Book review: AIDS: Don’t Die of Prejudice

Worldwide, 35 million people are living with HIV. Of these, 18 million don’t know they are infected. Every year there are 2.5 million new infections and 1.5 million deaths.

Aids: Don't Die of Prejudice

AIDS: DON’T DIE OF PREJUDICE

by Norman Fowler

Biteback, 304pp, £14.99

Since the beginning of the HIV pandemic in 1981, 36 million people have died of the disease.

This is a human tragedy more deadly than either of the two catastrophic world wars. Like war, HIV has cut down mostly young, productive people in the prime of their lives; creating vast personal, social and economic loss – particularly in developing countries where health care and education resources are limited.

In this powerful book Aids: Don’t Die of Prejudice, Norman Fowler, a Secretary of State for Health in the 1980s under Margaret­ Thatcher, argues that the biggest ­obstacle to tackling HIV is prejudice. He blames stigma around the disease and the particular stigma­tisation of sex workers, intravenous drug users and lesbian, gay, bisexual and transgender (LGBT) people – all of whom are criminalised by many, if not most, countries.

His testimony begins with Britain in 1986, making no mention of the previous three wasted years, during which the government failed to protect the blood supply and provided little or no funding for the pioneering HIV prevention and support organisation, the Terrence Higgins Trust. He picks up the story as he planned the government’s first ad campaign to warn the public about the ­danger of HIV. He had, he says, to man­oeuvre to circumvent Thatcher’s ­attempts to water it down .

With the support of Willie White­law, he adopted an evidence-based approach, citing the example of successful anti-VD campaigns during the two world wars to show why a combination of shocking facts and condom provision was necessary and effective. Sadly, his book reveals that many governments are still driven by ­prejudice, moralising and repression. A homophobic backlash in parts of Africa and the ex-Soviet bloc countries is denying gay men HIV prevention information and deterring them from coming forward for testing and treatment. In Russia, the government’s harsh anti-drugs policies are having a similar disastrous impact. India’s caste system and the marginalisation of transgender people exacerbates the spread of HIV. Condom provision for sex workers and harm reduction programmes are losing funding in the US.

Fowler concludes with a call to global action: including more funding for prevention programmes (the UK spent less than £5 million in 2011) and for testing, early treatment, needle exchanges and vaccine research; plus the decriminalisation of sex work and improved sex and relationship education to encourage wise, responsible sexual behaviour.

All very good proposals. Are you listening, David Cameron?