The Blog

HIV in David Cameron's Britain - ACT UP Comes Home to Roost

As the epidemic continues to rage today, we need ACT UP's inspiring message more than ever. I am endlessly amazed by the difference between the public and the private face of HIV in the UK; between the shiny NGO propaganda and the hard reality on the ground; between the grandiose intentions of HIV policy-makers and what is happening in practice.

The UK launch of 'How To Survive A Plague' was spellbinding. It celebrated one of the most powerful grassroots movements of the modern age. The AIDS Coalition to Unleash Power (ACT UP) placed HIV / AIDS on the political agenda and married strategic thinking with creative activism.

As the epidemic continues to rage today, we need ACT UP's inspiring message more than ever. I am endlessly amazed by the difference between the public and the private face of HIV in the UK; between the shiny NGO propaganda and the hard reality on the ground; between the grandiose intentions of HIV policy-makers and what is happening in practice.

Paul Crook, an epidemiologist from the Health Protection England has said "The HIV epidemic in London continues to present a major public health problem." The number of people in London diagnosed with HIV acquired in the UK has increased from 660 in 2001 to 1,480 in 2010, according to HPA. Approximately one in every 200 Londoners aged between 15 and 59 lives with HIV - a rate three times higher than any other region in England.

So last week, ACT UP had their inaugural meeting to put HIV back up the political agenda. Looking through the archives of ACT UP actions across the world, we weren't short of ideas. From ACT UP Paris's action of putting a giant condom on the obelisk, spraying fake blood on politicians' surgeries with giant super soakers through to occupying profit-making pharmaceutical companies HQ's, the room was brimming with ideas and people ready for action.

The austerity policies of the current Government are making a bleak situation even more grim. Government figures show that a shocking 44% of people with HIV who have completed a "Work Capability Assessment" have had their support cut off and charities warn that this is causing destitution. These severe policies to reduce budget deficits during these adverse economic conditions include spending cuts and tax increases for the poor.

Yet today, the UK remains the seventh richest country on the planet yet the most unequal in the industrialised world.To illustrate, "Rising unemployment and the recession have been the price that we have had to pay to get inflation down. That price is well worth paying", said Norman Lamont, ex-Chancellor of the Exchequer. But who was paying this price? Certainly not the Chancellor's friends. The Archbishop of Canterbury recently dismissed David Cameron's 'Big Society' austerity policies as 'aspirational waffle' and a ploy to conceal 'a deeply damaging withdrawal of the state from its responsibilities to the most vulnerable'.

The Education Minister Michael Gove is continuing to cut the capacity of HIV Education and Prevention services by almost half in some parts of the UK. Young people are growing up without decent sexual health education and little knowledge of the consequences of HIV infection. To make matters worse, without comprehensive and holistic support for those affected by HIV, the lifelong costs will drain more and more National Health Service (NHS) resources, as subsequent illnesses rear their head. Alcoholism, drug abuse, depression, suicide, and other manifestations of a severe lack of self-love, are all interwoven in living with the precarity of HIV. Indeed, according to a third of specialist HIV doctors questioned by the British HIV Association (BHIVA), the NHS is already providing poorer care for people with HIV since the implementation of the Health and Social Care Act.

In his ground breaking book 'The Spirit Level', Pickett and Wilkinson pleads systems of governance to comprehend that, "life-diminishing results of valuing growth above equality in rich societies can be seen all around us...removal of economic impediments to feeling valued ... will allow a flourishing of human potential."

Back in the world of large HIV lobby groups, cars get sleeker and the offices even slicker. Cut-throat tactics and hostile takeovers of other HIV groups are not only enabled but lauded as model conduct. These are NGO's who refuse to discuss the wider political picture when lobbying government ministers. The result is the gulf widens between the UN's admirable dreams to'build an HIV/AIDS free generation' and national policy where HIV is seen as a 'soft target' as thousands of people have their benefits removed.

The real tragedy remains that as the HIV community is increasingly excluded from society, we often internalise the blame and guilt. Many of us begin to believe we are simply not good enough to exist. How is this loss to societal welfare measured in this world of economic statistics and indicators? Can we put a price tag on the increasing number of HIV/ AIDS suicide's? What's the economic cost of loneliness? Surely the thousands whom are depressed and alone in their beds at night could be more economically valuable? The list goes on. You can't quantify human tragedy. Scarcity-based economics does not account for qualitative value so everything, every feeling, every experience and every relationship must be quantified and sold to the highest bidder.

As the cuts rise and the wealth of books devoted to 'equality' stack up, we must explore the chains of power which are at the root of the problem. If we are to stop the 'Second HIV/ AIDS's Silence' we must look at the interplay between the powerful and powerless that is playing out in our lives. We must understand how decisions are made - why banks are bailed out for billions whilst life-saving HIV services are cut. This enables a clearer understanding of who people can rely upon for support - the people in power or those on the ground around them. This critical consciousness helps separate the false hopes of grandiose policies, such as the punishingly unreachable 2012 UNAIDS goal, from the change that we need to make within our communities.

We must not be loyal to our suffering and perpetuate a defeatist 'victim mentality'. Understanding the dominant values, beliefs and myths of our society involves critical questioning. What blocks the people's will to act for or against something?

The movement that the 'How To Survive A Plague'film documents answers this. It's release has given us renewed energy for this fight. We are dusting off the ACT UP Suggestions for Direct Action. In this wave of renewed HIV / AIDS activism, the reciprocal relationships built between compassionate doctors and the activists on the ground will prove vital. Doctors, nurses and many others witnessing the destruction of the NHS around them have come to the meetings eager to right the world that is crumbling around them. The sharing of knowledge between professionals and those oppressed by a system that protects the 1% breaks down the isolation and hegemonic gridlock behind the marginalisation of the HIV community. It provides us with an opportunity to paint a picture of what life looks like from the point of view of the dominated instead of from that of the dominator.

The Aids Coalition to Unleash Power (ACT UP) have now built a transatlantic movement in the 21st century to put HIV / AIDS back up the political agenda as the epidemic continues to rage in the US aswell. It's a battle too risky to leave solely to the United Nations admirable dream of 'an end to HIV / AIDS in our lifetime'.

Without vision we shall all perish: Proverb 29:18