The World at Bangkok

Thai Activist Thaweewat Prongchit and Gus Nasmith

The world united in the struggle to confront HIV/AIDS converged on Bangkok for the XV International AIDS Conference, July 11-16. Record registration of 19,843 "delegates," underscored the global condition of HIV/AIDS and its spread. "Delegate" designation harkens back to the founding of the United Nations upon the devastation of World War II, when the US government was truly inspired in its leadership. I was proud to be delegate among my international fellows in Bangkok. I was not proud of the U.S. government.

American medical and scientific personnel, activists -- all those affected by and caring about HIV/AIDS have been cherished team members and often leaders in the ranks of those fighting the incredible human plague, a devastation beyond the 70 million thus far infected, the 30 million dead. Those 70 million affect the struggles to survive of so many hundreds of millions more.

As a person living with HIV/AIDS, my first international conference was 1992 in Amsterdam, when Harvard University had to host it from the Netherlands, since the first Bush government would not allow infected participants entry. But at least then our key government researchers, among the 3,000 Americans attending the conference, were in presence as warranted. (And candidate Clinton included a platform that recognized AIDS in the frankness and commitment that was needed.)

Before the 2004 Bangkok conference, the Bush Administration limited participation of medical researchers from the National Institutes of Health (NIH) and the Center for Disease Control (CDC) to 50 (236 attended the XIV conference two years ago in Barcelona). Supposedly they explained that the travel money would be better spent on research, but this decision was not made by the operations analysts so capable in the institutions concerned. (How does one conceive and guide international research -- from isolation in Bethesda and Atlanta?) These days government employed Americans are rarely regarded as important caring and contributing participants in international meetings, but in the AIDS world they are highly respected. A leading European from the International AIDS Society under whose aegis the conferences fall, usually so diplomatic and respectful to the and grudge-holding Bush government, publicly responded to a reporter's question about the limitation of the NIH and CDC as "shameful." He added that the Americans forbidden participation by their own government would be sorely missed by their interational colleagues.

Over in the massive Bangkok conference exhibit hall, obviously no expense was spared on the U.S. government pavilion touting the supposed magnificence and munificence of the "President's Emergency Program for AIDS Relief" (PEPFAR) -- bilateral dealings with 15 Bush government selected countries in Africa, the Caribbean and, now, Vietnam. Uganda is to be such a recipient. My infected women leader friends from there found it horrifying that their president, Museveni, in many ways the first and foremost African political leader to meet the AIDS challenge, spoke distancing himself from the importance of condoms. Bushlite alliance and actions with infectious implications.

While the epidemic rages in all of Asia, and the tardy Indian and Chinese governments are finally asking for help. But of all Asia, "PEPFAR" chooses Vietnam for its one partner there. The truth is that HIV/AIDS is global, and contributions are best made to the Global Fund for AIDS, Tuberculosis and Malaria (Global Fund), UN agencies and non-biased international non-governmental organizations such as Doctors without Borders, CARE, etc.

At the opening ceremony, Thai and international activists staged a well-organized, principled and peaceful march to the entrance of the mammoth "Impact" conference center outside central Bangkok. Articulate, energetic regardless of their health or limited means, they expressed their demands for equity in the global struggle, realization of the plight of marginalized groups in all societies, and how their infection with HIV is the sparrow in the mineshaft of all societies. There was directed attention to the plight of Thai drug users and the murderous police and misdirected public health policies affecting them.

Joep Lange, president of the International AIDS Society; Peter Piot, Director of the UNAIDS program and others came to receive letters from the protestors and to interact with their leaders. It was announced that Randall Tobias, President Bush's Global AIDS Coorindator, had been invited. He refused to show his face, missing an opportunity to relate, choosing instead to distance himself from the realities of the epidemic.

Days later, watching Tobias give a speech of arrogant American separatism, and Reagan-Bush like vignettes of sympathy with individual AIDS "sufferers," I was ashamed and even sorry for the man whose face, contorted in anger, was projected on the huge screen in the arena. More than just discomforted by the ACT-UP protests (relatively small and certainly not threatening) against him, he seemed so walled off from all the human beings around him -- those who shared the stage with and spoke eloquently and warmly of his right to speak, and those of us in the audience, living the world of AIDS far more than his ambassador tourism to photo-ops at the bedsides of the ill and orphaned. Tobias claimed that the United States does more than anyone financially (which is not true either on a per capita basis, or with relation to the European Union as a comparable entity). To their credit, many of the committed civil servants in the U.S. -- NIH, CDC and Agency for International Development (AID) -- have been able to overcome bureaucratic and political hurdles and still provide programs meaningful to fight the epidemic and complement other international efforts.

Everyone from UN Secretary General Kofi Annan, Nelson Mandela and grassroots activities from developing and developed world find the Global Fund the entity most worthy and needing of additional support. Tobias intoned that the Global Fund has not proven itself, and therefore didn't yet merit the additional funds from the U.S. that so many have urged. (Howard Dean pledged significant increase in his campaign, and John Kerry does so in his.) One wonders that still living with the destruction of recently going it alone in Iraq outside the UN systems (which we created), that we plow new ground to go it alone in the midst of global mass destruction that is hidden only to those who close their eyes.

The past two years and this conference itself brought no astounding medical breakthroughs in HIV/AIDS. But the body of knowledge built up over the years, and the linkage of care to prevention form bases to halt the progress of AIDS. Fullsome attention to funding, education, drug supply, training of needed health care workers -- these are full agendas that if properly implemented will reduce infections and improve quality of lives for those infected. We must keep the pressure and the creative means to lower prices and insure accessibiliy for all who need drugs. Providing economic empowerment, policy and legal protections, rationale religious and embracing involvement, the health to all in removing any stigmas, including those of gender and sexuality. ... Keeping our eyes on the ball is what is most essential. There is so much to be done, and no need to wait for a sound-bite.

Instead, lack of political, religious and cultural leadership allows social discrimination, abuse of women, acceptance by the elites of mass conditions of poverty to fuel the HIV epidemic. South Africa's Nelson Mandela, his wife Graca Machel (the former first lady of Mozambique) and India's Sonja Gandhi brought their presence and eloquent commitment to the conference. But in an agenda that made "leadership" a special focus, the absence of many other world leaders, especially with the vacuum created by the U.S., and the terrible spread of AIDS in Asia and the former Soviet Union, is an indictment. (Randall Tobias touted Tommy Thompson, U.S. Secretary of Health and Human Services, as chairman of the Global Fund. Thompson was no where to be seen.)

In such a context, I wonder if my own outrage and shame at the American government reflects in itself how self-centered Americans can be. But, I was raised on school civics of the universal ideals of the Declaration of Indpendence, the Constitution and the Bill of Rights, and that our work on their fulfillment was part of a great awareness of the rights of all human beings. We used to be a beacon to the world, never having to scream such debasing chants as "We're number one!" plow our way without seeing others.

Too rich (materially), too powerful, we have veered off course, with terrible repercussions for others. Like a Greek chorus of antiquity, those in the U.S. who have some common sense and clarity, and those at the conference in Bangkok who have followed the path of HIV for 20 years see the lies and that the emperor has no clothes. "Shame, shame. Liar, liar. ..."

What are we afraid of? Do the Bush Administration members, and fundamentalist ideologues, believe that they and their children breathe a different air? The abstinence that speaks reality is to refuse to give them our power. Our own American AIDS champion of human rights, the late Jonathan Mann said it years ago: "To be connected is to choose life. Everyone knows this: the rich know that their separation from others is life-denying regardless of their enjoyment of rich pleasures. ..."

Thai participants and 2,000 volunteers at the conference, no matter how materially poor, or "marginalized" their social status might be considered, brought smiles and humor in their welcomes to us and to each other. Their spirit was mirrored by a small group of American Peace Corps volunteers who had come from their various villages in Thailand to join and help. They were a reminder of what a gift and relief it will be for Americans to be again led by a government that is not afraid of "the other" but knows that we are truly part of the human family. Our separation, our fear and the arrogance and selfishness that have gone with it are harmful to us all -- not only for the consequences to our fabric but to realizing our spiritual potential.

Augustus "Gus" Nasmith, Jr. attended the XV International AIDS Conference in Bangkok, Thailand (July 11 - 16, 2004) participating for AIDS, Medicine & Miracles; the Vermont People with AIDS Coalition; Vermont CARES. These comments are his own and speak for no organization.

Back to the Summer 2004 issue of Positives for Positives.