We all have AIDS: HIV/AIDS is everyone's problem — a global public-health threat of staggering proportions. Wayne Ellwood investigates the social inequalities which nurture the deadly disease - This Month's Theme AIDS/Keynote

New Internationalist, June, 2002 by Wayne Ellwood

The hardest-hit countries can't do it on their own - especially not when global economic conditions are conspiring against them. With healthcare systems limping, debt payments draining national budgets and nations, North and South, diverting millions into antiterrorism measures and military spending, the prospect of more resources to fight AIDS seems slim.

There are no short-term solutions. But there are solutions. Some of the most inspiring efforts are being carried out by PHAs themselves working in small-scale NGOs. As a group of African women declared at a recent gathering on HIV in Kampala: 'Without HIV-positive people, researchers can not do their work. We are the real experts in our' communities about how HIV infection affects individuals and their families.' (10)

Steve Mueller is one of those experts. Until his latest bout of oesophageal cancer he worked with the Toronto People with AIDS Foundation (PWA) - a lean, street-smart agency offering practical advice on everything from housing to alternative therapies.

'Mentally, AIDS is a huge, stigmatized death sentence,' he says. 'Suicide is a big concern. So whenever I dealt with clients the first thing I'd say was: "Like you, I also have to live with the disease." You have to be a role model; you're sick and you're back in the work force. You might die next week and you might last another 50 years, nobody knows for sure. All kinds of awful things could happen to you and all kinds of wonderful things. But if you jump off a balcony you'll never know.'

There are also countless successful projects, like Toronto's PWA Foundation, peppered across the South. But they are swamped by the virulence and intensity of the virus itself. The time for a fully resourced, international, multi-dimensional programme is now. Already the virus is racing through India, China, Russia and Eastern Europe.

The AIDS historian, Allan Brandt, wrote these words in 1988:

'In the years ahead we will, no doubt, learn a great deal more about AIDS and how to control it. We will also learn a great deal about the nature of our society from the manner in which we address the disease. AIDS will be the standard by which we measure not only our medical and scientific skill but also our capacity for justice and compassion.' (2)

The simple truth of that analysis would not be lost on Steve Mueller.

(1.) AIDS Epidemic Update, UNAIDS/WHO, December 2001.

(2.) Paul Farmer, Infections and Inequalities: the modern plagues, University of California Press, 1999.

(3.) Gideon Mendel, A Broken Landscape: HIV and Africa, Network/ActionAid, London, 2001.

(4.) J Collins and B Rau, AIDS in the Context of Development, UN Research Institute for Social Development, Paper no 4, December 2000.

(5.) Vincent Mwanma, Africa Recovery, December 2001.

(6.) Radhakrishna Rao, Taming HIV/AIDS in India, unpublished article available on the NI web site: www.newint.org

(7.) Lunga Masuku, Swaziland's AIDS Ambassador, Africa Eye News Service, August 2001.

(8.) HIV/AIDS among aboriginal persons in Canada remains a pressing issue, Health Canada. www.hcsc.gc.ca/hpb/lcdc/bah/epi/aborig_e.html