Podium: The real causes of Aids are ignored

Neil McKenna

From a speech to the Amnesty International-HIVOS Lesbian and Gay Rights Programme, Amsterdam

PERHAPS ALL of us are all too familiar with the degradation of human rights of lesbians and gay men. We have lived through the long nights of the Aids epidemic to witness yet further assaults on our right to love who we choose, our right to be free from persecution, and our right to health.

In 1992, I was a newspaper journalist. I set about learning and writing about Aids in the developing world. I started asking what I thought was a perfectly simple and straightforward question. I wanted to find out what role sex between men played in the pandemic of Aids in the third world.

I was unprepared for the response. My question was met with denial, hostility and dishonesty. Most of the answers I got were variations on the same theme which was "male-to-male sex plays no role in Aids in the developing world," or "there are no homosexuals in our country". I was told by a number of agencies and organisations that my questions were damaging the cause of Aids prevention in the developing world.

I called my report On the Margins because I concluded that virtually every aspect of the lives of men who have sex with men is marginalised by an Aids and HIV epidemiology which usually ignores male-to-male sexual transmission, which pretends it doesn't exist.

Why are men who have sex with men the forgotten people?

I think to understand the reasons for this neglect we must go back to the very beginning of Aids.

The Global Programme on Aids set about constructing Aids in moral, political and development terms. An ideology of HIV and Aids quickly grew up. The challenge of Aids became an opportunity to put into practice a new way of thinking and working around development. In 15 years of often worthy rhetoric about human rights and health rights, about empowerment, about development, barely a word was said about gay men, bisexual men or men who have sex with men in developing countries.

History will judge the success or otherwise of the first years of Aids prevention under the leadership of the Global Programme of Aids, and now under UNAIDS. Where it failed was its reluctance to grasp the nettle of male-to-male transmission of HIV. Its consistent, simplistic public statements that HIV in the developing world was almost invariably the result of heterosexual sex contrasted uneasily with its private knowledge of the significance of male-to-male sex as a means of HIV transmission. But most of all it was a failure to give leadership. Underneath all the rhetoric of development, behind all the morally correct, politically correct statements lurk some unresolved feelings about men who have sex with men in developing countries. I believe that many people working in the field of Aids prevention and development are unhappy and uncomfortable with the idea. The day-to-day realities of sex between men in many parts of the developing world stretch and test the very limits of liberalism.

Sometimes it's a dark, strange, covert, promiscuous, often unpleasant world. It's about a male sexuality which is unrestrained, lustful, often involving the sexual exploitation of boys, often involving prostitution, coercion and violence. It's a world where most of the protagonists are married and their sexual activities with men can damage the wife and the family, especially when it comes to the transmission of sexually transmitted diseases.

For men in the developing world, there has been a virtual famine of Aids prevention, and a drought of funding. Were this happening to any other group of human beings, there would be an international outcry. As it is, there are just a few, faint voices of protest.

So what is to be done? Well, the situation is not entirely bleak. Some Western governments have funded AIDS prevention projects for men who have sex with men in developing countries. Even Britain's Department for International Development has funded one or two projects. But despite written submissions made to DFID about establishing appropriate funding strategies for the health of men who have sex with men, DFID has so far failed to come up with a policy.

We are left with the depressing conclusion that the health and human rights of men who have sex with men in the developing world are not deemed to be a priority by our government. It's a scandalous, shameful state of affairs. I am calling for an international task force to tackle years of neglect of the sexual health needs of men who have sex with men in the developing world.

Until the health and human rights of all men who have sex with men are assured we cannot cease our struggle.