opinionBy Mark Heywood
This week thousands of activists, scientists and government officials will troop to Melbourne, Australia, to participate in the 20th International AIDS Conference.
Melbourne, of all places! Melbourne, where AIDS is largely an academic issue, because most people who live with HIV are on treatment. Melbourne with a first world health system! Melbourne, 10,000 kilometers from Africa where tens of thousands of people still die of AIDS! Melbourne, 9,088 kilometers from China where AIDS activists are still harassed, threatened and imprisoned. Once the activist response to AIDS changed the world. Now, it seems, the world is trying to change the response to AIDS again.
In the early 2000s AIDS was an issue that evoked our common humanity. Across the world AIDS mobilised people regardless of race, class or sexual orientation to stand up for people's equal rights to life and dignity. AIDS taught us to understand sexual orientation as a matter of choice to be celebrated not castigated. A truly global movement for treatment of AIDS helped establish the idea that access to life saving medicines was a human right that should be protected by law against voracious companies that sought to make huge profits out of illness and the fear of death.
That was then. This is now.
Although the AIDS industry in Melbourne will be full of theatre, rail and rage, it is far too timid and far away to make anyone with power over the future of AIDS uncomfortable.
So here are some of the things the conference-goers should have on their consciences.
Today AIDS is fast becoming just another disease of the poor, criminalised and marginalised. It is just another manifestation of global complacency about poverty and inequality. AIDS is slinking ashamedly back into the shadows, where many think it should always have been, like Tuberculosis. People with AIDS are learning to die quietly again and not shout about rights. Today the shadow-people go in their millions, month by month, to decrepit clinics and hospitals where they often face abusive health workers in order to collect medicines that --as much as the food they also struggle to obtain-- are needed to keep them alive.
The antiretrovirals (ARVs) we fought for are now one more hard to come by necessity of life, one more insecurity based on reliance on governments that can't give them jobs, quality education or dignified and effective public health services.
Once upon a time AIDS used to bring out the best in us. Today it reflects the worst. AIDS, like apartheid, once helped privileged people to see the need to get out of their comfort zones and discover their shared humanity with the poor. AIDS helped middle class people, with the best of intentions, to dip their toes into the dark lives of the poor, sometimes even keeping them there for a few chilly years. But as the movement has receded (as social movements do) they have pulled their toes out again, moved on with secure living, leaving the shadow-poor once more to fend for themselves in the shadow-lands.
AIDS points fingers at academics who romanticised and theorised 'social movements' when they were on the rise, but deserted them when they began the difficult days of staying alive. AIDS rebukes media houses who brought AIDS to light and now help to put it back into the shadows; journalists who found convenient heroes but now ignore the real ones because they are poorer or darker. AIDS reviles editors who make something into the past when it's still in the present.
Ten years ago, during the Presidency of Thabo Mbeki, who would ever have thought that during the 2014 elections the ANC government would make a virtue of its response to AIDS with loud billboards boasting about the numbers of people on ARV treatment!
But today AIDS makes a mockery of government leaders in South Africa who have made a virtue of their disassociation with the old AIDS denialism but have now embraced a new form of denialism. The new AIDS denialism denies that parts of our health systems are in cardiac arrest, that medicine stock-outs are epidemic; it denies condoms to schools, or TB control in prisons. It protects corrupt politicians and imprisons low-paid health workers.
In South Africa today, defending the rights of people with AIDS to access ARVs has fallen back upon the same organisation that struggled to make it an issue in the first place, the Treatment Action Campaign (TAC). Other countries are not so fortunate. The movements have gone or become shadows of themselves. TAC tells you a counter-story, not a good news story, not an end-of-AIDS story. TAC will tell you that there is a flashing red light over the AIDS epidemic in South Africa and globally. TAC will tell you that the numbers of people being enrolled on treatment are declining. The numbers not adhering to treatment is rising. Last week, TAC was forced to embark on another civil disobedience campaign in the Free State, a province with where too few people are on ARVs. TAC is refusing to go back to its place in the shadow-lands.
Finally, dear conference goer, be aware that the great social movements that once rose to fight AIDS risk becoming extinct. For example, in a world awash with money TAC is struggling to get the funds it needs to keep activism alive. It seems that TAC is an organisation that stands for an ethic and an imagination that is no longer valid currency in the donor 'market' - human rights, equality and political accountability.
In this context AIDS should force you to question the duplicity of international aid, the donors who rode on AIDS whilst it was a badge that they could use for self gratification, but whose short-sightedness and lack of enduring commitment to poor people's health is once more plain to see.
AIDS also makes us doubt many philanthropic foundations who one year stand on their highly educated, untouchable, unquestionable horses and dispense alms to rising social movements and the next year criticise them while they try to do the much more difficult, much less visible, less sexy task of holding a government to the implementation of its policies.
AIDS makes us see sexy aid not shadow aid.
You might well ask what do we owe to those movements that campaigned to save millions of lives... and still have a job to save millions more. You might well ask when societies will invest in their own democracy. If you don't ask these questions by the time you get to the 21st International AIDS Conference, which will take place in Durban in 2016, TAC may be history.
Of one thing we can assure you though; we will not go quietly into the bad night.
Mark Heywood is a member of the TAC Board of Directors and Director of SECTION27.
An abbreviated version of this article was published in the Sunday Times on 20 July.