Disease as Development: Marketing HIV/AIDS for NGO Profit

[Guest guest]

Dear Forum,

I read this article in TOI. A food for thought and introspection.

Manish Mathur

Manager - Child Survival and Disease Project CARE Inc.

BHUJ-KACHCHH

E-mail: <mmathur_in@...>

[Thanks Manish. Food for thought indeed. Moderator]

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Disease as Development: Marketing HIV/AIDS for NGO Profit

An article by Shastri Ramchandran in TOI Saturday August 30th 2003)

Modernity and Development are as much about disease as they are about health and

wealth. In every age, societies have courted a disease as fashionable. In

Europe particularly in the 19th and early 20th century, sexually transmitted

diseases were considered chic. It was a fashion among the ‘cultures’ such as

the aristocracy, artists and writers to actually take pride in being afflicted

by venereal disease. There are accounts of how bored, aristocratic women

preoccupied solely with diversions to amuse themselves actually offered to pass

on their disease to writers and intellectuals to whom they look a shine.

Much like venereal disease in that period, today HIV/ AIDS seems to have become

a fashionable cause for the rich and the powerful. Everybody – NGOs, governments

celebrities, film stars, condom Manufacturers,advertisers, media, politicians

socialites, cultural activists, businessman- loves HIV/AIDS. The cruel exception

is the people who are suffering from the dreaded disease.

Led by external research and lobbies driven by international finance and

boosted by media hype, AIDS prevention projects and awareness campaigns have

become a booming industry. This is a cash cow that everybody wants to milk for

the profit it can fetch alone with the respectability, if not the prominence,

that is assured by association with a public health issue. The AIDS prevention

lobby has cultivated every influential section within the country and funding

agencies abroad. NGOs are flourishing and as the number of affected people keep

swelling, so do the coffers of those awareness and prevention Business.

Like sex, HIV/ AIDS too has been commodified with the industry thriving on the

people who are suffering from it.

In a country of over one billion, there are four million cases of HIV/ AIDS. As

has been pointed out in these columns, the number of people suffering from

tuberculosis (TB) and malaria put together is five times as much. Air and water

borne diseases are rampant in the country, as are infectious diseases and

malnutrition. These are simply dismissed as inescapable tropical maladies

instead of being treated as public health priorities. In the prevailing climate

of globalization, where government has been with drawing from public health, the

only exception seems to be HIV/ AIDS. Earlier this year, the Global Fund –

a financial institution set up during the G-8 Summit in 2001 for targeting

diseases of poverty – approved Rs 650 crores in its second grant to fight

HIV/AIDS and TB. Predictably Rs. 500 crore was earmarked to HIV / AIDS as

against Rs 150 crore to TB.

The obsession with HIV/ AIDS as a so-called issue of public health dominates to

the exclusion of for example tuberculosis, because the former is an

internationally marketed success with immense scope for networking. Conferences

and seminars, workshops and study performances, invariably in exotic resorts

and five star hotels, speak of a new genre of travel that may appropriately be

dubbed AIDS tourism. Every conference and seminar is a platform for magnifying

the problem, exaggerating the numbers affecting and of course ‘spreading

awareness’ – all with a view to wresting more funds, which in turn spawn more

NGOs who, keep the chakkar going with more conferences.

Thus crores of rupees are spent discussing and debating how to spend the

hundreds of crores that are available even while planning how to get more

behavioral change among the high risk groups. Simply put, behavioral change

means getting people use to condoms.

In a globalized world, the market forces driven by the interest of the advanced

economies dictate the agenda, which is business. In the interests of its

business, the West has made HIV/ AIDS a business proposition

that developing countries have to accept. Even HIV/AIDS related research,

regardless of many and varied findings end up prescribing condoms and

medicines for STD. And cash strapped Third World government and public broad

casters are forced to massively fund campaigns for condom use. That the

campaign had to be taken off Indian television, in face of public protests,

meant that much more money down the drain. The only winners in this global

campaign have been condom manufacturers and advertisers.

All this is not to suggest that HIV/ AIDS is not a public health priority, but

on the contrary, to emphasize that it is not treated as such. Anti – AIDS

campaigns have been Hijacked to provide the stage or party setting for

glitterati who enjoy the hype and hysteria associated with the events. There is

supreme unconcern for the condition of affected four million.

For instance, AIDS treatment in the form of active retroviral therapy (ART)

offers no cure. This is been capitalized upon by the awareness prevention lobby

for grabbing a bigger share of funds, which curiously enough are not assigned

for basic remedial measures. It is conveniently forgotten that ART is necessary

for mitigating the condition of an affected person but unaffordable by the vast

majority.

Instead of seeing this reality the government and politicians are falling into

the awareness trap. The recent convention on AIDS at parliamentary forum

exposed that politicians, while eager to join the bandwagon, know little or

nothing about the issues at stake. In the circumstances, the government should

leave this business to those who have money to invest in it for their own

reasons and get on with other pressing priorities in governance and more serious

issues of public health.