AIDS AND IMPERIALISM: THE WORLD AIDS AGENDA

AIDS AND IMPERIALISM:
THE WORLD AIDS AGENDA

Reflections on the XVI International AIDS Conference
in Toronto,Canada

Compiled by: Jaime Montejo, Elvira Madrid and Rosa Icela Madrid
of Brigada Callejera de Apoyo a la Mujer “Elisa Martínez”

“A third of the world’s population does not have access to medication, according to World Health Organization official statistics. Currently, 9 out of every 10 people who die due to an infectious disease live in a poor country. These deaths could have been avoided, in many cases, if they would have had access to the necessary medication or vaccine to prevent these illnesses.”
Emilia Herranz, President of Doctors without Borders, Spain, 18 July 2005

We are currently witnessing the criminal negligence of the pharmaceutical industry, of the Bush administration and of other governments and institutions, in the limitation of access to antiretrovirals (ARV) for people who live with HIV or AIDS, particularly in Africa, a continent besieged by HIV/AIDS. Neither the pharmaceutical companies who have ARVs, nor the governments who have the money, nor the governments who could amend their laws to make inexpensive generic ARVs available, none are prepared to prolong or rescue lives, primarily African lives. These are some of the initial reflections made by Jesse McLaren, a Canadian doctor and activist, in his speech “AIDS and Imperialism; money for AIDS, not for war”, presented at the XVI International AIDS Conference in Toronto, Canada, celebrated August 14-18, 2006.

Jesse McLaren criticizes the Bush administration, as well as the governments of Great Britain and Canada, for spending hundreds of thousands of millions of dollars in the war against Iraq and Afghanistan, instead of investing resources to fight the greatest threats to human security: tuberculosis, HIV/AIDS, malaria and poverty. He tells us that the AIDS crisis will continue without any control, for a long time. Jeffrey Sachs, a well-known Harvard economist, adds that there are generic ARVs that could be imported from India to treat the majority of HIV-positive Africans for USD$350 per year, instead of the USD$10,000 per patient needed for patented medicine.

Medicines produced by large transnational companies cost USD$10,000 per patient per year, while generic ARVs produced in Brazil cost less than USD$300 per year. In Geneva in August 2002, and again in the summit meeting of the World Trade Organization in Cancun in September 2003, an agreement was reached that allows the sale to poor countries of generic medicines that save lives. Despite these agreements, the USA demands that poor countries buy medication from the large transnational companies. This demand is based on the claim that the low-cost generic medicines produced in other countries violate their “intellectual property rights”, or what is the same, the interests of their transnational pharmaceutical companies.

With free trade agreements like the one signed by the Mexican government, the United States pressures heavily for increased control on intellectual property rights, and prohibits the exportation of generic medicines to treat HIV/AIDS. With these commercial treaties, the United States obliges its commercial partners to disregard the World Trade Organization’s “Declaration Regarding the Agreement on Aspects of Intellectual Property Related to Trade” of Doha (2001), which allows certain flexibility in the interpretation of intellectual property rights for medicines, and allows WTO members to “protect public health and, in particular, to promote access to medicine for all”.

What is more, the US government requires that the majority of funds for AIDS-related project be distributed by American institutions such as the US Agency for International Development (USAID), which in turn obey the economic and political interests of the Yankee dominant capitalist class. In this way, their iron-fisted control of AIDS-related financing represents the political and economic blackmail of poor countries, and only deepens the dependence and poverty of the majority of people.

Jesse McLaren questions AIDS prevention programs that are based on the individualist ideology promoted by capitalism, which points to individuals’ sexual practices and calls them high-risk practices, without taking into account the causes that generate these unprotected sexual activities.

In this regard, he identifies three weaknesses of this individualist perspective, which has resulted in the failure of various preventive strategies implemented by the World Health Organization and later by UNAIDS.

The first weakness is in reference to the question: “what are high-risk behaviors”? Is it that women not have control over their bodies and their sexuality, and cannot demand the use of condoms? Is it the lack of access to medical care, due to the indifference of the health system when it comes to the poor? Or the lack of sensitivity of AIDS prevention programs to the different expressions of indigenous culture, which is expressed in an imposition of contraceptive methods? Without ARVs, there is more virus to transmit. Sexually-transmitted infections (STIs) open the door to HIV/AIDS. Discrimination against homosexuals in health care services, the black-market sale of condoms meant to be distributed freely, and the forced application of AIDS testing to sexual workers, all these are social factors which propitiate the reproduction of so-called “high-risk practices”.

As we can see, none of these proposals are “risky behaviours”; they are, however, social conditions imposed by poverty, racism, sexism and homophobia. In the same way, “promiscuity” has been related to “high-risk behaviour”: gay sex, sexual work, premarital and extramarital relations are all considered a priori to be a risk to public health.

The second weakness of the individualist perspective of AIDS prevention programs is the focus on people’s individual behaviour. Safe sex and protected sex are basic to breaking the vicious cycle of HIV/AIDS transmission; however, these goals cannot be achieved as long as they are considered “life styles”.

This is part of the neoliberal ideology of “personal responsibility”, which exalts the role of the individual in preventing AIDS, but does not take into account the material factors in one’s life, which determine the capacity of a person to choose between unsafe sex and other healthy sexual practices. This neoliberal vision often leads to blaming and stigmatizing specific population groups who are already discriminated against traditionally, such as gay men, transgender women, injection drug users, sexual workers and migrants.

The economic and/or emotional dependency of many women limits their possibility to negotiate – let alone demand – condom use with their partners who are the economic providers. Discrimination against women sexual workers facilitates the transmission of HIV/AIDS. Commercial sex does not transmit AIDS, but not using a condom in a sexual relationship does. Discrimination against injection drug users facilitates HIV/AIDS transmission. The used of injection drugs does not transmit the AIDS virus; but the social conditions that make people re-use syringes, do cause transmission. In both of these last cases, to criminalize and blame the “behaviours” only makes them more risky, while the socioeconomic context that reproduces these behaviours remains intact.

A third weakness of the individualistic perspective of AIDS prevention programs is in the narrowness of the “safe behaviour” theory. 90% of people with HIV/AIDS live in countries in “the south”, 70% are in sub-Saharan Africa. The highest rate in the west can be found in Haiti (with a primarily black population). Within the industrialized countries, people of colour and other ethnic groups are more affected that the white population.

Another weakness of AIDS prevention program, and this is one that we are adding to McLaren’s analysis, consists of stimulating government and non-governmental organizations’ dependence on “international cooperation funds” that provide condoms, patented anti-retroviral medicines and other inputs for health such as HIV/AIDS detection tests. It’s good business for the producers; governments use these funds as control mechanisms and the non-governmental organizations stay “in line”, in order to remain on the budget. One South African activist mentioned, in a panel discussion, that one reaction to US conditioning of providing AIDS-related funds could be the alternative of doing this work without these funds. There were no comments.

McLaren points to two structural characteristics of neoliberalist capitalism, which help spread AIDS. He calls these “risk contexts”.

The first characteristic is the health care budget (in AIDS attention and prevention) of the countries subject to structural adjustment programs; these budgets have been reduced drastically. One result of this is the lack of economic resources to ensure safe blood transfers. When abortion is neither safe nor legal, it is difficult to ensure the “safety” of the blood transfusions needed by many pregnant women.

The second structural characteristic of neoliberal capitalism that helps spread AIDS is the excessive level of payment of foreign debt, which lead to a reduction in public health budgets and the introduction of new arrangements for health care where the person who receives care has to pay for it. This leads to a reduction in the use of health care services.

McLaren’s reflections regarding the struggle for access to ARVs forces us to ask ourselves: “people or economic benefit?” In 1999, 39 of the biggest pharmaceutical companies sued the South African government for importing generic ARVs for AIDS treatment. However, Africa as a whole represents only 1% of their market. Why, then, are they so worried about the loss of 1% of their market, especially since the greatest part of their sales are not even related to ARVs? The pharmaceutical companies argued that this would cause a “domino effect”, and would affect their western markets.

It was even hinted that if the production and purchase of generic AIDS medication continued, the pharmaceutical companies would stop producing new medicines, thus undermining the possibility of progress in medications. At that time, widespread mobilizations against globalization defeated the pharmaceutical companies. This situation also alerted the owners of money, who began to “invest” resources in media manipulation of governments, public officials and non-governmental organizations of people living with HIV/AIDS, so that their pro-generic ARV activism would be reduced to a minimum. In the Toronto Conference, mention was often made that social activists were tired out. In Brigada Callejera, we believe that the nation-states and the pharmaceutical companies transformed their initiatives into tools of control, as the service of the transnational companies involved.

In this regard, the newspaper “Revolutionary Worker” tells us that it is no coincidence that Africa is the continent suffering most from AIDS. For centuries, colonialism and imperialism robbed the land, labor power, minerals and other riches of this continent, with which they stimulated the economic development of Europe and the USA. The slave runners kidnapped millions of men, women and children; they took them as slaves to the New World, where their work formed the economic base of the USA. The European powers divided Africa among themselves in the Berlin Summit, in 1884-5. Not a single African was present. The colonizers stripped them of their land, and obliged the Africans to work in plantations and mines, at starvation wages.

According to the imperialists, they developed Africa. However, history shows that Africans’ health failed and the population of many African countries declined from 1890 to the end of World War II. The African political classes indebted their countries to the imperialist powers, but the huge loans did not benefit the people; they only served to build the colonial infrastructure needed to take out the raw materials and to enrich the members of political parties.

Civil society organizations such as “Doctors without Borders” and “Oxfam”, among others, insist that patients are more important that patents, and point to companies like Pfizer, GlaxoSmithKline, Bristol-Meyer-Squibb and Roche as the ones responsible for the deaths of millions of human beings who died because ARV patents would not be liberated. The battle to stop the holocaust against the poor of AIDS must continue. The Global AIDS Fund of 10 billion dollars has not been raised yet, while Bush spent 300 billion dollars in the first year of the war against Iraq – an amount enough to eliminate the foreign debt of all of Africa.

Jesse McLaren continues his analysis, mentioning that in the end, “progressive” reforms of public policy will not free us from a system that promotes the permanent search for new markets and benefits for imperialist nations and corporations. These latter forces will oblige the international political class to step back, in order not to affect the interests of financial capital. Each reform to the capitalist system is like a beach landing in wartime, always under red alert, always under constant attack.

During the XVI International AIDS Conference held in Toronto, Canada, people questioned the “colonialist intellectualism” of the confessional right wing, headed today by George Bush, which aims to impose their values on the rest of the world. These values include promoting the ABC of “Abstinence, Be faithful or use Condoms”. Nevertheless, other people were exalted, such as former US president Bill Clinton, and Bill and Melisa Gates (the owners of Microsoft). These people publicly supported condom use, women’s empowerment (without transforming the material conditions of their lives or changing the patriarchal order which subordinates them), as well as supporting prevention efforts aimed at gay men and sexual workers.

Melisa Gates, wife of the owner of Microsoft, “justified” prevention work with sex workers in order to avoid transmission of HIV/AIDS to the wives of their clients; this won her great applause. Melisa and Bill Gates are working to develop microbicides that can widen the scope of prevention offered by condoms, and called on human rights activists to help disentangle research that can lead to obtaining such substances, even at if it means violating individual rights.

All this sounds very nice, “cutting edge”, “committed” and even “with a gender perspective”; nevertheless, they made no mention of “softening” the patents on ARVs or on poliurethane female condoms, which result in an increase in their cost. Nor did they mention decreasing the dependence of countries on funds of international cooperation, nor for people to take civil resistance into their own hands, as a response to the lack of supply of these medicines.

All these people: George Bush, representing the “confessional right-wing imperialists” as well as Bill Clinton and the Gates, representing the “progressive right-wing capitalists”, see the nation states and particularly their governments as agents of social change. According to this vision, the role of civil society is not to make change happen; their role is to elect others, through the electoral system, so that these third parties (candidates in popular elections) may carry out the change for them. Thus, discriminated groups such as homosexuals are to elect candidates who will promote their “legislative agendas” in the appropriate legislative bodies. The role of civil society is to organize itself to “fight” for a candidate, call out the vote for their candidate, and finally to vote. And if there is electoral fraud, they should mobilize and demobilize when the political class decides so. It is to this that civil society participation is reduced, by the four international strategists who currently dictate the world agenda in the struggle against HIV/AIDS.

Jesse McLaren finalizes his analysis on the relationship between AIDS and imperialism, mentioning that the tasks that AIDS imposes upon all people on earth, requires socially responsible work to prevent AIDS and to find the means to guarantee universal access to ARVs. Nevertheless, for this to happen, it is necessary to first eradicate the context imposed by capitalism.

Achieving this objective requires addressing three strategic matters, through a prolonged popular struggle:

1. To overthrow the current political regime, through peaceful means, regardless of which candidate is voted into office (¿traduje bien lo de mande quien mande?). We must remove this “representative democracy” that sells the illusion that nation states and particularly governments, are the agents of social change who will guarantee universal access to ARVs and freely distributed condoms. It must be replaced by structures of popular power, emerging from the class struggle of our Mexican people against capital and its armies. The other option is to generate a popular power structure, parallel to the “representative” structure, that can take its place in solving people’s problems without aiming to take over the formal power structures, as presented by John Holloway in his book “Change the World Without Taking Power: The Meaning of Revolution Today”.

2. To transform the capitalist economic system that gives preference to the profits generated by ARV medication patents, over the lives of people who live with HIV or AIDS. This system must be transformed into one based on free and direct interactions between organized units of production and consumption, with the goal of satisfying the needs of workers in the city and the rural areas, guaranteeing the community ownership of the means of production, which includes ARV generic drugs needed by our people. This is possible by creating a direct market based on exchange, not profit, between organized production and consumption units, through autonomous processes of economic integration of popular sectors.

3. To change the social system that is based on social class divisions, which gives preference to the oppression of workers in the rural areas and the cities by a privileged social class (the bourgeoisie and their allies). This privileged class is able to pay for ARV medication and condoms, in order to prevent the transmission of HIV/AIDS and other sexually-transmitted infections like that caused by the human papiloma virus, related to cervico-uterine cancer. This is possible if we promote a communal form of relationship between activists in the struggle against HIV/AIDS and other social sectors who have suffered at the hands of local power bosses and oligarchies.

Now, it seems to us that in order to clear the path toward the goal we have proposed – to eradicate capitalism – it is necessary to propose three tactical approaches that should be taken up by activists affiliated to the Zapatista Other Campaign who are struggling against HIV/AIDS.

1. To organize ourselves to agree on a collective national direction that includes representation by each and every one of the organizational units of struggle, and where the leadership of “other struggles, different than ours” are recognized in everyday life, where imposition is not an option.

2. To integrate the struggles of other movements, different from ours, in our national plan of peaceful civic struggle in the Other Campaign.

3. To mobilize ourselves and generate autonomy, which will allow us to establish different expressions of popular power, such as the Good Government Councils of the Autonomous Municipalities in northern Chiapas, or like the community police in the state of Guerrero. These are community bodies, parallel to the constitutional government and that, in practice, consolidate processes of autonomy in health, since “those who have power over health and sickness, have absolute control over people’s life and death, in this case over those who live with HIV/AIDS or are at risk of acquiring the virus, and who can do little or nothing in the face of this vertical power structure”. (Jaime: quien dijo esto? Estaría bien poner la referencia ) Because of this, non-governmental community health programs must remain autonomous of health businesses and of governmental health services. This does not mean that we must not collaborate with them, only that there must not be any dependence on private enterprise or on the Ministry of Health. A community that controls the health and sickness of its members has created a popular power and holds its life in its own hands.

As a corollary, we would like to point something out, with the goal of promoting an open and frank dialogue with indigenous sectors that are “resisting the bad government”, who are working to construct autonomous health projects. We refer particularly our friends in Osimech, Chiapas, and the members of the Indigenous National Congress, where we will promote “The Other Campaign of Sexual and Reproductive Health for Indigenous and FarmerResistence in Mexico”. We would like to share the ideas of the Indian Manuel Quintín Lame , which continue to ring true in the struggles against capitalist globalization and the empoverishment of the original peoples and working sectors. Subcomandante Insurgentes Marcos put it well, in a meeting with sex workers in the La Merced offices of Brigada Callejera: it’s one thing to have AIDS in Polanco , and quite another to have it in the misery that surrounds street workers. Unity, land, culture and autonomy; these are four principles of the political ideas of this rebel indigenous man.

The first element is UNITY, to confront those who threaten people’s lives, and in our case, who deny access to generic ARVs and free condoms that could prevent the transmission of HIV/AIDS and other STIs.

The second element is LAND and the fruits of the work carried out on it, for those who work the land (a Zapatista ideal); by extension, this includes the means of production for workers, and the generic ARVs that can save the lives of those affected by HIV/AIDS. We should not “pay” for costly patents on intellectual rights, held by pharmaceutical companies.

The third element is CULTURE and the rescue of traditional cultural values such as respect, equality, justice and the dignity of people and nature (values practiced by the original peoples of Latin America and the Caribbean). This is needed to confront the intellectual colonialism that imposes criteria upon us for HIV/AIDS prevention; criteria based in their individualistic ideology, which puts the responsibility on individuals for carrying out “risky practices”, without taking into account the context and social conditions that lead to a reproduction of behaviours which facilitate the transmission of HIV/AIDS and other STIs. In this respect, Manuel Quintín Lame tells us “people cannot impose their vision of the world, and in our case, of health and sickness, on other people”; such an imposition would reflect an imperialist point of view.

The fourth element is AUTONOMY, which allows people, communities and organizations to cease depending on the acts or omissions of the three levels of government in Mexico (municipal, state and federal). In the case being analyzed here, autonomy in health matters would mean strengthening traditional and alternative practices in community health spaces controlled by the community itself, such as the Zapatista micro-clinics in Chiapas, or the program for the social marketing of Encanto and Triangulo condoms by Brigada Callejera. Autonomy from the interests of the particular public servants in office in each administration, from the Mexican government, as well as from the pharmaceutical transnationals, in order not to have to be silent regarding what has been called the “AIDS Holocaust”, which is costing millions of lives throughout the world.

We close with the words of the Russian Alexander Rumiantzev, who was joined by other activists when they took the floor in the closing ceremony of the XVI International AIDS Conference in Toronto, Canada:

There will be no universal access to antiretrovirals under capitalism!

Let us overthrow the imperialism of pharmaceutical transnationals!

Activists of the world, Unite!


The XVII International AIDS Conference will take place in Mexico City, in the year 2008.

Will it be then that corporativism will impose itself on the popular resistance movement against the lack of access to ARVs and freely distributed condoms?

A coin has been tossed, and is still in the air ... which side will win? This is the first call to all the men and women who are active in the struggle against HIV/AIDS, to show our presence and not let this conference go by without showing our anger over what happens in our country and in the rest of the world.

Against AIDS, silence and discrimination:
Organization, mobilization and citizen resistance