Embracing our humanity on World AIDS Day

I have the best family, like, ever. Look, I’m sure your family is great, too, but seriously, these people are awesome. Today in awesomeness, I am sharing with you an essay written by my cousin, which was printed in The Rutland Herald last weekend. My cousin Gus (we all call him “Pete”), has been retired for several years, but has devoted his life to helping end the suffering and opening opportunities for others around the world. Please take a few moments to read what he wrote, and feel free to leave your thoughts on this day in the comments.

Embracing our humanity on World AIDS Day

By Augustus Nasmith Jr.

We have come a long way, with a long way to go, to eliminate the devastation of AIDS. Each Dec. 1, World AIDS Day is a reminder for every day that AIDS is fueled by societies’ and governments’ failings. Confronting AIDS requires what have always been key to human progress: love and compassion promoting rational action.

The unity in diversity reaching across social, economic and political differences to address the challenges of AIDS is a lesson that should not be lost in Washington, D.C., in 2011. For us, around the world, World AIDS Day is to reflect, remember and recharge.

Young Americans have not experienced the alarm of the 1980s caused by devastating illnesses, suffering and deaths of unknown origins. A fearful population sought refuge in disassociation. The worst among us declared the scourge retribution for the sins of homosexuals and drug users, whose numbers were high among the early ill and dead. In contrast, scientists and medical providers persevered to find the cause and seek a remedy. Through intensive research, by 1984-85 the human immunodeficiency virus (HIV) and its means of transmission were identified, a blood screening test and guidelines to prevent and protect from transmission established.

In the United States, even though health officials advocated robust national education to address the crisis, right-wing politics weakened effective national leadership against the spread of HIV and the ravages of AIDS (acquired immune deficiency syndrome) it causes. Loud voices fanned fear by stigma and discrimination against those viewed as marginal to society. Ignoring science, they caused many from all walks of life to become infected, since the virus knows no social boundaries. Hysteria isolated even those considered “innocent” AIDS victims: previous recipients of infected blood through transfusion, children born with HIV, women through “cheating” husbands. I still hear the voice of the student telling me how his outspoken “Christian” father reacted to his son’s HIV diagnosis: “You disgrace us. Don’t tell anyone. I am taking out a million dollar life insurance policy on you.”

HIV/AIDS’s spread became a world pandemic, most devastating to the vast poor of the developing world, where patterns of fear, ignorance and rejection that accompany the virus make it all the more life-threatening. One image, the straw hut in which an ill young Indian woman was abandoned far from her village and left to die alone, is a metaphor. In such contexts, still in the world today, a social death precedes — and is in many ways worse than — the physical suffering and death brought about by a destroyed immune system. Such cruelty only makes people hide further from rational understanding. HIV is not easily communicable when safer sex and other relatively easy precautions become the norm. Stigma discourages prevention and HIV testing, thus both promoting infection and denying intervention for life-giving health care.

Courageous people took to the streets in our darkest hours in the United States. “Fight AIDS, not people with AIDS!” became the battle cry. HIV/AIDS activism, while rocking the establishment, actually became the best alliance to the scientists and health professionals. Actress Elizabeth Taylor embraced movie icon Rock Hudson for an example of leadership so lacking from Ronald Reagan or George H.W. Bush. For those rejected by their biological families or erstwhile friends, others come to be family, and exemplify what is right. In the countries of western Europe — as wealthy as the United States, but more advanced in public policy, national health care, and education about sexuality — infection rates were less than the United States. Still, gestures such as Diana, Princess of Wales, holding people living with HIV/AIDS, were lessons to combat prejudice-driven fear.

The 1993 award winning movie “Philadelphia” accurately portrays the dire situation. By 1996, improvement in HIV medications brought about great gains in possibilities of care for the infected and became further cause for activism to promote access to the drugs for all. That, of course, is an ongoing challenge. Corporations’ drive to make the most profit possible out of illness makes U.S. health care less equitable than in other wealthy countries, which provide care for all at half the national per-capita expenditure that is spent in the United States.

In our country, with public education and media forums to reach all, one would expect new HIV infections to be a rarity. Wrong. Sadly, there are still those who think of AIDS as a “gay disease” or that the healthy-looking cannot be infected. Our rate of infection has not declined for more than a decade. Of the more than 1 million Americans living with HIV, the Centers for Disease Control (CDC) estimates that 20 percent do not know of their HIV-positive status. Needless to say, if they are not taking responsible precautions (as we all should, whether infected or not), the virus spreads. Eighteen thousand people with AIDS die each year in the United States. (More than 600,000 since the start of the epidemic.) Fifty-five thousand Americans are newly infected each year.

Groups — whether social, ethnic or religious — that deny the realities of promiscuity, prostitution or men having sex with men make women and men vulnerable. As 25 years ago, it has to be understood that through sexual relations or needle sharing a virus can connect diverse populations regardless of whether or not they identify with each other. This is brought home to seniors, too, given the popularity of erectile dysfunction medication and appreciation of the right to a healthy sex life. A healthy sex life for anyone includes understanding the reality that infection may be part of a person’s history even if unknown to them. “Safe sex” needs to become the norm, new needles provided where needles are shared, and HIV testing commonplace. Women and men need to wake up, be responsible and protect themselves and others.

In the developing world, the ravages of HIV and the fear of it mirror what we have known but are terribly magnified. There, struggles to survive — even without HIV/AIDS or natural calamity — are the norm. Governments are often corrupt. Human rights may be as absent as clean water and adequate food and shelter. Access to health care is rare. Men dominate and abuse women at the same time that women hold the fabric of family and society together.

Physical rejection, beatings and murder of the HIV-infected, the failure of men to use or allow women protection, blaming the infected woman who has been monogamous, forced marriages, denial of the realities of men having sex with men or prostitution — all fuel the spread of HIV.

I remember Irene of Kisumu, Kenya, whom I met in 2003 at a conference of infected people. Rail thin, too weak to stand from her chair, she motioned me to come to her. The young AIDS widow, who lived in a shack and tried to survive by selling charcoal, shared her story. “When I walk down the street people point at me and laugh,” she said. Irene died some months later, but during the few days at our gathering I saw her rise Lazarus-like with a vibrancy in her eyes. By the unconditional love finally experienced those few days, Irene knew rebirth before her passing. In addition, I think of 7-year-old Nancy in Nairobi, 13-year-old Christine in Washington, D.C., 35-year-old Kurt in New Jersey and so many others whom I knew and love.

They are in the following impersonal but essential United Nations statistics: 31 million dead of AIDS since 1981, 2 million deaths in the past year, 2.7 new infections in the same year period, 2.1 million children living with HIV, over 14 million orphans from AIDS in Africa, 4.7 million people infected in Asia. Up against much more than we in the U.S., grass-roots activists in poor countries provide leadership to force governments and people to acknowledge realities and break the silence that kills their own. Where corruption is rampant and national budgets may allow but a dollar per capita for health care, the grass-roots organizations provide the most effective partnership with the United Nations, international nongovernmental, and bilateral foreign aid programs essential to fight AIDS. Programs to address AIDS have in many places brought comprehensive health improvement and a degree of care not previously known.

Not long ago, given the exorbitant cost of HIV and related medications in the U.S., many wrote off treatment and care in poor countries. They were proven wrong by activists, leaders who really cared, the commitment of the International AIDS Society, the UNAIDS’s coordination of multi-sector U.N. agencies, and the newer Global Fund to Fight Against AIDS, Tuberculosis and Malaria. For those not guided by humanitarian reasons, the threats of international turmoil and social-economic collapse of states devastated by AIDS provided needed wake-up calls. In Vermont we can be proud that our senators and representative, and many of our elected state officials have been firm supporters, often leaders, in the key contributions of American commitment to international efforts. Progress has been marked, but not easy, given the developing country realities. Pressures from above and below did bring prices for first-line drug treatment down significantly enough to make funding possible and effective, with a goal that by the end of this year treatment would be provided 15 million infected people in need. Sadly, the world has fallen short by 10 million.

By the time of the XVIII International AIDS Conference in Vienna in July, another global problem, the economic recession, found donors behind previous commitments to the Global Fund and threatened failure to ensure three-year (2011-2013) replenishment targets in October. Just to continue successful existing programs, $13 billion are needed. To add new programs — to reach and save more people — $17 billion are needed. To provide optimum progress: $20 billion.

Calls in Vienna for continued strong leadership showed that the potential influence of the United States for positive change is still respected. Without it, other wealthy countries would take cover. Appreciation for American science, medicine and government commitment was also evident by the selection of Washington D.C., for the 2012 International AIDS Conference, made possible by Congress’s and the Bush and Obama administrations’ removal of the irrational 20-year ban on visits to the U.S. by HIV positive people.

At the October U.N. meeting, the U.S. commitment to $4 billion for the three years (an increase of 38 percent over its previous pledge) was a great impetus to other donors’ overall increase of 20 percent. Yet the total reached was only $11.7 billion. Pressure will continue on others to donate more. What if we raised our total to $6 billion upon assurances that others would follow? Six billion dollars to save lives as compared to the open spigots for $742 billion thus far in the Iraq war and $363 billion in Afghanistan? Or compared to the hundreds upon hundreds of billions to bail out profit-driven financial, insurance and mortgage institutions responsible for their own failures and our national recession? (While it is the leading donor with regard to AIDS, the U.S. ranks low among wealthy countries on the per-capita expenditures for non-military foreign assistance.) George W. Bush’s most positive legacy is the dramatically improved bipartisan commitment and funding to end the AIDS crisis. Looking to the new configuration in Congress for 2011, commitment to stay together in the fight against AIDS would be the most heartening exception to the failures thus far to unity in addressing problems. When leaders still identify that they live, bleed and die like anyone, they rise above their posturing. Confronting AIDS has shown the way back to our hard fought progress toward fulfillment of the American promise and to an advocacy for peace, progress, and equality for all.

Kenny Oh, one of the inspiring young leaders I met in July in Vienna, shares what is known to all of us who are in the world of AIDS: World AIDS Day means recognizing that HIV/AIDS isn’t just a human rights issue, or a public health issue, or a development issue, or a poverty issue, or a domestic issue, or a foreign issue. Rather, AIDS is all of these issues at the same time, and for one day we can come together to acknowledge this universal problem and address it together.

AIDS, the plague, mirrors and feeds upon all that is wrong and unjust in the world. The better natures that are in us all point the way for us to further embrace our humanity. Mary, an American nurse aware of the stigma that is still attached to HIV/AIDS in the United States, suggests that this World AIDS Day “we can be a friend to others, realizing that all of our lives are in some way intertwined.”

To achieve a world without AIDS will be the greatest advance toward fulfilling ideals and goals that were ours well before AIDS.

Augustus Nasmith Jr. of Rutland was infected by HIV in 1983.

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