I’ve been thinking about the original question Deb posed about how we might read and respond to the “concluding imperative” of Piot’s preface to the UNAIDS report: Now act!” Ensuing discussions have raised other questions that are nested in Piot’s injunction (I’m thinking in particular of Gregg’s intervention, which, as Deb notes, takes up the issues of “What,” “Who,” and “When”). I keep returning, though, to a question (or rather a set of questions) that, to my mind, is at least as urgent as the questions of agency and temporality on which Piot’s imperative invites reflection. That question is simply this: “Where?” Where is the space or field or geography of the action(s) “we” are enjoined to take?
The document in which Piot’s injunction appears is called the Report on the global HIV/AIDS pandemic. The nominative anachronism of this title is worth remarking, since it takes us back to an earlier time in the history of the naming practices that have enveloped the life of the virus (which, as Cindy Patton has recently reminded us, includes the pre-history before “The Name” of the virus itself). We all remember the moment in the 1990s when we began to speak of the “HIV/AIDS epidemic” as the “pandemic,” in order to register the emerging consciousness that this was a cluster of epidemics that covered, or would soon come to cover, the entire world. In the U.S. context, this new nomination has over time had the important and salutary effect of opening the national consciousness about HIV/AIDS. My sense is that U.S. based global AIDS activists have been able to use the language of an international HIV pandemic to expand the domestic discursive space accorded to HIV. The recognition that “we are not the world” has enlarged the national conversation about AIDS on issues from U.S. government spending abroad to the drug pricing policies of the transnational pharmaceutical corporations.
This shift in the U.S. public imagination has increasingly made it impossible not to think about HIV/AIDS in international terms. Surely that is a good thing. However, it would probably be a mistake to read too much into the broadened public perception of the AIDS crisis in the U.S. For example, a recent survey by the Kaiser Family Foundation found that a majority of Americans are able to correctly identify Africa as the region of the world with the largest population of people living with HIV/AIDS. However, only a minority of those surveyed believed that the U.S. government should be more involved than it has been in responding to AIDS in Africa. To paraphrase Richard Rorty, the “globalization” of the U.S. public’s perception of AIDS has meant little more than an increased interest in “hearing sad and sentimental stories.” During the first two decades, the “face” of AIDS in the American mind was the headshot of the “ravaged” Rock Hudson or the “courageous” Ryan White; by the third, that “face” belongs to the “frail” South African Nkosi Johnson. In many ways, the image of the “international AIDS pandemic” in the collective U.S. consciousness serves much the same purpose as that of “international human rights”: it is a tool (to borrow again from Rorty) for “manipulating sentiments, [for] sentimental education.”
[Kendall Thomas’ e-mail continues in the following post]