HIV Own Goals – LGBTQ in Uganda

Shaming people for their alleged sexual behavior has deadly consequences for everyone infected with HIV and anyone engaged in behaviors said to result in HIV transmission, or claimed to be so engaged. Given the weight of evidence against the sexual behavior paradigm of HIV transmission (which, mysteriously, only operates in high prevalence African countries), why does the industry still use it to prop up every campaign?

When HIV was identified in several US cities in the 1980s, it was mainly found among men who had sex with men (MSM), injecting drug users (IDU) and people who received blood products or transfusions that contained the virus. Now, 40 years later, the largest proportion of people in those same US cities with HIV are MSM, with IDUs a distant second.

A few years later, when HIV started to spread rapidly in African countries, such ‘high risk groups’ did not account for the highest proportion of HIV transmissions. Rather, prevalence was higher among people who were not MSM or IDUs. Prevalence was high among a group often referred to as commercial sex workers (CSW), or just as sex workers. But it’s not clear that these were coherent groups of people who self-identified as sex workers, or if they were assumed to be sex workers by those collecting data, on the basis of their HIV status.

In fact, many of the people infected with HIV early on in the epidemic in African countries which subsequently experienced the highest prevalence rates in the world were more closely associated with healthcare than with high levels of ‘risky’ sexual behavior. Women who gave birth in health facilities, even clients of STI facilities, were infected in very large numbers. And that is still the case. Most people infected do not engage in any kind of risky behavior. Their infections are unexplained by the prevailing paradigm.

From the 1980s onwards, very high transmission rates in African countries tended to be found in cities, within the compounds of employers of large numbers of people, such as mines and other labor-intensive industries, close to well-developed infrastructures, in the vicinity of large hospitals, and in areas and countries where healthcare was accessible to all or most people. Examples of this are South Africa, Botswana, Zimbabwe, Zambia, Swaziland and Lesotho, mostly in Southern or Eastern Africa.

In contrast, most countries, even on the African continent, experienced lower transmission rates. Transmission rates in countries in the north of the continent, especially those on or overlapping with the Sahara, were, and still are, lower than in many US cities. Isolated areas, places where healthcare facilities didn’t exist, or were not used by most people, remained relatively free of HIV. Even in countries where HIV prevalence was very high in some areas, it remained low in isolated areas. Examples are Kenya, Tanzania, Uganda and others, where there are only a few high prevalence hostpots.

So why did the HIV industry play the LGBTQ and promiscuity cards in countries where neither MSM nor sexual behavior seemed to be the biggest risk for HIV transmission? If the industry wanted people in African countries to reduce transmission, they would have had more success if they had encouraged healthcare facilities to figure out why they seemed to be the source of a lot of infections, perhaps a majority. The funders of healthcare (and HIV) would have been ideally placed to insist that an appropriate proportion of funding be spent on healthcare safety, or to withdraw the funding if it was not.

Some transmission may have been a result of sexual behavior, although probably not the sexual behavior of most people, which tended to be conservative. And MSM sex does occur, despite western ‘experts’ initially claiming that it was rare in ‘African’ countries. But successive Modes of Transmission Surveys have shown that infections among these higher risk groups make up only a small proportion of total infections.

All people infected with HIV, young women, men, married or single, those engaged in sex work, or alleged to be so engaged, every MSM, including those alleged to be gay, prisoners and almost everyone else in high HIV prevalence countries suffer the consequences of the continued association of high HIV prevalence with promiscuity and with MSM.

An article in SciDev.net trots out the tired old fictoids, about homophobia threatening ‘HIV progress’, about HIV prevalence being "higher in countries with laws that criminalize homosexuality", and the insinuation that this “could impact foreign aid to Uganda”.

The deep homophobia that we see in Uganda and other high HIV prevalence countries didn’t exist in the 1980s. The bill (the ‘Bahati Bill’) that initially proposed lengthy sentences and even the death penalty was supported by US evangelical Christians. The spite towards ‘sex workers’ and people who were perceived as being promiscuous was a continuation of long-held prejudices about ‘African’ promiscuity, dating back to the Eugenicists, and beyond.

The worst HIV epidemic in the world is in South Africa, where as much as 20% of the global population of HIV positive people live. Yet, homosexuality is not criminalized there. In contrast, HIV prevalence in most North African countries is lower than that found in many western countries and in US cities where HIV prevalence has been high since the 1980s, although homosexuality is criminalized in most North African countries. Many countries where homosexuality is criminalized are also countries with low or very low HIV prevalence, such as those in the Middle East, Central Asia and elsewhere.

Numerous Aids Indicator Surveys and Demographic and Health Surveys show that most people in all countries, on every continent, engage in relatively low levels of sex, ‘risky’ or otherwise. Some people engage in high levels of sex, sometimes ‘risky’ sex, in every country. Among MSM, only some are ‘promiscuous’ and many take precautions to avoid infecting others or being infected with HIV. Outside of sub-Saharan Africa, people engaged in sex work are unlikely to be infected with HIV unless they are also IDUs or have some other, non-sexual risk.

Playing the promiscuity and LBGTQ cards is what drives the increasing homophobia seen in countries like Uganda. Obama and Cameron threatened to reconsider HIV funding after the Bahati Bill was proposed and Museveni, predictably, said they could keep their funding. This SciDev.net article seems to be reiterating that threat. It was the HIV industry that built itself up around prejudices and issues that the legacy and trade media will always report assiduously.

If SciDev.net and the HIV industry in general are genuinely interested in addressing HIV transmission, after dithering for 4 decades, they could start asking some of these questions that have long demanded an answer. If only some HIV transmission is accounted for by sexual behavior, including MSM sex, how is the rest to be accounted for? If that question is not answered then HIV transmission will continue through the industry’s next ‘target’, 2030. 

Have We Got Brews for You!

Apparently you can now 'print' a plant based meat substitute in 3D, and the texture and taste are excellent, according to the new Jeremy Clarkson of the culinary world, George 'GM' Monbiot. He has been singing from the rooftops about other wonderful techno-utopian offerings, such as 'precision fermentation' and even genetically engineered 'solutions' to all the world's problems. On his RePlanet, ReBoot, ReFood, ReGurgitate manifesto he actually claims that these technologies can provide "abundant food to the world's poorest".

When was the last time a new technology was used to benefit the world's poorest? Covid vaccines may have been produced remarkably quickly, but billions were made out of them. The same billions could have been used to feed people, or cure the conditions that most people in poor countries die from, prematurely. For example, provision of clean water would eliminate a huge proportion of the most deadly pathogens, even polio. But no, we're going to address each water-borne pathogen, one by one, with a vaccine, because we make money out of that.

When George lists how much protein food produced by precision fermentation will contain, requiring 1,700 times less land, less water too, and producing less greenhouse gases, I wondered how these 'facts' were so much more reliable than similar 'facts' that have been published about GM. Of course, for the English guardian, a fact is whatever the mainstream currently holds to be the orthodox view. And that can change. But being a mainstream journalist means you turn with the wind, nothing new about that.

Anyhow, since the English guardian has become such an evangelist for techno-fixes, perhaps they would consider the much hyped Artificial Intelligence, Natural Language Generation (NLG), in particular. Using the online (free) version of GPT3, you can take the first paragraph of George's encyclical:

"Let’s focus for a moment on technology. Specifically, what might be the most important environmental technology ever developed: precision fermentation."

And the result you get is:

"The technology has been around for decades, of course, but it was never used to tackle a big environmental problem. Now it is. Precision fermentation is the technology that will allow us to make the next generation of biofuels. It is also the technology that will help us make a new generation of medicines, including antibiotics. And, if we can find a way to use precision fermentation to make food, it will help us feed the world."

A little bit of editorial work could make that indistinguishable from something penned by the venerable man himself. It goes on:

"Precision fermentation is a technology that allows us to control the environment in which microorganisms grow. We can control the temperature, the pH, the amount of oxygen, and the nutrients. We can also control the genes of the microorganisms. This means that we can make microorganisms do what we want them to do. This technology has already had a big impact on the world of medicine. We now have vaccines that are made with precision fermentation. We also have a new generation of antibiotics that are made with precision fermentation. And, we are just beginning to explore the potential of precision fermentation to make new medicines."

The Natural Language Generation tool goes on about producing biofuels using the precision fermentation process. Can this be done? Because even the guardian can't control what precision fermentation (or GM, or NLG, or any other techno-utopian next big thing) is used for.

But here's another question: how do we know that NLG isn't already being used by the mainstream media? A lot of BBC articles are clearly written using a template, with a few bits shuffled around. How do we know George didn't use it when he was writing the article in question, or that he won't use it in the future?

I don't think anyone would mistake the unedited paragraphs for the work of a human. But if any mainstream media baron were to think how much money they could save on expensive columnists (note that the guardian article appears in their ironically titled section 'comment is free'), there's no telling what 'solutions' they'd stoop to. As long as they don't print 3D, plant-based versions of George himself. And I'm now imagining the movie: 'Being George Monbiot'.

But I digress. Or do I?

Who Killed Schrödinger's Environmentalist?

GMWatch reports that the former activist George Monbiot is teaming up with his good friend, the publicity hungry Mark Lynas. Monbiot has decided that EU organic targets need to be scrutinised (which is a good point, nothing should go unquestioned). But he also aligns himself with the 'ecomodernist' movement. The process of 'modernising' includes deregulation, neoliberalism, corporate takeover and other phenomena that Monbiot (and even Lynas, a long time ago) once opposed.

Monbiot seems to be joining the GM lobby in shedding crocodile tears about the need to 'feed the world', as if outlandishly expensive and embarrassingly unproductive technologies were ever about anything beyond serving the interests of those who owned it. Is he going to promote the highly destructive glyphosate, which is designed to systematically wipe out everything in its path except genetically modified organisms, which are completely resistant to the pesticide (for a while)?

Perhaps Monbiot himself has developed resistance to the dangerous lies of the likes of Bayer Monsanto (Zyclon B, HIV contaminated blood products, Roundup, etc)? Taking money from the Gates Foundation to promote GM organisms, as Lynas does, wouldn't be such a big step for Monbiot. He already works for one of the most slippery neoliberal organs, the (English) Guardian, whose 'Global' development section is bought and paid for by Gates's 'Foundation'.

Monbiot claims that he and his neoliberal apologist friends don't agree on everything. That's good to hear. Such as? About 10 years ago, Lynas wheeled out GM as a 'solution' to staple food price increases, threatened shortages and famine in East Africa. Even a former activist should know that famine is not a result of a country's inability to produce enough food, and that rapidly increasing prices were a result of commodity speculation in rich countries, including the UK.

Committed environmentalists have campaigned for GM to be recognised for what it is: a technology for taking over global food production, controlling it with any legal, political, (un)scientific, (im)moral or other means, and using that position of global domination to make the owners of GM and other controlling technologies as rich and powerful as possible.

The English Guardian, BBC and other 'liberal' media have made it absolutely clear where they stand on the issue of global domination. They are completely in favour of it, as long as they are the ones in control, on the 'right' side of history. They will go to any lengths to ensure that all legal, political, scientific, moral and other means are in accord with their agenda (or vice versa, it's often hard to tell).

Ecomodernism is what's left over when you stamp out every vestige of humanity, sincerity and fellow feeling. It's tempting to say it's a form of greenwashing, but it's more like a pesticide that wipes out all opposition, a kind of branding iron that you can use to punish all detractors, and warn the devout to keep their distance.

Global Health Tears the World a New One

The Felicific Calculus used by international institutions and global media has decreed that all the bad things in the world, whomever or whatever may have been blamed for them in the past, are now almost entirely accounted for by Covid-19. The world of ordinary people knows that the calculus is a hoax, and that poverty, sickness, disability, economic and environmental collapse, anything that is getting worse since the pandemic started, are a result of the response to it, not the pandemic. 

The English Guardian churns out another clickbait article, deeply concerned about the effects of Covid-19, seemingly oblivious to the fact that every item ticked off in their spreadsheet predates the virus by decades, even centuries. Other media have jumped in with organ trafficking, persecution of people with HIV, family planning provision, availability of sanitary pads, teen pregnancy, child abuse, domestic abuse, female genital mutilation (sic), child marriage, orphans and much else, striving to update their advocacy with the latest hashtags. 

And the universal solution to all these problems is technology! There are vaccines, masks, hand sanitizers, handheld computers and anything else that can be sold to people who have lived their whole lives without access to running water, an adequate and varied diet, in environments that have been depleted, to a large extent, by the same countries that produce all the technology and the purported solutions and their array of placebo suppositories. 

For the Guardian, decades of progress on extreme poverty is now in reverse due to Covid, so the title goes. But much of the ‘evidence’ for this is from a World Bank wonk, who pours out the usual sanctimonious spiel about all the great things that have been achieved, but that are now threatened by a pandemic. They are not threatened by a pandemic, they are threatened by the response to it. 

Bear in mind, this is the institution to which almost every poor country is in debt. Much of those countries’ annual earnings is sent to repay loans they have been persuaded to take over a period of several decades. A handful of international institutions have pushed poor countries to reduce public sector employment, spending on health, education, infrastructure and social services. Indeed, they have ensured the destruction of the very things that they now claim are vital to address Covid-19: hospitals, schools, infrastructure and social services. 

Poor countries are arm-twisted by such international institutions into handing over all resources that are of value to multinationals. Multinationals are not content to rip out everything they can get their hands on, but will happily destroy environments, communities, water supplies, economies and anything else, and leave behind an enormous tab for the host to pay. The very means to survive for most people, fertile land, water, food, employment, agriculture, etc., are denied to those countries in the name of modernization and development. 

The World Bank knows more than most about the conditions in poor countries, because they have spent so long reducing struggling economies to rubble. Countries that had anything worth exploiting were, effectively, colonized by poverty profiteers, people who were paid to take what they wanted, and often took a lot more. Media, like the Guardian, dutifully cover ‘disasters’ as if the damage they wreak on increasingly vulnerable populations is entirely unforeseen, unpredictable, an ‘act of God’. 

Since when has the World Bank been the go-to source of ideas for reducing poverty, or for improving the conditions that most people in the world live in? The countries that have followed their ideologies, as they gradually moved from the vile and despotic policies of 40 years ago to the most comprehensive and widespread enslavement and subjugation of people living in poor countries that we see today, are the ones suffering the most now. 

The only thing more disgusting than promulgating this kind of poverty porn is the pretence that the English Guardian, the World Bank or any of the other big players in the media, international financial institutions and the development industry have the slightest sympathy for those who suffer most from the conditions that underlie this veneer of humanitarianism and philanthropy.  

If these prognostications from the media are correct, and many things really have improved over the past 30-40 years, then we must return to where we were before the pandemic, and identify what we were doing right, and do more of that. Many things will need to be done differently, and the big players of the past will be reluctant to do anything not in their interest. But these lockdowns are a disaster and must be ended before the damage they are doing becomes irreversible. 

To those who herald in the ‘new normal’, there’s nothing new about poverty, disease, food shortages, droughts and disasters. Lockdowns exacerbate and further institutionalize phenomena that have been around for as long as people in poor countries can remember. There's nothing new about authoritarianism, but we have been happy to overlook it when it was imposed on distant countries. It now threatens everyone and it's not something to be encouraged. 

In Memory of Dr Joseph Sonnabend, 6 Jan 1933–24 Jan 2021

Dr Joseph Sonnabend’s first concern was always the welfare of his patients, their families and the people they loved. Before HIV was identified as the virus that caused Aids, Dr Sonnabend was treating people suffering from the shocking illnesses that he and others were discovering among their patients in New York, mostly gay men. Many people infected in the 1980s died. But some survived because of the work of professionals such as Joseph. He pioneered safe sex as a response to HIV and Aids among gay men, and gave his patients the undivided attention that few others were prepared to give.  

Joseph set up and ran several institutions to address the epidemic, care for sick people and research the disease. But when some of his colleagues joined with other parties to create a myth about an imminent ‘heterosexual Aids’ pandemic in order to raise funding, he left. Joseph was branded a ‘denialist’ by those who didn’t wish to deal with any of the numerous concerns that he raised. However, Joseph continued to insist that you cannot understand the spread of a disease if you fail to identify the most important circumstances surrounding its transmission. He still held his ‘multi-factorial’ view of HIV a few months ago, in a discussion about the history of the pandemic with Sean Strub and Dr. Stuart Schlossman. When Schlossman claimed that no one held such a view any longer, Joseph disagreed, but did not have the opportunity to defend his position at that time.

Joseph told me later that his ‘multi-factorial’ view of disease transmission is a characterization of epidemiology as the study of pathogen, host and environment, and not an idiosyncratic theory of his own. He said that most people he worked with in immunology and epidemiology held a similar view, and did not reduce the explanation of HIV infection and the development of Aids to an account of the pathogen, alone, independent of host and environment factors. That’s why the multi-factorial view of HIV explains a lot more than its sexual transmission among men who have sex with men. The theory can also be used to understand the extraordinary outbreaks of HIV transmission among people who are neither male, gay, intravenous drug users, nor even sex workers. The worst of these outbreaks are all to be found in a few countries in southern and eastern Africa, including Zimbabwe and South Africa, where Joseph spent several decades of his life.

Joseph confirmed my belief that HIV is not ‘all about sex’ in high prevalence countries, and that the worst epidemics cannot be accounted for by alleged ‘unsafe’ sexual behavior among African people. He often asked how women can transmit HIV to men via sexual intercourse, saying he knew of no causal mechanism to explain it. Something about the host and the environment, African people and the conditions they live in, the experiences they have, the diseases they suffer, their crumbling healthcare facilities, their poverty and their position as former possessions of European powers could turn out to be a part of a credible explanation of the highest rates of HIV transmission in the world.

Joseph was concerned about the way people lived, their welfare, their “complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO’s definition of health, not necessarily exemplified by their activities). He was not content with vaccines and cures, treatment regimens and medications, alone. In fact, Joseph was opposed to what he saw as the rapidly increasing ‘medicalization’ of healthcare, and disgusted by the systematic humiliation of African people, who were blamed for their own sickness and told to quietly accept what they were given.

Many people have learned a great deal from Joseph, and benefited from his work. He distanced himself from those who saw HIV and Aids as a launchpad for their own careers and ambitions, and he refused to get involved in the more lucrative side of the pandemic. He will be much missed.

 

With Responses Like These, Who Needs a Pandemic?

The Open Society Initiative has announced a Covid19 Emergency Response Fund. Great to hear, but first key area on their list is health system strengthening. Health systems have been in need of funding for decades.  

Second on the list is mitigating the economic impact of Covid19, but that is far more a matter of the devastating effects of lockdowns, people unable to work, purchase food, tend to food production, sell produce, etc. 

A few headlines highlight some of the emergencies faced by African countries and they seem to be either: 1) caused by the response to Covid19, not the virus itself, or 2) emergencies that go back many decades, and increase the harm that kneejerk lockdowns, curfews and the like can cause. 

Unemployment, nothing new, but exacerbated by global lockdowns: Nigeria Records 21.8 Million Jobless People After Covid-19 Effects 

Female Genital Mutilation, nothing to do with the pandemic, but NGOs need to follow the money: No Christmas for West Pokot Girls 

Economic inclusiveness, again, every cause needs to mention the current focus of the media: Covid-19 - Where to From Here for Efforts to Support Youth Economic Inclusion? 

The number of confirmed deaths from Covid19 in Africa is about a third of the number of people who die of rabies every year: Lessons From a Community-Driven Rabies Vaccination Campaign in Kenya 

Diabetes, a recognized risk factor for many conditions long before Covid19: Covid-19 - Understanding the Increased Risk in People With Diabetes 

Foot and Mouth, like all other health conditions, put on the back burner. If there’s an outbreak of this disease now, countries that have closed their economic and administrative functions down will be able to do little to protect themselves: Mozambique: Foot-and-Mouth Outbreak in Maputo Province 

Tourism, conservation, environmental and other projects, all threatened by lockdowns: In Kenya, Maasai Entrepreneur Moves Conservancy Beyond Tourism Hit By Pandemic 

Hardly surprising that food prices have rocketed. They are unlikely to drop anytime soon. Unlike most articles on the pandemic/response, this one identifies other pressures driving up food prices, all of which were there before Covid19, but are made a lot worse by the response: Food Prices in Nigeria Have Shot Through the Roof 

If countries can’t get food locally, or import it from other countries because they can’t get around restrictions on movement and trade, they may end up depending on illicit trading, black markets and other threats to economic and political stability. The above list is from today’s AllAfrica.com newsletter, not at all exhaustive, unfortunately. 

Many are now questioning the wisdom of rigid Covid19 responses urged on them by international institutions, NGOs, donors and foreign leaders. Tanzania is one of the only one to impose a modest lockdown with a viable exit plan. Other countries could soon follow their example. None can afford the millions shelled out by rich countries. 

Covid-19 in Tanzania: Pursuit of Health Sovereignty?

What’s the difference between Kenya’s response to Covid-19 and Tanzania’s? It’s difficult to know about Tanzania because journalistic practice dictates that if an African leader stands up to western leaders, experts or even mere bureaucrats or journalists, they must be slapped down, ridiculed and hounded for the remainder of their office for their temerity.

It’s not so difficult to find out about Kenya’s response: a curfew was imposed and violently enforced, many people were held (effectively, interned) in insanitary conditions, some were beaten and some died, children will remain out of school until next January, hospitals are said to be overwhelmed (aren’t they always?), there are restrictions on movement, shortages of food, etc.

In Tanzania, children were sent home for a few months, but people were encouraged to go to work, feed their families, take care of themselves so that they could take care of people who were not able to. Magufuli refused to go running to the international community for handouts earmarked for (well-behaved) African leaders.

Consequences from Kenya's response to Covid-19 are far more severe than those from the virus itself. Of course, Tanzania is going to have to face the consequences of the responses of countries around them, and the consequences of their trading partners’ respective responses; for example, there is already a massive drop in tourism, globally, something a lot of poor countries disproportionately depend on.

But perhaps the difference between Kenya’s and Tanzania’s response to the virus runs deeper than the daily struggle for basic things, such as food, habitation, education, healthcare and the rest. The BBC, in that sneering tone specially honed for Africans, have coupled Magufuli’s approach to Covid-19 with his objections to ‘imperialism’.

In fact, Magufuli objects to the likes of mining operators from rich countries granting his country a paltry 3%, quaintly referred to as ‘royalties’, of anything declared as a profit. He advises people to balance rich countries' 'giving' against what they take, which is not unreasonable. Or perhaps the BBC doesn't recognise imperialism that hasn't been branded as such by them?

While the Constitution of the World Health Organization states that “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”, their response to the virus appears to view health as the avoidance of certain pathogens deemed more catastrophic than others, pretty much at all costs. Tanzania, and all poor countries, have a lot more to worry about than Covid-19. (Don't we all?)

In their anxiety to depict Magufuli as an unworthy opponent of imperialism, an incapable leader of Tanzania and a generally uninformed person whose tenure verges on dictatorial (and I’m certainly not saying he’s faultless), many commentators have missed something important. Africa and Africans won’t be ‘rising’ when, or because the English Guardian or the BBC plasters it up in banner headlines.

Perhaps it will happen when leaders like Magufuli, human as he is, stand up to the sanctimony of the western media, the neo-imperialism of wealthy countries, and the complicity of the ‘international’ institutions they fund. But the difference between Kenya’s and Tanzania’s response? Tanzania refused to be cowed into overseeing a complete breakdown of the economy, of law and order; they even refused to take money to do what Kenya and other countries happily did.

It could be argued that Magufuli is striving for health sovereignty, which is, by definition, autonomous, unlike the top-down, one-size-fits-all ‘solutions’ that rich countries and their institutions are so keen for poor countries to adopt. At least, he seems to be highlighting a tension between the WHO’s definition of health and their approach to health emergencies, especially in poor countries (but not exclusively).


Much remains to be seen, but what Magufuli has done so far has resulted in a lot less harm than what Kenyatta has done, which is just more of the same. In contrast, Magufuli has stood up, with his people; he has refused to be goaded, and to be induced into handing over everything to rich countries and institutions. He refused to betray the Tanzanian people, refused the readies. How many other leaders, in Africa and elsewhere, can claim the same?