially sanctioned and deeply encoded patriarchal privileges, resources and positions of power, there is no evidence of a statistically significant link between testicular growth and male responsibility. Still, it is never too late to acknowledge some accountability, start passing up privileges and taking some actual responsibility for building a fairer future for all.
Jerker Edström is a Research Fellow within the Participation Power and Social Change team at IDS.