The language of diplomacy and the AIDS epidemic

By Chris W. Green

JAKARTA (JP): Try to imagine a country in which one in three of the population aged 15 to 49 is doomed to die within the next ten years. Think of the effect on companies, schools, government, families, and of course, the children. How could they cope? Surely the world would not allow this to happen?

It is happening, right now, in Botswana, in sub-Saharan Africa. The reason is AIDS. Other countries in that region are not much better off -- one in five adults in South Africa is infected with HIV, the virus that causes AIDS. In the absence of treatment, this results in the death of most of those infected within ten years.

Yet we do have the means to treat AIDS, even if we cannot yet cure it. And despite the best efforts of some large pharmaceutical manufacturers, the cost of this treatment has dropped significantly over the last year, from around US$15,000 a year for each person to under $600.

Of course, for most of those in the developing world, $600 is no more easily affordable than $15,000. In much of the world, including Indonesia, less than $5 a year is spent on all elements of health care for each person. There is still a long way to go.

The world has finally woken up to the catastrophe that is AIDS. Next month, the United Nations General Assembly will convene a three-day special session specifically on AIDS. Over the last few months, in preparation for this, activists and bureaucrats have been busy attempting to draft a declaration of commitment that can satisfy their widely varying agendas; a task that is clearly impossible.

These agendas range from stressing the importance of investment in vaccine research, to the need for spending more on AIDS treatments, to ensuring that funds needed for prevention efforts are not diverted to these other activities.

But one comment, from an HIV-infected activist in Australia, stood out. The writer started by asking if there is a crisis -- because if so, the language of the draft does not reflect that. He urged the replacement of 'diplomatic' words like 'acknowledges', 'mindful that', and 'noting that' with words like 'terrified that', 'our moral obligation is', and 'on behalf of the millions of dead'. "Where are the words 'fear', 'pain', 'suffering', 'grief', 'anger', 'despair'?" he asks. "Also, the words 'irresponsibility', 'contempt', 'indifference', 'failure', and 'corruption', to honestly reflect a full picture of the key features of the response so far. This declaration needs to reflect the experience of the epidemic, not the meaningless neutral language of diplomacy."

Again and again, we find ourselves talking of numbers of cases, statistics, surveillance, forgetting that all of these reflect actual people who are living and dying with little hope or support. 'Government language', 'UN language', or even 'NGO language' often insulate us, and the community, from this reality.

There are topics that deserve straightforward talk. A disease that continues to kill so many people in the developing world must surely be one of those. To talk in a language that no one can understand is no better than silence -- the silence that is allowing so many to die.

This year, the 18th International AIDS Candlelight Memorial, to be held tonight (May 20) will also provide an opportunity to prepare ourselves for the UN Special Session.

In Indonesia, the group which coordinates the candlelight activities urges all those concerned with AIDS at a local level, government, legislature, non-governmental organizations (NGOs) and the community, to get to know each other, and to identify roles that each play. In this era of local autonomy, local groups have both the responsibility and the opportunity to take an active role in the response, in a way and a language that is appropriate to the local conditions and culture.

Discrimination has been a feature of the AIDS epidemic since it started 20 years back. Our responses must therefore be non- discriminative and inclusive, embracing those groups like sex workers, transvestites, gays and drug users who are at greatest risk. The language we use will determine whether they feel welcome and engaged, or excluded and ignored.

Could the epidemic in Indonesia reach the apocalyptic proportions of sub-Saharan Africa? The answer depends on us, on the response of all of us to what is already an increasing problem here. Let us all commit to this response in a simple language which all can understand, accepting that history will judge us harshly if we fail.