It was World AIDS day yesterday, but I didn’t get time to post this, but I don’t mind being a day late.
I find it difficult to write about AIDS. It seems so unreal, that there can be anything so devastating in the world and for it to have so little impact on everyday life. There are 33 million people living with AIDS, and we actually hear very little about it. It is primarily a disease of the poor, and the poor are orphans, as they say. And it is a disease of Africa, and generally speaking people know very little about Africa – Sarah Palin famously thinks it is a country rather than a continent, and if I had a pound for every time I’ve had to tell someone where Madagascar is, I’d be a rich man. (I’ve met others who think they made the place up for the film.)
Then there are the moral implications. Because AIDS is sexually transmitted, it is a minefield. It means you have to address the intimacies of sexual behaviour, that you have to deal with cultural and social norms and expectations, and broach taboo subjects. All of this has to be done without being patronising, and without letting moral judgement cloud the issues.
There are prejudices too. The cause is not helped by those of us who still think of Africa as ‘the dark continent’. Equally unhelpful are those who do their best to live up to those expectations, presidents who deny the existence of the HIV virus, or say AIDS is a conspiracy against Africans. The dangers of racism are never far away, on either side – suspicion of white science on the one hand, and inexcusable apathy on the other. By 1990 the World Health Organisation was predicting that 30 million people would die by 2000. The international community did very little, and in fact 40 million people died – that’s the holocaust three times over. The AIDS crisis was entirely preventable, and I wonder what the response might have been if the WHO had predicted 30 million white deaths. That’s an unpalatable statement and I don’t want to overplay it, but it’s a question worth asking.
We are waking up to the AIDS crisis. More is being done, it is on the agenda. Lives are being saved. It’s still hard to talk about. 18 months into a blog on some of the world’s most serious issues, this is the first time I’ve written about it, so today’s post is mainly a challenge to myself. This is primarily a blog about consumerism and its many tentacles, but we can’t talk about development or poverty without dealing with AIDS. Now that I’ve cleared the decks with all of the above, here’s one way consumerism and AIDS cross over:
AIDS is also a matter of economics, because every death is not just a failure of aid or of politics, but a failure of the market. We have, as a global society, embraced the logic of the free market. Unfortunately, that means that only those with any kind of purchasing power get a say in where investment goes and what products are made. The West has purchasing power, so medical research will go into whatever we need or want, and even plenty of things we don’t want – cosmetic surgery, hi-tech mascaras, face creams for both men and women. Why? Because we’re worth it.
Meanwhile, the market has no solution for AIDS, nor for malaria for that matter, or diarrhoea, cholera, or countless other curable diseases. Why? Because Africa isn’t worth it. Not in economics terms, and economics has never known the true value of anything. As Paul Collier notes in ‘The Bottom Billion’, the whole of sub-Saharan Africa represents a market only as big as Belgium. (and when was the last time you heard a pop star say they wanted to ‘crack Belgium’) It’s just not a market that appears to offer anything, and so it is marginalised.
There will not be a market-driven solution to AIDS for some time, though I daresay it isn’t impossible, especially as drug prices fall. Strategic aid is required, on a local level, and real research is needed into the patterns of HIV spread. A good example of innovative thinking is this TED lecture by Emily Oster, which is well worth twenty minutes of your time. Most of all, AIDS needs our unflinching attention.
The Earthbound Report 