“It would at least be a small act of redemption if the same wealthy countries now provided low-cost generic anti-retrovirals to help diminish the scourge of AIDS.” This from Stephen Lewis, UN Special Envoy on AIDS in Africa, in a September 25 address. Lewis was speaking of the wealthy western nations, whose position on agricultural subsidies at the Cancun round of WTO talks essentially dooms resource-rich Africa to continued poverty. Lewis also described the reaction of these countries as “mass murder by complacency.” Indeed, a slow, drawn-out holocaust is taking place in Africa – as we look on.

AIDS is affecting every single aspect of life and society in Africa. In some places more than half the population between ages 15 and 24 are infected, agriculture is buckling under the loss of workers and a generation of orphans is being born.

It makes you wonder what’s wrong with those who have the money – the power to write a different ending to this story. It could be their heads aren’t screwed on quite right. It could be, perhaps, that their shoes are too tight. However – to continue to paraphrase Dr. Seuss – maybe the most likely reason may be that their hearts are two sizes too small.

Besides their well-publicized Grinch-like behaviour in withholding pharmaceutical goods, the major multinational drug companies are actively working to make the whole situation worse. One example: Robert Ingram, chief operating officer of GlaxoSmithKline, organized a gala fundraising event for the Republican Party in 2002, and his company, a major Bush campaign donor, happily handed over $250,000 to attend. And it’s only been a couple of years since GlaxoSmithKline and fellow drug companies dropped their lawsuit against the South African government for planning to import or manufacture low-cost generic anti-retroviral drugs for their dying citizens.

To talk about “development,” “poverty alleviation,” “freedom” and “social justice” in this context is a joke. It’s more a question of mitigating the immense harm already done. The AIDS Foundation of South Africa says “past attempts to curb [the spread of HIV] have failed miserably. Now the fight is to provide simple, humane support within those communities hardest hit.” Instead of working for fundamental social change, anyone living or working in Africa is forced back to dealing with basic needs, palliative care, dealing with the fallout of illness and other end-pipe issues. And yet, the very starkness of the need in southern Africa is beginning to force a realization that, without fundamental change, even band-aid solutions won’t work.

Zachie Achmat, who as a child set fire to his school during the wave of student unrest and anti-apartheid action, is now the world’s most prominent AIDS activist. He’s focusing on getting the anti-retroviral drugs his compatriots so desperately need – as he does himself. After a decade of life with HIV, he is beginning to lose weight and suffer other complications. With the same spirit of solidarity that characterized the anti-apartheid struggle, he has refused to take anti-retroviral drugs until his fellow South Africans can afford to do the same, despite entreaties by none less than Nelson Mandela.

While the sheer need in South Africa forces Achmat and others to focus on treatment, rather than prevention or real social change, the struggle against HIV in Africa requires focus upon causes, taking drastic measures and forging alliances. In short, it still has the potential to effect lasting change, as well as to apply band-aids.

The contest of wills in the fight for cheap anti-retroviral drugs, for instance, has highlighted the role of multinational corporations in perpetuating economic inequality, injustice and war. It should be noted that GlaxoSmithKline itself recently announced it would slash the price of a two-drug combination pill (a third drug is still needed) to 65 cents per day. Having lost the battle for public opinion, its decision to try to compete with generic drug makers (who can do it for 36 cents) for scarce foreign-aid dollars is once again the cynical choice.

Just as the blatant hypocrisy of the drug companies is becoming a focus of worldwide attention, so are social norms that are oppressive to women, like the difficulties facing women seeking title over land after being left as AIDS widows, or like new anti-woman actions like the rape of young virgins, both a rumoured cure for HIV and a form of safer sex for the rapist.

Violence against women and sexist legislation both result from and contribute to the spread of AIDS and make it impossible for women to cope with the extra burdens that the AIDS toll places upon them. Increasingly, women’s groups in South Africa and elsewhere are calling for equality rights for women as a critical part of the struggle against AIDS. All is not lost.

This article appeared in the January/February 2004 issue of Canadian Dimension .