Eduardo Verdugo/AP Images
In April 1985, more than 2,000 people from thirty countries made their way to Atlanta for the world’s first International AIDS Conference. The epidemic was four years old, and President Ronald Reagan had not yet uttered the name of the disease in public. There were no treatments for HIV infection. The next year, William F. Buckley Jr. would propose in an op-ed in the New York Times that “everyone detected with AIDS should be tattooed in the upper forearm, to protect common-needle users, and on the buttocks, to prevent the victimization of other homosexuals.” In Atlanta, conferencegoers noted the “remarkable mixture of participants,” which reflected, even by this early date, how different the politics surrounding AIDS was from that of most other medical conditions. “Doctors and scientists of almost every discipline [were] rubbing elbows with gay activists and media personalities,” according to the newsletter of a gay doctors’ group.
Over the years, as a hybrid and increasingly global mix of AIDS warriors has pursued prevention, treatments and social change, the international conference has found its way to Berlin, Barcelona and Bangkok, to Yokohama, Durban and Toronto. (The United States may soon be back on the list as a potential host, now that Congress has removed the statutory basis for an infamous ban on the entry of HIV-positive people into the country.) This August marked the seventeenth such event, with 24,000 participants from 194 countries converging on the giant Centro Banamex in Mexico City. What has remained constant over the years is how this hyperkinetic and multifaceted convocation–part celebrity showcase, part media circus, part pharma trade show, part networking extravaganza, part activist stage and, yes, part scientific meeting–has seemed to embody central elements of the AIDS phenomenon. It has shown clearly how the response to AIDS has taken shape as a heterogeneous global industry, and it has raised the perennial question of who really “owns” AIDS and thereby gets to say what should be done about it. And as the tally of infection has climbed upward over the years, the conference has also epitomized the ultimate limitations of the now vast and impressive scientific and political campaigns being waged against this epidemic.
As early as 1990, the activist and scholar Cindy Patton described, in her book Inventing AIDS, the emergence and worrisome growth of an “AIDS industry” that seemed to have taken on a bureaucratic life of its own and imposed its monolithic vision of the problem and its solutions. In The Wisdom of Whores, AIDS industry insider Elizabeth Pisani airs the latest dirty laundry. A journalist turned epidemiologist who has consulted for governments and NGOs around the world and particularly throughout Asia, Pisani holds a dim view of business as usual by the AIDS establishment, from the global health agencies on down. In this bracing account, Pisani is especially concerned about the impact of the recent flood of funding–by 2007, she notes, global expenditures on HIV in developing countries had reached $10 billion a year, more than has ever been spent on a single disease–which inevitably draws in “people who don’t really care about the problem, who are truly queasy about sex and drugs, but who want some of the cash.” In this “Be careful what you wish for” story, Pisani claims that now that AIDS has become a “boom industry,” we’ve learned that “money can actually be an obstacle to doing the right thing.”