The XVII International AIDS Conference set a precedent. The United States AIDS epidemic was contextualized within the larger global epidemic unlike ever before. The new statistics revealing the disparities regarding HIV incidence rates were presented alongside protesters who reminded us that the U.S. has no national AIDS strategy. The authoritative report released by the Black AIDS Institute, Left Behind (Black America: A neglected priority in the global AIDS epidemic) added fuel to the fire. The United States health disparities were squarely placed on the international stage for all to judge.
The world watched, listened and made some recommendations. At a regional dialogue, where thirty women of the Global North and South met to discuss solidarity, more than one woman from the Global South mentioned the unique opportunity the United States has to learn from the PEPFAR recipients.
These comments resonated deeply with me. The thought of the United States actually learning from the countries it is trying to help reflects a massive opportunity to build transnational solidarity. PEPFAR recipient countries have been engaged in scaling-up national AIDS programs in difficult circumstances that have much to teach about how you implement a national AIDS strategy.
The question is: will we listen? And more importantly, who will be at the table deciding?
As a physician who works in West Philadelphia, where violence is high, economic opportunities are low, and HIV prevention is about building healthy communities, the parallels to my Global South colleagues’ experiences are not dissimilar. Yet, the links between domestic and global health are nascent. Somehow, our mental schema has not allowed for the connection.
Moreover, I have a hard time imagining a U.S.-led delegation would visit a PEPFAR recipient country, with the intention of learning something new to bring back home. Somehow, the arrow of learning rarely points in this direction. It’s usually “our way or no way”, if not worse, when considering U.S. involvement in countries outside of the G8. In fact it is often the latter. Haiti’s history serves as a devastating reminder of what U.S. involvement can mean for the fate of a poor country and its consequently high HIV rates.
However, times are definitely changing and increasingly there are Americans that are holding the government accountable to new standards. The Honorable Congresswoman Barbara Lee is leading the call for a domestic PEPFAR. She was unstoppable and uncompromising in her claims during the conference. “This is a political struggle,” she said, “The stars are aligned and we must capitalize on this opportunity.”
As the United States begins to think through a domestic AIDS strategy, it has a unique opportunity to build authentic transnational solidarity with countries in the Global South. We can collectively shape a new power paradigm that begins to redress the injustices of the past by including unrepresented voices at the table and also listening to what their experiences teach. Building on shared experiences results in solid partnerships that are mutually respectful, equitable, and transformative for our world. This new power paradigm will have ripple effects that lead to the end of the global HIV/AIDS epidemic.
(As posted in: www.AIDS2008.com)
I am an Ethiopian- American public health physician that is using oral histories to teach about health. I have been listening to stories as a public health practitioner for a long time and as a physician for the past six years. In medicine, there is a true moral compass that points north. These stories are meant only to serve the patient. This blog is my attempt at documenting the stories that have the potential to teach how to heal for us all.
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