Tag Archives: HIV/AIDS

“Cc…: CCC,” part 15

[Kendall Thomas, in continuation from “Cc…:  CCC, part 14]

My point here is that the landscape of “international AIDS” in the U.S. is, first and foremost, a psychic space whose field of action is the interiorized projection (Rorty’s “sentimental education”) that allows Americans to “feel” that they are part of the global culture of concern about the HIV pandemic.  Needless to say, the heightened sensitivity of the American public to the imagined pain of those who are living with (and dying from) AIDS in other parts of the world has yet to take the form of a collective public demand that the U.S. government increase its support for international treatment and prevention efforts.  (Tellingly, the Kaiser Foundation survey I mentioned earlier found that nearly half of those polled doubted that more money would result in any meaningful progress in the struggle against AIDS in Africa.)  If anything, the “international turn” in the U.S. domestic discourse on HIV/AIDS has served as an alibi for not addressing the intranational scandal of HIV infection and illness on our own shores.  Consider the following state of affairs.  The U.S. continues to record about 40,000 new infections each year.  Roughly one-half to two-thirds of the 800,000 to 900,000 Americans with HIV/AIDS do not receive regular medical care.  Up to one third of Americans do not know that they are infected.  African Americans, who represent 12% of the U.S. population, make up 47% of new AIDS cases.  African American women account for nearly two thirds of the new AIDS cases among women in the U.S.  Some 56% of the African Americans living with HIV are not on combination drug therapy.  They are 1.5 times more likely not to get preventive treatment for PCP.  Although they represent only 15% of the total U.S. population under the age of 13, African Americans make up 62% of the nation’s pediatric AIDS cases.  Half the new AIDS cases among young people between the ages of 13 and 19 are among African Americans.  AIDS continues to be the leading cause of death for African Americans between the ages of 25 and 44.  A recent study of young men who have sex with men suggests that in parts of the U.S., one in three gay African Americans are infected with HIV, a rate fully comparable to that of the hardest hit African countries.

Does this mean that AIDS analysis and activism in the U.S. should turn inward and cut itself off from the rest of the world?  Not at all.  I am not urging a narcissistic return to the isolationism that has characterized too much of the history of the U.S. response to HIV/AIDS.  I am saying that in engaging with the question of where to act now, we in the U.S. have a responsibility to continually think the global around the axis of the domestic.  We have a responsibility, too, to develop and defend a radical vision of solidarity across the mental borders that AIDS sentimentalism has drawn between the international pandemic and the intranational epidemic.  In my view, the measure of those of us who live in the U.S. must be taken by our willingness to fight AIDS as fiercely at home as we do abroad.

Kendall

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Media, Reading and writing

“Cc…: CCC,” part 14

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]

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Media, Reading and writing

“Cc…: CCC,” part 13

Hi  all,

John, your invocation of Stuart Marshall’s effort to historicize the epidemic in his 1987 videotape brought to mind your own indelible contributions in this regard, notably Zero Patience, which dates from 1993.  As Paula Treichler writes of your film in How to Have Theory in an Epidemic, “Early in Greyson’s musical…the character of Sir Richard Burton performs an ode to empirical science:  ‘A culture of certainty,’ he sings, ‘will wipe out every doubt.’  But by the end of the film, virtually every apparent certainty has been called into question, including some of the most treasured certainties of AIDS treatment activism.  The character of George, losing his sight from CMV, is also losing patience with treatment orthodoxies, no matter whose they are.  But even as his poignant refrain asserts this condition of radical uncertainty – ‘I know I know I know I know that I don’t know’ – Greyson’s story of the stories of the epidemic never lets us forget what we do know:  That a narrative can be powerfully persuasive, that a democratic technoculture must find ways to acknowledge the power of competing narratives, and that, for all the power of narrative, this epidemic leaves hundreds of thousands of people dead.”  She goes on to remark that, as the film unfolds, the various codes and conventions that have characterized the historiography of the epidemic “are self-consciously framed, contrasted, and denaturalized:  repeatedly called ‘tales,’ ‘stories,’ and ‘histories,’ they are used and manipulated to furnish data for grant proposals, fed to the media, distorted by the media, juxtaposed to other stories, told differently by different people, espoused and repudiated, hammed up, camped up, acted out, politicized, ridiculed, idealized, and discredited.  In this sense, they represent competing regimes of credibility…placed in visible collision.”

In the aftermath of writing The Brevity of Life, this recalls for me the threat to historiography formulated by Walter Benjamin in his fifth thesis On the Concept of History:  “The true image of the past flits by.  The past can be seized only as an image which flashes up at the instant when it can be recognized and is never seen again…. For every image of the past that is not recognized by the present as one of its own threatens to disappear irretrievably.”  Like the dancing shadows John invoked in his last message to us, flitting around the hearth of the virus, whose company presumably includes a number of more and less helpful, useful, risky analogies.  As William Haver notes in his admirable essay “Interminable AIDS,” “The ghost is the figure of what we can never quite forget altogether, but also of that which memory can never satisfactorily recover:  the figure of the impossibility of forgetting what we have forgotten.  The ghost is the figure of what disrupts every attempt at historiographical pacification.”  Witness Zackie’s video phantom addressing the conference delegates and the world from the screens temporarily erected in Barcelona for the occasion.

And John’s question – “Do we learn from history, or do we do history a disservice by recasting its specificity into a generalized metaphor for today’s agendas, today’s needs?” – resonates with Gertrude Stein’s singular history lesson, the final line of her poem “If I told him”:  “Let me recite what history teaches.  History teaches.”  If, as Gregg contends (with Benjamin), “A radical break with history can only follow from a radical break with an understanding of history,” we urgently need to attend to what HIV/AIDS has to tell us, to teach us, about our understanding of history.  For example, as Gregg also points out, “When we are forced to contemplate the AIDS crisis in the U.S. [in 2002], all illusions of progress disintegrate.”  Hence our received understanding of what Benjamin calls “the historical progress of mankind” is radically undercut by the material events that constitute the history of the pandemic to date, and in particular is shown to rely on a notion of our progression through a homogeneous, empty time.

More later, I hope.

Deborah

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Media, Reading and writing

“Cc…: CCC,” part 12

Thinking out loud in response to John’s last e-mail:

The analogy between the AIDS crisis and the Nazi holocaust was once very common in AIDS discourse in North America.  I have, for a long time now, doubted the usefulness of analogies between the AIDS crisis and the Holocaust (and by the term Holocaust I understand that to refer to the Nazi Holocaust) because through analogy we lose our ability to grasp the crisis at hand in its specificity.  The use of analogy is somewhat useful to gain immediate attention and it’s perhaps useful as a shorthand for ethical criteria established through the experience of the Holocaust.  However, we gain little through the analogy because we foreclose on the possibility of new outcomes when we resort to historical analogies.  In other words, what we attempt to change and avoid through the use of analogy, we can doom to repetition in our analysis.  Through analogy we risk closing our minds to current options and possibilities.

I do not accept the old adage that those who refuse to learn from history are doomed to repeat it.  Rather, I believe that those who fail to grasp the present, in all its complexity and specificity, are doomed to repetition.  A radical break with history can only follow from a radical break with an understanding of history.

Regarding the problem of doing something “here,” from the vantage of the privileged north, that will help “there,” in the disadvantaged south:  I have been preoccupied with this problem ever since I returned to  Chicago from Durban in July 2000.  Initially, after returning from the Durban conference, I found receptive audiences for consciousness raising and fundraising, specifically about AIDS in Africa and the efforts of the Treatment Action Campaign.  These efforts were supported and amplified by the established press.  Papers such as the New York Times and the Wall Street Journal gave a great amount of coverage to AIDS in the “third world” and the battles over pharmaceutical drug company patents.

The success of the efforts I have been involved with – fundraising, lecturing and the production of advocate video work – has reached a limit for a number of interesting reasons.  Discussions here and in the U.S. about AIDS in the resource-poor world inevitably, and perhaps rightly, lead back to discussions about AIDS in our country [the U.S.].  When we are forced to contemplate the AIDS crisis in the U.S., all illusions of progress disintegrate.  Sure, there are a large number of people on life-saving drugs, far larger proportionately than in the resource-poor world, BUT there are many other things to consider.  Over half of the million people in the U.S. who have HIV don’t know it.  Among those who do know it, the number of those who have access to drugs and adequate medical treatment is small AND may get smaller.  The government is now attacking and seriously threatening to dismantle the benefit system AIDS activists fought hard to establish.  ADAP (the AIDS drug assistance program) is currently under attack.  Plus, the Bush administration is also quietly going about the business of undermining and discrediting already compromised and underfunded prevention programs.

The needs of people in the resource-poor world are far greater in scale than the needs of people in wealthy countries.  There remain a great many unsolved inequities in wealthy nations.  How do the needs of people with AIDS in poor countries and the needs of the poor in rich countries become separate and competing problems in the minds of those who think about AIDS?  Given the shortage of resources to fight AIDS here or abroad, how do AIDS activists choose effective courses of action?

There is a crisis of community among those hardest hit in the U.S.  A kind of complacency has set in about AIDS.  The reasons for this are very complex and will have to be thoroughly considered in a following e-mail.  For the moment, let us recognize that the negative effects of privatization, the suffocation of the public sphere through capitalist incorporation and instrumentalization of all organic community structures has stymied and arrested those hardest hit by AIDS.  Though things are getting bad, in ways that feel very much the same as the late eighties, the communities hardest hit do not seem to have the wherewithal to fight back.  And it is hard to rally people simply by referring them back to the late eighties.  Again the problem with analogy.

In the past two weeks, I have learned of two friends, gay men, who after a decade or more of remaining HIV negative, have now seroconverted.  This is by now a common experience for many of us, witnessing the seroconversion of our friends.  And we have developed an ethical response to the experience.  No judgment.  We must immediately make ourselves available to our friends, support them, love them, help them to make appropriate treatment decisions, and help them get access to treatment.  That may sound odd to others.  Of course you should respond that way!  It took some of us a while to get past our anger and frustration, to develop a complex understanding of the role of the unconscious and the limits of safer sex, to be able to respond ethically, with love and not anger or resentment, to recent seroconversions.  The complexity of all this preoccupies me now.

More later.  XOXO  Gregg

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Journalism, Media, Reading and writing

“Cc…: CCC,” part 11

[John Greyson, in continuation]

In late July [2002], Zackie was scheduled as a plenary speaker at the Barcelona [International AIDS] conference.  (This is very much Jack, TAC and Zackie’s story; I’m only contributing it now because they’re upstairs sleeping, and I’m sure they’ll throw in their corrections at all my errors and misinterpretations!)  Because he was too sick to attend, a video was shot and edited by Jack and his Beat It! crew a couple of nights before.  The tape was couriered to the conference, where it was played on huge monitors to the thousand-odd delegates.

International news teams shot clips off the screen; some broadcasters even carried it live.  The world thus saw Zackie, explaining how HIV and the epidemic had prevented him from addressing the conference in person, live.  It was an unforgettable intervention, rife with urgency:  the real toll of the epidemic, illuminated by technology, portrayed by a voice nearly silenced by AIDS, able to speak only on a screen, thousands of miles and several days distant from the real event.

Because of this mediated moment, the Archbishop of Cape Town, Njongonkhulu Ndungane, visited Zackie the next week, to convey concern, best wishes and blessings.  Coincidentally, a TV crew was in attendance.  The blessing thus went out live to the nation, a broadcast that was seen by millions, and also by Mandela.  Who picked up the phone and invited himself over for tea.  Which led to the tea party, and discussions of how Mandela’s AIDS foundation and TAC could work together to set up treatment clinics, despite governmental resistance.  Which of course was carried by every TV station and newspaper in the country, and, to a much lesser degree, around the world.  (I myself participated in a bit of real-time posturing, boasting to friends how I was the lucky recipient of the Zackie/Nelson pic, courtesy of Jack’s email J-peg, an hour after the tea party, and hours before the mass media had circulated any images).

In this way, the necessities of illness triggered a chain of reactions, all mediated by miles and technologies and urgency, mediated most of all by the poignancies of time, which resulted in a tangible step forward in the war against AIDS.

In their press release, TAC also called for the meaningful inclusion of PLWAs at every level of decision-making in Africa’s pandemic.  For artists, there has been since the early eighties a related implicit corollary (one that too many institutions and power-brokers have thoughtlessly ignored):  to give special priority to the words and pictures created by PLWAs.  Earlier, we mentioned Andrew Sullivan’s notorious and nonsensical contention that for North American artists, AIDS is now passe.  As much as there is a need for northern artists to continue to vigourously interrogate AIDS and all its meanings, it is equally important that we work right now to hear the voices of African artists, addressing AIDS through myriad paradigms and aesthetic strategies.  The voices are emphatically there – why does the north not hear them more, encourage them more, assist them more?  Why was there so little AIDS work in this year’s Documenta, especially when so much of the show revolved around questions of culture and activism in a global context?  Why aren’t there more commissions, exchanges, exibitions, grants, specifically for African artists addressing HIV/AIDS?  What have we done, or more likely, not done?

Following this, how can northern artists contribute to a meaningful dialogue, without falling back on patronizing missionary tropes?  We all have relationships (so often fraught!) with various institutions, schools, arts centres, granting bodies.  How can they be mobilized?  Art exhibitions:  can these contribute to a truly two-way exchange of aesthetics and ideas?  Video residencies:  what makes these viable and effective?  Should video artists be brought to the Banff Centres and Charles Streets, or should the priority be given to getting more state-of-the-art tech and training to African artists?  Why wasn’t the massive African AIDS series Steps for the Future (whatever limitations it might have), which included episodes by/about Jack, TAC and Zackie, not shown in its entirety in North America?  How can art supplies be collected, shipped and distributed to PLWA artists most effectively?  And so on:  as many questions as there are ideas, but equally, as many things to act on.  Now.

XXX  John

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Journalism, Media, Reading and writing, Tech

“Cc…: CCC,” part 10

Dear all:

TAC’s call, “to prevent a holocaust against the poor,” inevitably reminds me of another holocaust, and another puzzle of time.  In 1987, UK video artist Stuart Marshall produced an extraordinary tape about AIDS, history and representation entitled Bright Eyes.  Stuart was certainly one of the first artists (and PWAs) to critically historicize the pandemic, using a mixed-genre collage of fake news reports, critical interpretations, and dramatic excerpts to tease out AIDS and its historical metaphors, lurking like the dancing shadows around the hearth of the virus.  In particular, he explored if and how useful analogies could be drawn between the slaughter by design of pink triangle prisoners in the concentration camps, and the slaughter by indifference of so many gay men in the early years of the epidemic, succumbing to AIDS while the world dithered about green monkeys and Patient Zero.

His representational techniques always leave this explosive question hanging in the air, for his viewers to wrestle with:  is it illuminating or productive to juxtapose the Third Reich’s homophobia with that of Reagan, Thatcher and Mulroney?  Do we learn from history, or do we do history a disservice by recasting its specificity into a generalized metaphor for today’s agendas, today’s needs?  Are the fruits of history apples and oranges, or indeed Granny Smiths and Macs?

One extraordinary scene involves archival footage of the burning of the Magnus Hirschfeld’s Scientific-Humanitarian Institute in Berlin.  Hirschfeld was of course the pioneering sexologist who had led the campaign against the recriminalization of homosexuality under the Nazis, the infamous Paragraph 175.

In retaliation, the Nazis razed his institute, committing to the pyre a lifetime’s achievement concerning human sexuality.  Stuart shows how Hirschfeld actually witnessed the incident.  It was weeks later, and the good doctor was in a film theatre in London, having fled the Nazis, watching a newsreel about the incident before the main feature.  There’s something unbearably poignant about the scene:  the footage itself, of course, but more, the flicker of blue light on the expressionless face of Hirschfeld, as he watches his life’s work incinerate, a thousand miles and several weeks’ distant from the real event.

Stuart’s puzzle:  How can we ever hope to truly imagine the times of Hirschfeld, and his relation to time?  Last week on CNN, we perhaps watched a TAC speaker address the side conference on sustainable development in Jo’burg, live [at the Earth Summit convened in Johannesburg in September 2002].  Next week, we perhaps may watch the incineration of Iraq, live.  Real time commands the new, true-blue test of value:  We now only venerate images of towers if they’re tumbling as we watch them live, the realness of the digital clock on the lower left of the screen goldplating our participatory frisson.

[John Greyson’s e-mail continues in “Cc…:  CCC,” part 11]

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Journalism, Media, Reading and writing, Tech

“Cc…: CCC,” part 9

Hi guys.

Prompted by John’s allusion to the intensity of activity in Cape Town last weekend, I just logged on to TAC’s website [ http://www.tac.org.za ] and read the following (excerpted, again for the record).

Deborah

@@@@@

25 August 2002

Dear All:

Over 70 delegates from 21 African countries met in Cape Town from 22 to 24 August to begin developing a Pan-African HIV/AIDS treatment access movement.  The following declaration is an outcome of that meeting.  Please distribute far and wide.

PAN-AFRICAN HIV/AIDS TREATMENT ACCESS MOVEMENT

DECLARATION OF ACTION

We are angry.  Our people are dying.

Without treatment, the 28 million people living with HIV/AIDS (PLWAs) on our continent today will die predictable and avoidable deaths over the next decade.  More than 2 million have died of HIV/AIDS in Africa just this year.  This constitutes a crime against humanity.  Governments, multilateral institutions, the private sector, and civil society must intervene without delay to prevent a holocaust against the poor.  We must ensure access to antiretroviral (ARV) treatment as part of a comprehensive continuum of care for all people with HIV who need it.  In this regard, at a minimum, we call for the immediate implementation of the World Health Organization goal to ensure antiretroviral (ARV) treatment for at least three million people in the developing world by 2005.  Together with our international allies, we will hold governments, international agencies, donors and the private sector accountable to meet this target.

We represent activists and organisations from 21 African countries that met in Cape Town, South Africa, 22-24 August 2002, and launched a Pan-African HIV/AIDS Treatment Access Movement dedicated to mobilising our communities and our continent to ensure access to HIV/AIDS treatment for all people who need it.

We have heard reports on the state of HIV/AIDS treatment and prevention interventions throughout the continent.  Remarkable achievements have been registered in every region resulting in some countries significantly reducing new infections and improving care for individuals, families and communities affected by HIV and AIDS.  However, there was a consensus that current efforts are insufficient.  The AIDS epidemic has exposed many of the problems facing Africa, including poverty, socio-economic and gender inequality, inadequate health-care infrastructures and poor governance.  We insist that access to ARV therapy is not only an ethical imperative, but will also strengthen prevention efforts, increase uptake of voluntary counselling and testing, reduce the incidence of opportunistic infections, and reduce the burden of HIV/AIDS – including the number of orphans – on families, communities and economies.

The recognition of the human rights to life, dignity, equality, freedom and equal access to public goods including health care are the fundamental principles of a successful response to the epidemic.  In this regard, we reaffirm the Universal Declaration of Human Rights and the African Charter on Human and Peoples’ Rights.  Furthermore, we recognize that the rights of women, children and youth are particularly vulnerable in Africa.  Treatment and prevention strategies for HIV/AIDS must consider their particular needs.  Critically, the rights of people with HIV/AIDS (PLWAs) must be protected, including equal access to social services and to medical insurance plans.  Discrimination and stigmatisation threaten our dignity and hamper efforts to address the epidemic.  Our experience as African PLWAs has been that of token involvement, not meaningful participation, in decision-making processes.  It is only through active involvement of PLWAs in all policy and implementation decisions related to HIV/AIDS that we will achieve our goals.

Alleviating the effects of the AIDS epidemic will require political leadership and greater accountability from national governments, international organisations, the private sector, especially the pharmaceutical industry, and wealthy countries, particularly the United States and European Union.  We are faced with enormous barriers:  national governments do not prioritise HIV/AIDS treatment; donor countries refuse to fulfill commitments to mobilise necessary resources; pharmaceutical companies deny access to essential medicines and diagnostics by charging exorbitant prices; structural adjustment programmes, driven by the World Bank and the International Monetary Fund, destroy public health-care systems; and debt to rich countries hampers financing of vital social services, including health care.  Community mobilisation and civil society action are essential for forcing action and ensuring greater accountability from all these institutions.

Health is a prerequisite for sustainable development.  The AIDS epidemic presents an immense challenge to health care systems in Africa.  Sustainable economic development can only be possible through the implementation of sound social security policies that target the poor and include HIV/AIDS treatment and prevention programmes….

We know that this is an immense challenge.  Millions of lives are at stake.  We must succeed.

 

Leave a comment

Filed under Books, Culture, Current events, Death, History and historiography, Media, Reading and writing