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Review: Politics of Representing AIDS

Author(s): Vinay Lal


Reviewed work(s):
AIDS, Africa and Racism by Richard Chirimuuta ; Rosalind Chirimuuta
Source: Economic and Political Weekly, Vol. 26, No. 47 (Nov. 23, 1991), pp. 2687-2688
Published by: Economic and Political Weekly
Stable URL: http://www.jstor.org/stable/4398335
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REVIEWS
Polities of Representing AIDS
Vinay Lal
AIDS, Africa and Racism by Richard and Rosalind Chirimuuta, Free
Association Books, London, 1989; revised edition, paperback, pp 192, price
not stated.
THE president of Uganda has recently, ac-
cording to an article in the New York Times
on January 30, 1991, "reversed a long-held
position" by urging Ugandans to use con-
doms. This change of heart apparently came
about when the president was shown a com-
puterised slide presentation with mathe-
matical models which projected a loss of
population of 12 million people in Uganda
by the year 2015, from 32 million to 20
million, on account of deaths from AIDS.
Another chilling statistic that was high-
'ighted is that an estimated five to six million
Ugandan children are expected to be or-
phans by 2010 because their parents would
have succumbed to AIDS. The president was
advised that though Uganda had devised
and implemented several programmes to dis-
seminate information about AIDS, the sex-
ual practices of his countrymen and women
had seen little change, and in particular con-
doms, the most effective prophylactic in
reducing the risk of being infected through
sexual intercourse by HIV, the virus that is
said to lead to AIDS, were seldom used. In
the five yearm since the
pyblic
first became
awaroof AIDS, a mere 10 million condoms
are expected to have been sold in a country
with a population that now stands at 16
million.
This is not the first time, however, that we
are hearing of a massive AIDS epidemic in
an African country. What is being said of
Uganda has also been claimed for other
African nations, particularly in the sub-
Saharan region. Richard and Rosalind
Chirimuuta, in their persuasive and
thorough study of the politics of AIDS,
point out that both the media and the scien-
tifi'c establishment of the west have been
inundating the world with stories about
'millions' of Africans falling to AIDS. For
example, one reporter for The Times
(London), in the first of a three-part series
entitled 'Africa's New Agony' that appeared
between October 27 and 29, 1986, wrote that
"a catastrophic epidemic of AIDS is sweep-
ing across Africa, scarring the face of the
continent and killing thousands of men,
women and children'. But how could
'thousands' be enough to convey a sense of
the 'horrific picture' before mankind, offer-
ing "harsh truths and inescapable lessons for
the rest of te world"? Appropriately, the
second paragraph stated that "the disease
has already infected several millions of
Africans from the Atlantic coast to the
Indian Ocean, posing colossal public health
problems to more than 20 countries. Within
the next few years, hundreds of thousands
Ere doomed to die. . ." Similarly the Panos
Institute, one of the many pompous think
tanks' on third world development issues
with which the affluent west proliferates, in
its inaugural publication entitled AIDS and
the Third World, published in late 1986,
asserted that though America could expect
to have 1,45,000 people dead from AIDS by
1991, African countries like Tanzania, Rwan-
da, Kenya, Uganda, and Zaire would have
to contemplate "a crisis which is 20 to 50
times worse". We should haye had many
millions of Africans dead from AIDS by
now, and if the ominous prophecies of the
early- and mid-1980s have so far not come
true, many western commentators would
have us believe that a catastrophe is just
around the corner.
What is all the more remarkable, as the
Chirimdutas point out, is that even in
October 1988, the latest period for which
they cite data related to AIDS, the United
States accounted for 70 per cent of deaths
from AIDS world-wide. The Weekly
Epidemiological Record of the World Health
Organisation (WHO) for November 4, 1988
showed that African countries had reported
nearly 20,000 cases of AIDS, western Euro-
pean countries a little over 15,000 cases, and
the United States 76,670 cases. Nonetheless,
from the early 1980s to the end of the
decade, the west was shamelessly orchest-
rating a campaign that would link AIDS
specifically to Africa. The Chirimuutas
make the pregnant, not to say chilling, obser-
vation that "if Africans are supposedly dy-
ing by the millions, then it becomes political-
ly acceptable to use them as a vast human
laboratory for testing an AIDS vaccine"
(p 140). The life of a white man or woman,
even one dying of AIDS, is construed by the
west as far too precious to throw away on
a risky enterprise, but can the death of a few
Africans matter when 'millions are d) ing of
hunger, malnutrition, civil wars, and the
machinations of tin-pot dictators? And must
not some Africans willingly become cannon-
fodder when the development of a vaccine
might save them from decimation, from the
holocaust wrought by AIDS? Lest the sug-
gestion made by the authors sound prepos-
terous, it is well to keep in mind that early
in this century several hundred black
Americans afflicted with syphilis were
treated with only placebos as part of a
massive study conducted over a decade by
American scientists to assess how syphilis
ran its 'natural' course in human beings. The
unfortunate victims of this study, when they
did not die over the period of observation,
were rendered insane or blind.
Throughout their study, the Chirimuutas
place a considerable reliance on statistics and
studies generated by WHO. Medical resear-
chers and scientists in the west have not only
paid scant attention to WHO's findings, but
some have even sought to implicate WHO
in giving birth to AIDS. The theory that the
live vaccines used by WHO to inoculate
everyone against smallpox released a dor-
mant virus is rightly dismissed by the
Chirimuutas, although one of the leading
American AI DS researchers, Robert C
Gallo, whose conduct in falsely claiming to
have isolated the HIV virus is now under
investigation by the National Institute of
Health in the United States, was apparently
quite agreeable to give credence to such a
dubious theory (pp 74-5). The countries
where smallpox was still prevalent before be-
ing finally eliminated were all in the third
world, and what the theory really argues for
is that the third world, having been saved
from the scourge of smallpox, must now be
somehow held responsible for unleashing a
new terror on the world and defying the
claim that the west at least is free of
epidemics. What makes racism, as indeed
any form of discrimination, ultimately so
pernicious is that it blames the victims.
it is, however, possible that as the
Chirimuutas find accounts of an AIDS
epidemic in Africa grossly exaggerated, so
others will find them greatly underestimating
the problem. Since their book was published,
WHO has published an entirely different set
of figures to indicate the extent of the AIDS
problem in Africa. Africa is now said to have
two and a half million women infected with
the HIV virus, whereas in the United States
only 1,00,000 women are estimated to be
HIV positive Another United Nations agency,
UNICEF, in a pamphlet entitled Children
and AIDS, which bears a publication date
of 1991, estimates that over a million
children will have been rendered orphans in
10 African countries by 1994 owing to the
deaths of their parents from AIDS, and by
1999 this figure is expected to rise to a stag-
gering 4.4 million. These numbers, emanat-
ing from sources that the Chirimuutas would
appear to respect, must be treated with great
caution. As the Chirimuutas point out, what
makes the diagnosis of AIDS in Africa so
exceedingly difficult is that many diseases
which are common to Africa but unknown
to the west induce symptoms similar to those
found in people suffering from AIDS.
Depressed cellular immunity is "a well
recognised complication of malaria infec-
tion", tuberculosis, pneumonia, and other
diseases (pp 36-9). Kaposi's sarcoma, which
in the west is a rare form of cancer linked
specifically to AIDS, is endemic in the
tropics. How many of those 'millions' in
Africa described as being infected with
AIDS are in reality suffering from other
diseases?
Supposing even that the extent of AIDS
in Africa is vastly underestimated by the
Chirimuutas, the controversy over the degree
of its prevalence should not detract from the
merits of their work. Science is, to use a
metaphor from biology, as infected with
racism as any other endeavour. Nor does this
Economic and Political Weekly November 23, 1991 2687
racism stop with the depiction of Africa as
a vast morgue, where (in the words of an ar-
ticle in the International Defiense Review for
1988) "thousands of freshly dug graves" lit-
ter the co;untryside from place to place,
"evidence of a massive catastrophe" (p 161).
Much more insidious is the argument that
AIDS originated in Africa. When the first
cases of AIDS were reported, the victims
Were all white homosexual men from Cali-
fornia and New York. To counter the widely
propagated suggestion that AIDS was speci-
fically a 'Gay Plague' particularly afflicting
whites, the highly organised American
homosexual community, in a two-pronged
effort, attempted to shift the onus on to
Africans, among whom AIDS was said to
be prevalent mainly among heterosexuals,
and to Haitians, who were alleged to have
infected gay men from San Francisco. On
their viewpoint, it was inconceivable that
white Americans could be carriers of so
hideous a disease, and more than probable
that black Haiti, the playground for American
homosexuals, should be the breeding ground
for AIDS. The non-white world, when at all
it has anything to give to the west, can only
infect it with diseases, poverty, and moral
laxity.
In its effort to pinpoint the origin of
AIDS among heterosexuals and the non-
white population, the gay community receiv-
ed the support of medical researchers work-
ing on AIDS, many of whom were them-
selves homosexuals. When the hypothesis
that AIDS had originated in Haiti could not
be substantiated, the western medical and
scientific establishment, not to mention the
media, directed all of its efforts to linking
AIDS to central African countries. Papers
began to appear in reputable journals, such
as Lancet and the New England Journal of
Medicine, allegedly 'proving' the presence
of AIDS in Africa prior to the outbreak of
the epidemic in the United States. One paper
in the British Medical Journal, bearing a title
'AIDS: An Old Disease From Africa?'
designed to pre-empt the terms of the debate,
argued that "early African cases preceded
the first documented American cases by
several years' and offered the following ex-
planation for the trans-continental transmit-
tal of the virus: "The first American cases
are likely to have become infected in the
early- to mid-1970s, a time when tourism
from the United States to Africa was
developing as a result of heightened cultural
interest!' The Chirimuutas make short work
of this and other similar papers (pp 23-43).
They point out that none of the Americans
first infected with the virus reported having
travelled to Africa; secondly, "the heightened
cultural interest" was in west not central
Africa, and most present not among whites
but among black Africans stimulated by
Roots (the novel and the television series);
finally, why is it that the French, Belgians,
and the British with their colonial ties to
Africa were spared, while Americans on
short trips were infected (p 36)?
"As the hypothesis that AIDS was an 'old
disease of Africa' became increasingly
untenable': the authors write, "researchers
diverted their attention to the possibility of
a monkey origin of the virus" (p 71). Not
just any monkey would do; it must perforce
be a monkey found in Africa, indeed only
in Africa, and indigenous to it. Western
researchers claimed they had found a high
prevalence of antibodies to the HiLV-I1l
(now HIV) virus in "healthy African green
monkeys" (p 72). ivly antibodies to the
virus should have been found in 'healthy'
rather than diseased, monkeys was not ex-
plained, but such incongruities mean
nothing to the logical western mind. And
how had the virus crossed the species bar-
rier? iWo English AIDS researchers prof-
fered the explanation that monkeys are
hunted for food in Africa, and an infected
monkey was accidentally consumed by the
natives; moreover, we learn, "monkeys are
often kept in huts for some time before they
are eaten. Dead monkeys are sometimes used
as toys by African children." The Chiri-
muutas ridicule these purportedly 'scientific'
explanations, and as they suggest, the theory
that the AIDS virus was passed on from
African green monkeys to African men and
women can have no purpose other than that
of caricaturing Africans, and reviving such
deplorable racist notions as that "Africans
are evolutionarily closer to sub-human
primates" (pp 71-2).
Much of what passes as 'scientific'
research on AIDS in Africa is vitiated by a
racism that the west likes to believe is a thing
of the past. The charge must appear as even
more outrageous because of the supposed
'neutrality' of science. When it comes to
science, the objective-subjective dichotomy
still reigns supreme: the findings of science
are unimpeachable, because objective, quite
unlike the subjective opinions that men and
women bring to a discussion of politics, art,
or literature. A related consideration, of
which the authors are well aware, is that sub-
Saharan Africa, which is alleged to be the
epicentre and point of origin of the AIDS
epidemic, has always been considered quite
outside the scope of human history. They
quote so eminent an 'authority' as Hugh
Trevor-Roper, who warned undergraduates
to not be seduced by the 'history' of black
Africa: "Perhaps, in the future, there will be
some African history to teach. But at present
there is none, or very little: there is only the
history of Europeans in Africa. The rest is
largely darkness... And darkness is not a
subject for history.' Can one reasonably ex-
pect the west to forgo its racial outlook when
as dreaded a disease as AIDS, for which at
present there is no cure, is the subject of
inquiry and discussion?
The authors bring to their task the know-
ledge and skill required to reveal and dissect
the racial presuppositions of the western
discourse on AIDS. Rosalind Chirimuuta,
who specialises in ophthalmology, also has
a diploma in Tropical Medicine and Hygiene,
and is a Fellow of the Royal College of
Surgeons; Richard Chirimuuta, on the other
hand, has written widely on African affairs:
thus knowledge of medicine and politics
complement each other. They detect, among
the many journalists and writers whose work
speaks of 'millions' of Africans dead from
AIDS, almost a genocidal wish that their
prognosis should come true The missionary
zeal with which the Chirimuutas write is
easily explained, but it obfuscates certain
philosophical considerations which indu-
bitably should have fallen under their pur-
view. One might say that it is human, all too
human, to attribute evil, disease, epidemics
to 'others, to locate the origin of all that we
dread in a foreign source. Susan Sontag has
eloquently written of one feature of the
script for plague: "the disease invariably
comes from somewhere else' When syphilis
began its epidemic journey through Europe
in the late 15th century, the English describ-
ed it as the 'French pox, the French
characterised it aS the 'German disease', and
in Florence they said it had come from
Naples. To the Japanese, syphilis was a
Chinese import, just as AIDS in Japan was
described by medical researchers at Nagasaki
as having been "probably directly brought
in by the Portuguese or their associated
Black Africans" (p 71). In India, to instance
one more example of how AIDS is perceiv-
ed to be a wholly alien element, the direc-
tor of the Indian Council for Medical
Research recently stated: "This is a totally
foreign disease, and the only way to stop its
spread is to stop sexual contacts between In-
dians and foreigners!' The west does not have
a monopoly on ethnocentrism, and this is
a dimension of the AIDS problem to which
the Chirimuutas could have been more sen-
sitive. Still, what is patently obvious is that
it is the west alone that shapes the contours
of discourse, that has the power, technology,
and financial means to make itself heard,
and for this reason, if no other, we must con-
temptuously dismiss and battle the various
pronouncements that in more than one way
attempt to describe AIDS as an 'African
disease'.
Modern Nepal;
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2688 Economic and Political Weekly November 23, 1991