By Kelly Jean Cogswell
The 4th Francophone Conference on HIV/AIDS met last week in Paris. Political questions were handled with kid gloves, if at all, and everything from ethics in drug trials to HIV permutations was stuffed so elegantly into PowerPoint presentations that the mammoth obstacles of governments and history and biology seemed like mere pebbles in our path.
Still, the reality of AIDS intruded occasionally, like when you saw delegates choking down handfuls of pills, or ACT-UP Paris zapped the Abbott pharmaceutical company.
A Taste of Their Own Medicine
To get to the conference rooms two levels down at the Cité des Science et de l'Industrie, you had to pass warrens of stands from the big Pharma companies that make AIDS drugs and machines that count T-cells.
If you were anywhere near the Abbott booth on Friday, you got to see AIDS activists pour fake blood on the displays of glossy brochures where everybody taking Abbott drugs was happy. And they probably were, since a lot of people can't get their hands on the stuff -- especially in Thailand.
Vengeful after Thailand's decision to manufacture generic varieties of some of their drugs under a WTO agreement for health emergencies, Abbott has declared an "embargo" against them. None of their drugs for that country.
Forget about selling them the new second-line ARV cocktail, Kaletra, which is hugely important because there's no need for refrigeration, a groundbreaking advance for tropical countries where many don't have their own refrigerators.
To protest, activists painted bloody handprints everywhere, and shouted, "Ten thousand deaths a day aren't enough for Abbott," and "Kaletra: it's an emergency."
Forging Alliances
ACT-UP Paris organized the demo at the stand, but they were joined by dozens of African AIDS activists who tend to take actions like Abbott's very personally.
Most of them are HIV-positive, if not actually living with AIDS. In an earlier action in the morning, when a dozen members of ACT-UP interrupted an Abbott symposium to unfurl a banner reading "AIDS = DEATH UNDER COPYRIGHT" and ask for signatures demanding Abbott end the embargo, African activists were the first to get involved.
They walked out of the symposium en masse, and Jeanne Gapiya, founder of the AIDS organization ANSS in Burundi, helped pass out flyers. "It was an act of solidarity and revolt because it's the first time that we've seen a pharmaceutical company take such punitive measures against a country that was acting within the bounds of international law."
She takes Kaletra herself and said she couldn't live with herself if she just stood silently by. "I put myself in the shoes of Thai people, and wonder how they'll survive," she said.
Besides, as one man shouted, "Our countries are next - Solidarité!"
Khalil Elouardighi, a spokesman for ACT-UP, added that Abbott's hard-line stance on Thailand may well be a trial balloon for tactics on restricting access to other developing countries. "They increase their profit, while actually lowering the number of people treated."
Fighting For Ethical Drug Trials
The irony is that in the last few years, Africa and Southeast Asia have been overrun with researchers doing their drug trials on the "virgin bodies" that have never touched an aspirin, much less an antibiotic.
They test their experimental formulas, and then market the new-found drugs at hefty prices their guinea pigs could never afford.
And while big Pharma weeps over the erosion of intellectual property, not to mention profits, community activists struggle to hold researchers to the same basic ethical standards they'd use among gay men in San Francisco, for instance.
"Just because there are economic and cultural differences doesn't mean you have license to change the protocol," said Jean-Marie Talom of REDS Cameroon at a workshop on Ethics and Research. It was his critique of the Tenofovir research trial in Cameroon that ultimately led to its cancellation.
A kind of oral vaccine against HIV, researchers gave Tenofovir or a placebo to a test group of prostitutes, promising they were safe if they took it daily, and skipping the part of the protocol that said they had to tell the women about safe sex. So what if they got HIV and died? It's all grist for the statistic mill.
In fact the drug does seem to work, and Talom would have preferred that the study continue, only live up to its obligations.
It shouldn't be an either/or situation with drug trials, where activists either have to let studies continue unchallenged, or shut them down completely. There's a third way, he asserted. "Ideally, questionable studies could be halted temporarily until satisfactory changes are made, then continued."
Stopping them entirely is the worst outcome of all. "There's no progress without research. What we need is to have researchers and drug companies and activists and governments working together to move forward."
Crossing Borders
Unfortunately, transparency and good will is in short supply. In a later conversation, Talom admitted that he'd known some of the Tenofovir researchers for years. "We were practically like brothers, but when I started calling them for information on the study," he shook his head, "Nothing."
He finally asked activists in Paris to get involved, and it was only their connections that uncovered the paper trail of abuses. He was stonewalled again when he confronted the researchers and politicians to demand the study conform to its own protocol and inform the women about safe sex.
But again, nothing was done until activists in Paris zapped the Cameroon embassy and got a TV station to pick up the issue. Then the whole thing became a circus and the study was shut down.
Getting outsiders involved is a tricky issue. During the ethics workshop, activist Christine Kafando from Burkina Faso, chastised him, declaring, "Just because people are illiterate, doesn't mean they're beasts. We have ears, and they're open now. It's we that have to organize. We that have to learn. We that have to demand!"
That's true, kind of, but it doesn't take into account how many activists are hogtied by unresponsive, undemocratic governments, and the failure of the rule of law. Jeanne Gapiya of Borundi has been threatened with arrest so often it's almost, but not quite, a joke in her family.
When push comes to shove, activists do what they must to get the information out and protect people, even if it means asking for help from outside. Which is why African activists were there to participate as ACT-UP Paris left bloody handprints on walls of the Abbott booth, chanting, "It's an emergency."
So is the situation of gay men.
The Incredible Invisible Queers
Instead of emphasizing that HIV is an equal opportunity virus, all the new blah, blah, blah about how the face of AIDS has changed, and it is now a disease of straight people, has somehow managed to erase African and Asian queers.
At the conference, homos were sometimes included in laundry lists of "vulnerable populations" along with children, prostitutes, prisoners, and illegal immigrants, but often not. When a speaker finally focused on homo-transmission, it was in the context of France, Brazil and Holland.
Apparently, there are no queers in Afrique.
So much for the benefits of having gay men in positions of power in the AIDS hierarchies. By and large, they've kept their lips zipped on the subject of African homophobia, if they noticed at all.
Like with Bush and his quick jettisoning of women's issues when he has to negotiate with mullahs, I suspect professional fags have left us behind on purpose as they negotiate AIDS programs with homophobic health ministers.
While we were eating canapés and drinking champagne from one of the Pharma booths, prior to zapping Abbott, Olivier Jablonski, one of the few French queers actively fighting for gay Africans, got a text message that cops were rounding up queers in Senegal and a lot of people were trying to hide out on the beach.
How many of these guys do you think get tested, much less treated for HIV?
Already in Africa, straight men are afraid of the health system and the stigma of AIDS. I can't imagine the courage it takes to show your face at a clinic when you're a big fag in a country where homophobia can land you in jail, or dead in a muddy ditch along the side of the road.
Confidential testing is mostly imaginary. The best they can do is find a place far from their home communities, tell lies about hiding the test from the wife back home, and hope and pray none of their neighbors has the same idea.
For gay men in Africa, fighting homophobia = fighting AIDS.
Groups like ACT-UP Paris seem to have lost the connection when they scoot past national boundaries. They believe all forms of discrimination are related, and do fight homophobia, and sexism, et al, but all the gay stuff stays at home as if there were no queers south of Gibraltar, and the phantom African fag couldn't catch AIDS.
Larry Kramer is right. We need a queer army that goes everywhere. If the homophobes don't get the fags in Senegal, AIDS will. We should do something. C'mon, put on your pink triangles and pink Timberlands. Let's hijack a few tanks and march. Solidarité!
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