We should hold in our minds the 38 million people who have died of AIDS. And remember that virtually all of those deaths were avoidable or treatable.  Two illustrations may help.

I have a friend, Prudence, who is 34 years old.  When she was 19, Prudence, a second year electrical engineering student in South Africa, was diagnosed with HIV. She was, obviously, devastated. To make matters much worse, her diagnosis spread through the rumor mill and the school administration publicly identified her and her diagnosis to the student body.  Further devastated, Prudence dropped out of school, but soon rebounded to become an AIDS activist. Prudence is a reflection of a new generation of African activists who don’t have a victim mentality.  They’re looking at the big picture; focused on policy.  And, she’s someone we can relate to, with all her obvious potential.  Prudence made it through an incredible challenge, with a sense of directed anger about what is happening to people and their health-related human rights.  The status quo is simply unacceptable. 

The second illustration involves a Stephen Lewis quote, which is roughly as follows:  “It is as though we have chosen to pursue and protect our own prosperity at all costs.  It is as though distant women and children are figments of our imagination. . . . We are abetting their loss of life and we have become latter-day Kind Leopolds of the continent.”  The point of this quote is that seeing people as different from ourselves gives us an excuse not to act.  Lewis’s reference to King Leopold is to a king of Belgium, who once effectively owned the Congo.  He took every valuable natural resource he could from the region, had many slaves, presided over mass murders, and then conspired to cover up all his evil work.  And the world willfully acted to forget what King Leopold did in the Congo.  That is the politics of forgetting. 

With these two illustrations in mind, there are three things we must do. 

First, we must ensure that compassion and evidence outweigh moral judgment.  In the 25 years since HIV/AIDS was first identified, may people who would have initially reached out to help turned away, because HIV/AIDS was seen as a disease of criminals, whores, and drug addicts.  Dehumanization became a justification for our own inaction.  Factually, though, our moral judgment was incorrect.  In Southern Africa, reasons for the massive spread of HIV/AIDS include the fact that thousands of men went to work in mines, they were housed in single sex hostels without the opportunity to visit family, with sex workers located nearby, local prevalence of syphilis and gonorrhea, and good transportation to allow these men to later travel throughout the region.  Also, in Africa, the number of sexual partners that people have is not particularly high, but they have concurrent partnerships, which creates an opportunity for greater spread of HIV. 

Second, we must think about structural issues.  American’s like simplicity, as attested by Clinton’s political admonition: “It’s the economy stupid.”    But some things are complex.  With HIV/AIDS you could try to simplify things by saying: “It’s the structural issues, stupid.”  The fastest growing rate of new infections is in women, with the second fastest growing rate being among young people.  The ABCs – asbstinence, be faithful, condomize – are not enough.  Abstinence is not an answer for young women who need to put food on the table and who see sex as their only resource.  Faithfulness does not protect a woman whose partner is not faithful.  Condom usage is not viable unless women have the leverage to demand such use.  We have to see this as a long term investment.  Success will require time, money, and public support for things like the Global Fund for AIDS, TB, and Malaria.  Indonesian tsunami relief produced $US 550 per person directly affected by the tsunami.  The long crisis of HIV/AIDS hasn’t seen nearly that same level of contribution.  Yet, as consumers and citizens of a global world, we need to see “their” problems as “ours.”  We must insist that our governments do no harm, at least not in our names. As an example, the President’s Emergency Plan for Aids Relief (PEPFAR) does good work in terms of treatment, but has an unrealistic view of prevention, emphasizing the role of abstinence.  As a result, African governments are reluctant to criticize its failure to ensure that critical prevention information reaches children.