Liberation Generation: lesbian, gay, bisexual and transgender equality beyond 2000

Chapter 4

HIV / Aids


after the 1991 Gulf war the director of the World Health Organisation's global Aids a programme pointed out that a basic HIV prevention programme for 1994 all developing countries would have cost a 20th of the operation Desert Storm


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HIV/Aids is not the 'gay plague' that the media screamed about in the early 1980s but in Britain 60% of new HIV infections per year are amongst gay men. Around 1,500 gay men in Britain have tested positive every year since 1990.

The overwhelming bulk of HIV infections worldwide are amongst heterosexuals, predominantly in the most poverty-stricken regions.

Soon South Africa could be spending up to 75% of its health budget on Aids-related illnesses. Sub-Saharan Africa is home to 60% of HIV /Aids cases worldwide - by the year 2,000 it is estimated that the population will be 71 million fewer than it would have been without Aids.

Prejudice kills

LEAPS FORWARD have been made in the development of drug combinations, which have massively extended the life expectancy of people living with HIV.

Yet, still prejudice impacts on perceptions of the virus and consequently on allocation of resources for research, treatment and prevention.

In the early days of identifying the virus, genuine fears left unanswered by the bigoted Thatcher government fuelled a vicious backlash against lesbians, gay men and bisexuals.

Some found themselves turned out by friends and family. Others found dentists and nurses refusing to treat them. In Cleveland, the police had photographs of people they believed to be infected with HIV pinned on the station notice boards.

Physical attacks increased between 1986 and 1991, 70 gay men were murdered.

Discovery of the virus was seized upon to underpin the right wing's appeal for a return to 'traditional' family values - 'just deserts for an 'unnatural' lifestyle'. People living with HIV began to be categorised as 'deserving' or 'undeserving' gay men and bisexuals were deemed to have 'brought it upon themselves', as later were injecting drug users.

These dangerous ideas continue to pervade government policy, influencing the targeting of resources. Government priorities include mother-to-baby infections, which currently run at 50 new infections a year, but not gay and bisexual men amongst whom there are 1,500 new infections a year.

Guided once again by what New Labour thinks will win votes, Home Secretary Jack Straw proposes to introduce a new criminal offence of 'intentionally spreading HIV'. He is playing with fire. While further stigmatising people living with HIV, it leaves them open to malicious accusations and it will merely deter people from getting tested.

Safer-sex education has been massively hindered by censorship under the previous Tory government (See note) . Discriminatory legislation like the unequal age of consent and Section 28 (see above) has encouraged schools to self-censor discussion around gay sexuality.

Not only does this inhibit safer-sex messages but having your sexuality at best ignored, at worst condemned, by 'official' society undermines your self-esteem. Yet self-esteem, alongside economic and social well-being, is an important factor in encouraging people to look after their own health as well as that of people with whom they have relationships.

Discrimination

COPING WITH being HIV-positive is hard enough but it is made all the harder by the prejudices, which still get thrown up at every turn.

Your GP may be difficult; you may get sacked if you tell your employer; your friends and family may turn their back on you. Yet stress is the last thing you need your life expectancy rises dramatically if you can live a calm and healthy life.

But living with HIV is full of stress and uncertainty. Cuts in the benefit system pile on the worry. Will you be able to reclaim benefits if you have to stop work temporarily because your health dips or your employer sacks you? Will the government's 'Welfare to Work' programme push you into a job which adversely affects your health? It's a full-time job staying well - the stress of full-time work can literally risk your life.

Applying for work can be a nightmare. Employers often want to know your medical history. How do you explain unaccounted for gaps in your employment history? And if you get past that hurdle, trying to maintain the daily regime of 20-50 pills in secrecy at work is not easy.

Cynical profiteers

NEW DRUG combination therapies have given people living with HIV the potential of a new lease of life but it's put out of most people's reach.

In the US, fewer than a third of the urban poor with HIV receive these drugs, compared with nearly 90% of middle-class Americans. 4,200 lives a year would be saved if HIV drug therapy were made available to those without private health insurance and with an income below $10,000.

In the Third World, which accounts for the vast majority of HIV infections worldwide, the expensive drug cocktails are out of reach. While treatment costs $15,000 a year per patient, countries like Kenya have health budgets of $10 per person per year.

Meanwhile the pharmaceutical companies rake in the profits. The world market for these drugs is $3 billion a year Glaxo-Wellcome takes 38% of that, Merck and Bristol-Myers Squibb take 20%.

In Britain, far from having patients' interest at heart, the drug companies milk the NHS for obscene profit. People are dying as underfunding brings health care rationing, turning treatment into a lottery. The 'ring-fencing' of HIV treatment and care was lifted in April 1994.

Community services are suffering too as the relative success of drug combination therapies has given a mistaken excuse to cut funds. Birmingham lost its community-based HIV support services in 1997.

The pharmaceutical industry should be organised as part of a democratically run and publicly owned health service. Then, not only could their vast profits be cut to make the drugs affordable to everyone, but research and innovation could break free from the restrictions of the 'market'.

The huge waste of duplicated research in the race to get onto the market first could be eliminated. No longer would research be limited to search for profitable and quickly marketable 'cures'.

The biggest drug companies are able to influence the health policy of nations and to steer research and development into areas most advantageous to themselves. Through grants to medical research institutions and representatives on policy-making bodies, they can promote research into moneymaking curative drugs-based therapy and starve research into preventative approaches and alternative therapies.

In fact, the biggest leaps forward historically in world health have been through improvements in basic hygiene and sanitation by the richer countries - this is what curbed the typhoid, tuberculosis and other epidemics that wracked the industrialising countries of the nineteenth century.

Answers to the big killers, like cancer, continue to elude traditional medicine. Despite the optimism generated by the success of new drug combination therapies to prolong life, there is still no cure for HIV infection, while the virus continues to mutate, including into drug resistant strains.

The Wellcome Trust is the world's biggest private medical research fund, with assets worth more than 6 billion. It distributes more money to institutions than does the government's Medical Research Council (in the early 1990s around 400 million was being donated every year to doctors and scientists in Britain and around the world). Such resources and influence should not be left in private hands but put in the hands of democratically elected bodies that make decisions based on the interests of the majority, not on those of big business.

Battle for resources

THE STRUGGLE to conquer HIV/Aids cannot be separated from the wider struggle for proper funding with democratic public control and management of our health and welfare services, and a publicly owned pharmaceutical industry. Neither can it be separated from the battle to raise people's living standards generally - a healthy and stress-free lifestyle is crucial to prolonging life for people with HIV/Aids, yet successive governments are making this increasingly unreachable.

A trade union led campaign for decent jobs, pay, conditions, housing and benefits for all, would not only help people living with HIV /Aids, but every other working-class person as well.

The resources are available - it's a question of priorities. After the 1991 Gulf War, the director of the World Health Organisation's Global Aids Programme pointed out that a basic HIV prevention programme for 1990, for all 'developing' countries, would have cost a twentieth of Operation Desert Storm - protecting oil company profits apparently counts more than people's lives.


Note: 

In January 1994, the Health Education Authority was stopped from going ahead with a campaign to promote safer-sex and condoms. Two months later they were forced to withdraw a booklet aimed at teenagers called Your Pocket Guide to Sex (health minister Brian Mawhinney thought it was "smutty") Teachers were threatened with prosecution should they give contraceptive advice to children and instructed to inform parents if they discovered pupils having under-age sex (which, for gay teenagers, could mean two 17-year-olds).

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