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The Difference between Life and Death
THE THEME of World Aids Day on 1 December is 'Men Make A Difference', which focuses on one aspect of the pandemic.
For a person anywhere in the world - male or female - what will make the difference to their prospects, not just of avoiding infection with the virus in the first place, but also maintaining health and life if they do?
There are many answers, including a person's level of awareness about the HIV virus or the set of illnesses known as AIDS, their sexual identity and general health and the facilities in their local community. But social class is the one factor which towers above the rest.
In July, Edwin Cameron, a HIV-positive judge and white South African, addressed the 13th International AIDS Conference gathered in his country: "On a continent in which 290 million survive on less than $1 a day, I can afford medication costs of $400 a month. I stand before you as a living embodiment of the iniquity of drug access in Africa. I can afford to buy life itself...".
Cameron attacked the "shadow boxing" of drug companies on price negotiations, and condemned "the international patent and trade regime that seeks to choke off any large-scale attempt to produce and market the drugs at affordable levels." (Positive Nation, September 2000).
A Nairobi doctor told the same journal how Médecins Sans Frontières arranges for a drug to be smuggled into Kenya from Thailand, where a 'reputable' company produced fluconazole for 60 cents for a day's dosage, compared to $15 for the same drug bought in the USA.
He criticised drug donations, pointing out that one company had promised free nevirapine to tackle mother-to-child transmission in southern Africa, yet a country like Kenya, which is one of the poorest, doesn't get any.
Médecins Sans Frontières criticised another drug giant for offering free fluconazole to southern Africa, and then adding conditions to the offer afterwards.
Socialists would support any step which takes humankind forward in the battle against HIV and AIDS. Steps like slashing the price of drugs, and the widest possible cheap access to all urgently needed safe medication under generic licences.
But the biggest advance of all would be bringing to an end the rule of big business and private profit across the world. That would make the difference between life and death for millions of people.
Life threatening dangers: big business, cuts and privatisation
BRITAIN HAS one of the lowest rates of HIV infection in Western Europe. The expectations of the estimated 30,000 people living with HIV and AIDS in this country are markedly different to those facing the average worker or farmer in Africa or Asia.
But the same factor which bars treatment to the majority of HIV-positive people in the Third World - private ownership of the pharmaceutical industry - is now beginning to put a question-mark over the future of people living with the virus in Britain.
During the 1990s, new treatments including combination therapy, resulted in lower death rates in the advanced industrialised countries. In 1999, 419 people died from AIDS in Britain, a quarter of the 1994 figure.
Provisional figures for 1999 indicate a record 3,300 people were diagnosed HIV-positive. Around 1,400 are thought to have become infected through male-to-male sexual contacts, the first increase among gay and bisexual men for several years. The biggest group of new infections came from heterosexual contacts. Whatever one's sexuality, the risks of infection are increasing.
In 1998-99, the United Kingdom's AIDS treatment budget was £226 million. Pharmaceutical drugs accounted for almost three-quarters of the total. The cost of HIV treatment is placing particular pressure on health services in London.
London has a disproportionately large HIV-positive community, around 85% of whom receive combination therapy. NHS chiefs have responded by cutting the share of spending going to other services, through the use of competitive tendering for voluntary-sector services.
As a consequence, many HIV/AIDS projects have merged or closed. Closures include Body Positive, the AIDS Treatment Project, Camden Link, Centrepeace women's centre and the FACTS centre in Crouch End, which was recently occupied by users in protest at the threatened closure.
FACTS campaigner Kevin Greenan told The Socialist: "The health authority managers think if you give someone combination therapy, that's the cure. But one-quarter of the people who are prescribed the pills can't take them because their body rejects them.
"No one asked anyone living with HIV what the closure of FACTS would mean. They thought because HIV has a stigma, we wouldn't raise our heads above the parapet. Well we did, and we haven't finished yet".
Kevin and other FACTS users have now set up a campaign called coNsuLt, to put pressure on health authorities in north London.
THE LAMBETH, Southwark and Lewisham Health Authority Area (LSL) has the greatest concentration of people living with HIV and AIDS in Britain.
Last year the number of HIV-positive people in LSL rose by 20%, the highest rate of increase in Europe. Yet, south London HIV services such as Positive Place in Deptford are among those facing closure.
The centre's deputy chairman Joseph Healey told a local newspaper: "What we really fear is that they're going to reduce the HIV service to a skeleton service relying on telephone helplines and IT technology.
"Personal contact is very important for people who are in such a vulnerable situation. A lot of people, in this area particularly, don't have the skills or facilities to access these sort of services on the Internet."
People living with or affected by HIV and AIDS who are looking to defend and expand the range of services, need to link up with trade unionists and community groups, and make common cause against cuts and privatisation in the health service.
We need to campaign for a socialist health programme, involving public ownership of the pharmaceutical companies, under democratic control by workers, consumers and the community generally. The health service must also be under democratic workers' control, providing free treatment at the point of need.
There are other important issues in the various fronts of the global war against AIDS which socialists need to address:
Treatment and support for the estimated 34 million people living with HIV and AIDS to which, untreated, it usually leads - 70% of whom live in the countries of sub-Saharan Africa.
Support for the partners and relatives of the 19 million AIDS dead.
Greater stress on education and prevention, especially for the rising generation of youth and children, including unborn babies of HIV-positive mothers.
"The world spends $150 million a year on Aids in Africa. It spent $2 billion on one month's bombing of Kosova/o... Some 200,000 die in conflicts around the world every year while 2 million die of Aids." Guardian September 1999.
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