The Politics of HIV and the Voice of the Church.
The Politics of HIV and the Voice of the Church.
Revd Ijeoma Ajibade
30th October 2011
revdije@gmail.com
The morning session has focused on introducing us to some of the key issues about HIV as a virus. We have looked at how it affects individuals and what the treatment options are, but there are also wider social implications that we need to consider when looking at HIV and AIDS. It is an issue that not only affects individuals, but also affects societies. HIV is a political issue. It is of great concern to Governments throughout the world because it has an impact on society and on social issues. For example, in low income countries where treatment is not always readily available there is the issue of the growing number of orphans and the care that they need. In the world today there are more than 16 million children orphaned because of AIDS.
Countries need to provide care for these orphans and protect them from exploitation.
Another example of a political issue is the need for strong health systems. The response to HIV and AIDS can easily be frustrated by the lack of infrastructure in a country and this has been recognised by the United Nations (UN) in its focus on health systems strengthening. Even where treatment is available if the health system is not strong it can be difficult to treat people and monitor their care. There is also the crucial issue of economic development. In some countries HIV has had a devastating impact on people who should be economically active. Without these people and their productivity how can economies grow and develop? How can a country address poverty if its workforce is affected by HIV, particularly where there is limited access to treatment. These are some of the wider issues that countries have to face when responding to HIV. Some of these questions are being addressed by the work of development agencies such as Progressio who we shall be hearing from later this afternoon.
It is clear that HIV needs a political response. The devastating impact of the virus on countries across the world and the fact that there is no cure has meant that governments have needed to come together to mobilise a response, to work together and to hold each other accountable. It is this response that has been crucial to bringing us to the point at which we now are in the history of HIV and AIDS. This paper aims to explore some of the politics aspects of the HIV response at the global level, the national level and at the local level, and also to explore where the voice of the church is at all these levels.
Where is the Voice of the Church?
In the early eighties in the US and Europe, HIV and AIDS initially appeared in the gay communities, amongst homosexuals, and men who have sex with men. It was also seen in intravenous drug users and people who had blood transfusions such as haemophiliacs. As the epidemic spread, its impact amongst heterosexuals became more apparent, particularly in Sub-Saharan Africa. Because of the initial impact within the gay community, HIV and AIDS was also known as the gay plague. In general the initial attitude of society and of the church towards people who had HIV and AIDS was one of judgement, suspicion and fear, even from the medical community where people were isolated and placed in quarantine. This shameful attitude and lack of compassion towards those with the virus, led to the founding of organisations such as the Terrence Higgins Trust. It was not just religious groups that were acting this way, across the world the response to HIV and AIDS was driven by fear, resulting in stigma and discrimination which continues today in many forms.
Christians have traditionally been at the forefront of social action campaigns for example, bringing about justice through the abolition of slavery and the abolition of apartheid. More contemporary social justice campaigns include the sustainability of the environment, addressing global poverty and responding to development needs. These are all very commendable and play a key part in the Church mission, however in respect of HIV; some churches have failed to recognise that this is also a struggle against injustice. It is not that the issue is being ignored, but more the case that there is still a great silence from parts of the Church on HIV. However there are places where the voice of the church is heard clearly, particularly through the work of faith based development agencies such as Tear Fund, Christian Aid, Progressio and CAFOD, but there is still much more that could be done to address the challenge of HIV. Now the Church has found her voice we need to ensure that we speak out at all levels of society, both global and local.
The Terrence Higgins Trust was established as a charity in 1982. Terry Higgins was one of the first people in the UK to die with AIDS. A group of his friends wanted to prevent more people having to face the same illness as Terry. So they named the Trust after him, hoping to personalise and humanise AIDS in a very public way.
Politics and HIV at the Global Level
In June 2001 the UN General Assembly held a Special Session on HIV/AIDS (UNGASS).
Recognising the need for an urgent global response to HIV and Aids, the UN passed the 2001 Declaration of Commitment on HIV and AIDS clearly stating the urgency of the situation and the fact that the world was losing the struggle against HIV.
At that time the number of people living with HIV was increasing, anti-retroviral treatment (ART) which was revolutionising care in high-income countries was virtually unavailable in other severely affected countries. HIV and AIDS were eroding the progress of development particularly in sub-Saharan Africa and was recognised as a threat to social stability and development. In 2006 the UN General Assembly adopted a Political Declaration on HIV/AIDS in which countries reaffirmed their commitment to implement fully the 2001 Declaration.
The epidemic is stabilising, the number of new HIV infections has declined by 16%, mother to child transmission has reduced the number of infected infants, new interventions and emerging technologies have the potential to enhance prevention efforts, access to treatment has expanded and some gains have been made in promoting and protecting the human rights of key populations. Faith based organisations have been there at the forefront of this response and have played a crucial part in this response.
difficulties in securing full access to treatment. Ten million people who need treatment do not have access to ART.
For every person who starts treatment, two are newly infected. The number of children orphaned by HIV continues to grow. These are global figures. In this country mother to child transmission of HIV is rare. People do not die of AIDS in this country in great numbers any more. Across the world because of the
A Stocktake, The UK Civil Society Contribution to Universal Access to HIV Prevention Treatment Care and Support. UK Consortium on AIDS and International Development 2011
First of all we must acknowledge the tremendous leadership shown by the UN in the HIV and AIDS response. The UN has mobilised resources, provided strategic direction and has held countries accountable. Within these documents countries agreed certain targets to measure their response to the HIV epidemic. This included targets to reduce the rate of HIV transmission and to expand access to treatment and to raise funding. Both these documents emphasise international co-operation. This push at the global political level has resulted in progress.
At the same time there is still much to be done and there are still very difficult questions that must be faced. There are still efforts made people are living lives of dignity and health, but much more remains to be done in order to sustain this progress.
In April I was privileged to attend the UN Civil Society Hearing on HIV and AIDS. It took place in New York. The aim of this meeting was for civil society organisations from around the world to have an opportunity to deliver strategic messages which would then be used to influence the development of a new UN declaration to be announced at a UN General Assembly in June. It was a privilege to witness people from all over the world speak about their concerns and the work that they are doing and to call upon more action from governments across the world. It provided an opportunity to discuss the complexities involved in responding to the epidemic. Despite the fact that delegates were coming from all over the world there was real consensus about the main priorities.4 I am also happy to say that churches and other faith based development agencies played an active role in this meeting. The Ecumenical Advocacy Alliance which is an organisation set up by the World Council of Churches did a very good job speaking on behalf of the church and encouraging churches and faith based organisations in their response. Some of the key messages from this process can be found in the appendices.
In June the UN General Assembly convened a High Level Meeting on AIDS. The purpose of this meeting was for the world to come together and review the progress made in responding to HIV and AIDS, and to map out the future course of the global AIDS response. The key outcome of this review was a new political declaration on HIV and AIDS. This reaffirms current commitments and embraces new commitments which will guide and sustain the global AIDS response.
At the UN meeting in June the voice of the church continued to be heard but the church was also challenged by the UN. The Ecumenical Advocacy Alliance continued to provide leadership and focus for Christian and faith
4 Civil Society Priorities – Pre-Meeting UN Civil Society Hearing on HIV and AIDS :
Human Rights
Universal Access: 80% coverage for all by 2015
Prevention: Universal access to the full complement of prevention strategies
Treatment: 14 million people on treatment by 2015
Care and Support: Expansion of community based services
Key Affected Populations: Universal access for MSM, sex workers, people who use drugs, transgender populations, women and girls, prisoners and migrants
Eliminating stigma and discrimination
Fully fund the response
Public Health and not Politics
based organisations and called for faith communities to embrace a vision of healing without judgement and to embrace justice. They called upon faith organisations everywhere to recognise that all human beings are created in the image of God. The UN also challenged churches and faith organisations. The Deputy Secretary General of the UN, Dr Asha-Rose Migiro, told faith leaders that we (faith communities) are natural activists who can change attitudes and that we should speak out and end marginalisation, that we should not be silent and that we should be a force for reconciliation. She said we can be the difference between shame and pride, and between life and death.5
One of the challenges facing us is the fact that it is easier to judge than it is to love.
In Africa there is an increasing wave of homophobia and persecution of lesbian, gay, bisexual and transgender people. Within this rise of homophobia is a denial of the prevention needs of men who have sex with men. The recent World Bank report shows that effectiveness of HIV prevention is undermined by the criminalisation of homosexuality.
As a Christian I believe that working with and supporting key populations is critical to the HIV response. I believe the church is called to serve these people especially. We have the gospel and so we need not judge. We need only care and love. Real faith requires love even for those that don’t fit our theological frameworks or tick boxes. We must always remember that people are made in the image of God and that these are people for whom Christ died. Love not judgment is our starting point. When we do this the love of God becomes real in a very powerful way and people will respond to the voice of the Church. The overriding factor must be the recognition that lives must be saved even where they don’t fit our beliefs.
It is very easy to hold onto our theological frameworks and teachings and use this as a reason for doing nothing or for keeping silent. There are certain behaviours which are high risk for HIV and certain populations that are more vulnerable to the virus, these include sex workers, men who have sex with men and intravenous drug users. Some churches believe that addressing the prevention needs of people who engage in certain behaviours actually encourages the behaviour. So for example condoms are seen as encouragingpromiscuity, needle exchange programmes are seen as encouraging people to keep taking drugs. Homosexuality remains a very big issue for the global church and not only for the church but for nations.
Global HIV Epidemics Among Men Who Have Sex with Men (MSM): Epidemiology, Prevention, Access to Care And Human Rights.
Politics and HIV at the National Level
The Select Committee report can now be found on line. 7 The main focus for the session with faith leaders was the role that faith can play in HIV prevention initiatives, and in tackling stigma and discrimination around HIV.
My general impression of the hearing is that it was a good session which explored the many complexities around the issue of faith and how faith can help in HIV prevention and care, but how it can in some circumstances be a hindrance, particularly when faith leaders do not understand the complexities around HIV prevention. The hearing was helpful because it showed that some faith communities have been responding to HIV, particularly in the area of care and support services, but that much more could be done to raise awareness of HIV and to equip churches and faith communities particularly on the issue of prevention and stigma. A summary of the key issues from the hearing are in the appendices.
Politics and HIV at the Regional Level
In the UK this year there has also been much discussion and reflection on HIV and a stock take of where we have come from and where we are. In March the House of Lords held a Select Committee on HIV and AIDS. The aim was to examine the UK response to HIV and to see what needed to be done thirty years on from the emergence of the epidemic. I was greatly privileged to attend one of the hearing sessions as a witness and to be questioned about the response of Churches in the UK.
At the regional level (London) there is also a clear response to HIV led by the Department of Health, the different hospitals and by the voluntary sector (charities). London is home to some of the national HIV charities such as Terrence Higgins Trust, National Aids Trust, Positively UK, Positive East, the Naz Project, London Ecumenical AIDS Trust, and the African Health Policy Network. London is also privileged to be the home of many international development agencies that are responding to HIV at a global level. This afternoon the Deputy Mayor of London will speak to us about his personal commitment to helping those affected by the virus, and he shall speak about the role that the Mayor of London has in addressing HIV in the capital.
Select Committee on HIV and AIDs in the United Kingdom - First Report
No vaccine, no cure: HIV and AIDS in the United Kingdom
The Voice of the Church in the UK
As I have mentioned earlier the church is engaged through various organisations with the issue of HIV at global levels. The real challenge for us is found at the national and regional level. I think that it is here that the church needs to find a voice. I believe that in this country the church has left the work of responding to HIV very much to faith based development agencies and to HIV charities. I also have to say that where churches are acknowledging HIV it is sometimes in a way that is most unhelpful. Recent reports from the BBC highlighted the case of a church that was encouraging people to stop taking their treatment. I do not believe that there is malice in this, but if you do not take the time to understand HIV and its impact on communities how can you support them adequately?
In 2007 a survey was commissioned into British church congregations and their attitudes to HIV and AIDS. 84% of the church leaders surveyed felt that their response to the HIV pandemic was inadequate and that more could be done. The survey, which was published by the Christian HIV/AIDS Alliance, also found that nearly 50% of churchgoers want to know more about HIV and AIDS, and that approximately 1/3 of these churchgoers are interested in resources on HIV and would like to know more about ways to engage directly with the issue. 8 To find appropriate and meaningful ways for congregations and church leaders to respond to HIV can be both challenging and complex for churches, but this survey shows a willingness of church congregations to learn more and to engage.
The church has a vital role to play alongside secular agencies and we must increase our efforts, and expand and strengthen our work. It Is not just about our voice being heard but we must find a way in which we too can become actively involved. This afternoon we will have an opportunity to think a bit more about this and what we can do. Our response can be as simple as prayer and recognising World Aids Day, or it can involve mobilising our congregations to volunteer for some of the HIV charities, or to visit people in hospitals such as the Mildmay which treats people with complex cases of HIV.
There are also key political issues that I believe the church could speak up about and in this sense the voice of the church becomes one of prophetic witness. These issues include the need for access to treatment, the financing of treatment, the care of orphans, the discrimination against women that exists in so many societies, the issue of poverty, the abuse of human rights, the need to push governments to do more to strengthen their health systems and provide the care and support that people need. The church should be a voice for the voiceless in reducing SSDDIM9 and multiplying SAVE10 to end AIDS. This can be through awareness raising, training, research, advocacy practical programming/mainstreaming at congregational level and through SEDOPP11.
We need look deeply at the reality of our world today and look at these areas of life that do not always neatly fit into our theologies. We need to engage with areas of life that perhaps we do not understand and that challenge us. This is where God is calling the church to be. HIV is not an easy issue to respond to and the challenges are immense, but the reality of the work that we do is simply justice. We are seeking justice for and with people, families and communities that are vulnerable and often invisible. These are real people, families and communities living real life situations and we can bring hope and real change through our work if we take the time to learn, to listen and to understand. We can alleviate difficulty and isolation for people living with the virus in the UK. We can begin to address stigma and discrimination and the fear that keeps many people silent. This afternoon we will have an opportunity to reflect on our individual response in reducing SSDDIM and multiplying SAVE and hopefully commit to doing at least one thing. We do not have to do everything and we do not have to do big things, but we can all do one thing and it is the one thing that we do which can make a difference in our response to HIV.
Revd Ijeoma Ajibade
30th October 2011
revdije@gmail.com
