Helen Epstein's book is a vital exposition of the need to rescue the debate on HIV prevention in Africa from ideologyby Tony Barnett / August 31, 2008 / Leave a comment
Published in August 2008 issue of Prospect Magazine
The Invisible Cure: Africa, the West and the Fight Against AIDS by Helen Epstein
Almost 30 years into the biggest global infectious disease epidemic in history, we still don’t know what works practically in Aids prevention. Billions of dollars, pounds, yen and euros have been spent and we now have anti-retroviral therapies for people who have been diagnosed with Aids. But on prevention, we have very little in the armoury.
In early August, the 17th International Aids Conference is being held in Mexico City. If the 2006 Toronto conference is anything to go by, Mexico will attract as many as 30,000 delegates. Serious science and medicine will be interspersed with plenary sessions by star presenters from the worlds of science, politics, the arts and the UN: a mix of seriousness and razzmatazz akin to a US presidential convention.
A world away from this, in early 1995 I was talking with Rajiv, a middle-aged man, on the veranda of a shabby dhaba, owned by his father, on one of the hectic main transport routes running through Rajasthan in northwestern India. Dhabas are refreshment and overnight (and therefore sex) stops for thousands of truckers whose vehicles thunder along India’s roads in a cacophony of horns, colour and fumes. We discussed why the free condom dispenser—which sat discreetly on the front wall of the truck stop as part of a local NGO’s HIV prevention efforts—was empty, and had obviously been so for a long time. Rajiv was clearly embarrassed to explore this with me, saying I should speak to his father. Adopting a stern expression, the older man explained: “I keep these things in a drawer in my desk; I don’t give them to just anyone. I must know they are respectable. I am not wasting India’s national wealth on these things.” In July 2001, another old man, the then president of Kenya, Daniel arap Moi, made a speech to the Kenyan Pharmaceutical Society. He was, he said, reluctant to spend money on importing condoms to protect Kenyans from contracting HIV, because it was better for Kenyans to refrain from sex, “even for only two years.”