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GAY PEOPLE'S CHRONICLE November 26, 2004

621-AIDS

TASKFORCE

EXPRESS YOURSELF. PROTECT YOURSELF.

SEX LIKE ART IS NOT ALWAYS SAFE. For information on testing, safer sex materials and programs, call 216-621-AIDS. This is a confidential call.

AIDS

FUNDING COLLABORATIVE

A funding partnership of United Way Services, The Cleveland Foundation, The City of Cleveland, Cuyahoga County Board of Commissioners, Mt. Sinai Health Care Foundation and Saint Luke's Foundation of Cleveland, Ohio.

We're a proud partner in the fight against AIDS in northeast Ohio

For more information regarding the AIDS Funding Collaborative, please call Sondra McCurry at 216/436-2233 or Stacey Easterling at 216/615-7259.

Political will is the largest factor in world AIDS care

Moving Mountains

The Race to Treat Global AIDS by Anne-Christine D'Adesky Verso Books, $30 hardcover

Reviewed by Earl Pike

In George Orwell's Animal Farm, an initially democratic vision-"All Animals are Equal" morphs, in time, into something more regulatory and sinister: "But Some are More Equal Than Others."

Both versions find voice in the current global debates about providing care and treatment to the world's 46 million people with HIV and AIDS, a context in which, on the ground, some are more equal than others: Them with the money sets the rules. "Their" motives are more often political than charitable, argues Anne-Christine D'Adesky in her new book, Moving Mountains: The Race to Treat Global AIDS. As a result, on every point, in every region, disaster looms.

D'Adesky is no stranger to the subject, having written extensively about AIDS, women's issues, gay politics, and health care for a halfdozen newspapers and magazines. In Moving Mountains, she examines the crisis of AIDS and the staggering challenge of providing ef-

planet, the U.N.'s scattered and balkanized funding of treatment initiatives-all have fatal flaws and will not amount to much, until political agendas are removed from the equation.

The pharmaceutical companies, she argues further, must stop trying to derail attempts in India, Brazil, Kenya, and elsewhere to develop local, generic versions of antiretroviral medications, because at U.S. prices, no one can afford them-less than 2% of the world's people living with HIV/AIDS have access to antiretrovirals.

Local and international bodies must firmly place a collaborative response to AIDS in the context of human rights, including the rights of GLBT persons, women, and those struggling with addiction.

MOVING MOUNTAINS Clobal Apps

ANKE CHRISTINE DADESKY

fective treatment in just about every corner of the world, with specific chapters focusing on Brazil, India, Cuba, Haiti, Mexico, Uganda, Morocco, South Africa, and Russia.

In each country she asks similar questions: Who is getting infected? Who is paying attention? How is care being provided? What is the role of the national government, international aid organizations, the U.S., the pharmaceutical companies? What is each country's attitude toward, and policy governing the lives of, the marginalized communities most disproportionately affected by AIDS: women, injection drug users, sex workers, gay and bisexual men, the poor?

Perhaps most importantly, this single question, woven throughout: is there a way to fix the crisis?

A recitation of the scope of the problem is familiar territory to most, and in the end, only further numbs: Pick a country or a region and put the number of current or potential infections on one hand, and the available resources on the other. They are so wildly imbalanced that without fundamental shifts in policy, AIDS will kill tens of millions, and quite probably hundreds of millions, before it's all over. Which makes D'Adesky's final question all the more urgent: What can be done?

The initial answers are the obvious ones. The U.S., D'Adesky says repeatedly, and with ample documentary support, should stop treating AIDS as a geopolitical crisis, and instead treat it as a crisis of science and the human will.

President Bush's mobilization of funds for Africa, the World Bank's projects across the

All of us must insist on two fundamental principles: First, that the West, and most especially the United States, has an enduring moral obligation to help those who cannot afford access to basic, reasonable medical care. Second, that we must all resist specious arguments that the main challenges in providing treatment to the poor of the world are local customs and inadequate infrastructures.

The problem is political will. As D'Adesky points

out, the threat of anthrax exposure terrified many Americans after the September 11 attacks, and in response, the Bush administration decided that the national emergency required extraordinary measures. It demanded access to low-cost Cipro, made by Bayer Pharmaceuticals. When Bayer did not respond immediately, the Bush administration threatened to import generic ciprofloxin from Canada and India.

We could do the same thing with AIDS medications, both for U.S. consumers and for people around the world, but have not. The irony is painful: There are now 19 states in the U.S. where people with AIDS are on waiting lists to receive medications. Across the rest of the world, the waiting lists were never even created in the first place. Forty-six million people must surely qualify as an emergency.

To return to Orwell's animal dictatorship: One of their original Seven Commandments in Animal Farm was formed in reaction to the observation that while humans lived in comparative luxury, the animals of the farm lived in muddy sties and pens. Hence the rule: "No animal shall sleep in a bed."

But we all know the story. A privileged class emerges, and to them, the comfort of mattresses and cotton pillows is entirely too tempting, never mind what discomforts the other subject creatures must still endure. The rule is changed: “No animal shall sleep in a bed with sheets." Them that has, gets, conducts the obligatory moral parsing, and determines who else gets: beds, medications, clean water, life. Baa, baa; oink, oink, they say.

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