A new stone wall
Aids may soon become containable: a chronic disease, not a killer. But as the smoke clears, the battle for the peace is only beginning. By Jack O'Sullivan
Wednesday 11 December 1996
We are just beginning to understand the effects of a new generation of anti-Aids drugs, called protease inhibitors, which can, according to preliminary results, dramatically reduce the amount of the Aids virus in the bloodstream; they may lengthen life by many years. This is not the long-awaited cure, but the spell cast by the Eighties plague could soon be destroyed.
Those with Aids privately dare to imagine that the death sentence may soon be lifted from them. Members of the gay community in particular quietly speculate as to what life will be like without the constant threat of another friend turning into a walking corpse before an undignified demise. And those with a political axe to grind are sharpening their weapons.
For, as the smoke clears, the question is: who will win the peace? The conflicts of what may be called the post-Aids era are already beginning to appear. They will revolve around fresh efforts to turn the clock back on the increased toleration of and empathy for homosexuals that has sprung directly out of the Aids crisis.
The political right, whose opposition to Aids publicity campaigns was only quelled by fear of mass death, is back on its soapbox. There are increasing complaints about over-generous state funding for research into Aids, a condition which, the doubters point out, kills a tiny fraction of those who succumb to heart disease and cancer. Why so much funding, they say, when so few Britons, especially so few heterosexual Britons, have died?
There is considerable support for re-examining funding priorities. Gordon McVie, director-general of the Cancer Research Campaign, says: "Since Aids arrived in Britain, there have been about 1.5 million deaths from cancer and more from heart disease, while we have yet to notch up 10,000 deaths from Aids in this country. Yet government funding for cancer research is pounds 15m, compared with pounds 14m a year for Aids."
But the real focus of righteous anger is, simply, buggery. Many opponents of funding can't stand the idea that government money is still being granted to gay organisations to promote Aids awareness, particularly when those self-same organisations celebrate homosexual sex.
"This sort of Aids work is far beyond legitimate health education," declared the right-wing commentator Leo McKinstry this week, appalled at a project in which Coventry health workers are taking their message on to the streets to men "cottaging" and "cruising" for casual sex. "Public funds are now being used to subsidise private sexual activities," said McKinstry.
Meanwhile, The Daily Telegraph intones against an imbalance in health spending in favour of Aids, pointing out that "as most Aids sufferers still come from high-risk groups, there is a perceived lifestyle choice that can reduce the incidence". The subtext was clear: why spend money on these buggers when they bring downfall upon themselves? It is a gay version of not helping lung cancer sufferers because they ignored the warnings and smoked themselves silly.
Such protests have, so far, fallen largely on deaf ears in the Department of Health, conscious as it is of a continuing need to get the safe sex message across to the highest risk groups. But Simon Garfield, author of The End of Innocence - Britain in the Time of Aids, is worried. "It is clear," he says, "that the right feels they have far more ammunition because they can use hindsight to claim that money spent on Aids should have been spent on other things."
He argues that those seeking cuts in Aids funding should be celebrating, not decrying what has been spent. In the United States, which has four times the UK's population, the moral majority delayed the start of Aids prevention strategies. More than 300,000 people have died there, compared with about 9,000 in the UK.
And total Aids spending is likely to go on rising, rather than fall. The price of the new drugs is high. At the moment, they are generally only available if you agree to participate in a trial. The brutal truth is that if people with Aids live longer, they will probably cost more.
But what of attempts to curb the amount of information being made publicly available about homosexuality in an effort to promote safe sex? Gay men seem sanguine on this point. "The horse has already bolted," says one. "A few years ago, when I was at a dinner party and said I was gay, people would ask me what gay men did in bed. Not any more. The Government leafleted all households in Britain and told everyone what gay men did in bed. As a result of Aids, a great deal of what made the lives of gay men shadowy has disappeared. This disease has humanised us in ways that years of gay activism could never have achieved. It has shown us to have feelings, and to be caring in the same way as everyone else. It's too late to turn the clock back on all that."
The bigger issue facing many gay men, if we really are entering a post- Aids era, is coming to terms with the chance of a long life. "I have been preparing to die for a long time," says one gay man with HIV. "So the idea that I am going to live may not exactly be frightening, but it will take quite a long period of adjustment. Some people will not make that immediate transition. They have built rage and resentment so much into their lives that it will be very hard to let go of it."
Andrew Sullivan, the British former editor of The New Republic, an American political weekly, considers just this dilemma in a recent essay, entitled "When Plagues End". Writing in the New York Times, Sullivan, himself HIV positive, discusses Albert Camus's description of when a plague burns itself out. The reactions to the news, Camus notes, are "diverse to the point of incoherence". Many refuse to believe that there is any hope at all, burnt by dashed expectations one time too many, "imbued with a scepticism so thorough that it was now a second nature". Others found the possibility of an end too nerve-racking to bear, and almost dared the plague to kill them before it was too late.
Sullivan notes that the conversion of Aids into just a chronic illness would have big implications for others living with HIV. "The good news from the laboratory has robbed them not simply of the drama and intensity of their existence, but also of the recognition of that drama. Even among their own kind." Solidarity among gay men over Aids could, he warns, fracture as fewer feel threatened by it. Which could be a real danger at a time when the support of society for the remaining victims of the Aids plague looks set to plummet.
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