terça-feira, novembro 30, 2004
No Easy Walk in Bush Land
Mail&Guardian (South Africa)
November 26 to December 2 2004
World Aids Day
I have been an Aids activist since 1990. In the United States, activists in the 1980s and 1990s wrested a response to the epidemic from an unwilling public and government who were all too willing to watch gay men, drug users and the urban poor die horrendous deaths.
We spent more than a decade fashioning legislation that would protect our rights, give us the care we deserved and pave the way for research advances that would fundamentally shift the nature of the epidemic. We didn't achieve everything we had hoped for, but the Aids activist movement saved many from losing their jobs or their homes because they were HIV-positive. It prevented thousands of HIV infections through the distribution of clean syringes and condoms. And when the drugs arrived that were finally able to treat HIV infection, it ensured that most Americans could have access to drugs they could not otherwise afford. It's a proud and valiant legacy.
I have watched in horror over the past four years as President George W Bush has begun to destroy what we fought for for two decades, and to export the worst of a new Aids policy based on religious dogma and corporate greed. The president and his fellow crusaders have questioned the effectiveness of condoms, intimidated groups that talk about safe sex and drug use, pushed funding for programmes that take an abstinenceonly approach to HIV prevention, twisted science to support their claims and denigrated researchers who disagree with them.
The American republic was founded on a separation of church and state that the Bush administration would like to reverse. It's no coincidence that the Vatican, the conservative Islamic states and the US all blocked a motion to endorse the rights of gay, lesbian, bisexual and transgendered people at the United Nations General Assembly Special Session on HIV/Aids in 2001. I loathe the theocracies in Rome and Tehran, but the emerging god-state in Washington, DC, is only different from them in degree.
While conservative religious social mores have driven HIV prevention policy and approaches to the human rights of people with HIV/Aids and those at risk, a rapacious, robberbaron economics has guided much else in the president's Aids policy.
Thousands of Americans with HIV/Aids depend on Medicaid and Medicare, the public healthcare programmes for the poor, disabled or elderly that were put in place in the 1960s. A special program, the Ryan White Comprehensive Aids Resources Emergency Act, underwrites most of the other state-funded care and support for people with HIV/Aids.
The president belongs to a faction of the Republican Party that believes in supply side economics: tax cuts for the rich will spur investment and growth, with the initial benefits eventually trickling down to the masses below. Bush is also in thrall to those in his party who would like to shrink the federal government until, as one prominent conservative has said, "it is small enough to drown in the bathtub".
For the president and his cronies, the federal government has little purpose but to ensure the defence of the country - everything else it has taken on in 228 years is an encroachment on individualism and selfreliance.
Thus the tax cuts pushed by the president have a double purpose - to stoke the fires of the American economy by shovelling back money to the nation's richest, and to "starve the beast" as New York Times columnist Paul Krugman has called it: drain the federal coffers of revenue until the abominable social programmes put in place since the Great Depression collapse for lack of funding.
All well and good if you're rich, can afford private health insurance, and live in a gated community in Cobb County, Georgia, but if you're a poor, black woman with Aids a few hours away in a small town, this is tantamount to a death sentence.
I have been told on several occasions by Anthony Fauci, the US's top Aids scientist, and his protégé Mark Dybul, who is the chief medical officer for The president's Emergency Plan for Aids Relief (Pepfar), that I should be grateful for the president's generous Aids treatment and prevention plan for Africa, the Caribbean and now one or two countries in Asia.
What is so wrong with Pepfar? Is it the promotion of abstinence-only prevention programmes, or restrictions on critical work with commercial sex workers and drug users? Is it the promotion of brand-name, USmade anti-retroviral drugs rather than equivalent generics that cost half the price or less?
These undermine what I believe was initially a humanitarian impulse from somewhere in the administration, but quickly became a vehicle for promoting religious ideology and protectionist policies on essential medicines.
What makes the situation even more horrible is that the Bush administration is undermining the efforts of the World Health Organisation and the Global Fund to Fight Aids, Tuberculosis and Malaria by undercutting or under-funding their work.
So many countries in Africa, Asia, Latin America, the Caribbean and the former Soviet Union are dying of Aids, with millions going to their early and needless deaths unless their governments and my government change course in the fight against this disease.
I fear under Bush, for these next four years, people with HIV/Aids and the poor and the powerless in the US will also be at mortal risk.
But the US faces another sort of death: the demise of a spirit of generosity and openness that defines my country at its best.
But as Nelson Mandela has said, there is no easy walk to freedom.
We will get through this period of darkness and national shame and rise up to seek justice another day.
Gregg Gonsalves is from New York City, where he is the director of Treatment and Prevention Advocacy at Gay Men's Health Crisis, the world's oldest Aids organisation founded in 1981. He is HIV-positive.