(from the September 13, September 20, and November 1, 2000 issues of Challenge-Desafio, weekly newspaper of the Revolutionary Communist Progressive Labor Party)
"I can choose to die of starvation now, or of AIDS later"—Prostitute in Harare, Zimbabwe
Reports to the 13th International AIDS Conference last month in South Africa described a holocaust of mind-numbing dimensions. Fifteen million have already died. Thirty-four million are HIV-infected, including 25 million in sub-Saharan Africa. HIV/AIDS will kill 67% of today’s teenagers in some African countries. Women are twice as likely as men to become infected. Thirty million African orphans are predicted by 2010, life expectancies dropping from 70 years to 30 in some countries. If neutron bombs were dropped on the dozen biggest cities of Africa, the damage could not be worse. International response to this crisis has been obscene. Bosses and politicians fight over drug prices and profits, while they spend much more on Viagra and baldness remedies ($333 million QUARTERLY earnings, according to Pfizer), than on all international HIV programs in sub-Saharan Africa ($600 million YEARLY of international aid for HIV/AIDS).
Though many see the AIDS pandemic either as a "natural" disaster or as a biological warfare conspiracy, it is actually rooted in the devastation imperialism has inflicted on African societies. This first of a series of articles on the political economy of AIDS will discuss where the HIV virus and the AIDS pandemic in Africa came from.
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Scientists have recently learned much about the origin of HIV. Like influenza and rabies, AIDS is a disease transmitted from animals to humans. The closest relatives of HIV are SIVs, viruses carried by apes and monkeys. HIV-1 most resembles a chimpanzee SIV, found in rain forests of coastal West Africa. HIV-2, a milder West African virus, is nearly identical to a monkey SIV. These viruses have lived in their natural hosts for millions of years and don’t make them sick. Among scientists, the currently favored idea of how the viruses jumped into humans is that people hunted chimps and monkeys for meat, and cut themselves while butchering.
HIV is relatively new to humans. The earliest verified HIV case was in 1959, in Kinshasa, Congo; African blood samples from earlier times are free of the virus. HIV exploded in Africa during the early 1970’s, just before it spread to the U.S. and Europe. Very early cases were found near the borders of Congo, Uganda, Rwanda, and Burundi. From there it quickly spread to Zambia and Tanzania. Before the 1970’s, AIDS was as unknown in Africa as in the U.S.
HIV evolves rapidly. Its gene sequences accumulate mutations in a steady, clock-like manner. The more differences, the more time has passed since viruses had a common ancestor. By comparing the genes of currently circulating viruses, it is possible to make an informed guess as to when the common M type of HIV-1, the one responsible for the worldwide pandemic, began. The best guess is in the 1930’s.
HIVs not only jumped from animals to humans recently; they also did so OFTEN, at least four times. This is inferred from the fact that some HIV strains are genetically more similar to SIVs than to each other. So it seems that HIV is relatively easy to catch from animals, and that no special mutations are needed to make it virulent in humans. In fact, a lab worker recently developed AIDS from a monkey SIV after an accidental needle stick.
So, if the virus jumps easily to humans, why did the pandemic not start until the late 20th century? What changed that made repeated transfer to humans more likely and explosive growth a certainty?
Until the late 19th century, most Africans farmed and lived in rural villages. Then feverish land grabs among imperialists—seeking rubber, gold, ivory and diamonds—created the largest forced labor system since African-American slavery. For example, King Leopold II of Belgium seized the Congo and ruled it for years as his personal rubber plantation. Fifteen million Congolese died in this genocidal holocaust. Forced labor was the rule in colonial Africa. Copper mines in Katanga (Congo) rounded up miners from Zambia, Rwanda, Angola and Mozambique. Colonial armies drafted millions of Africans during both world wars. During the 1930’s, the French built a railroad through coastal West Africa, drafting hundreds of thousands of African laborers from distant locations and marching them through the rain forest under appalling conditions of near-starvation. According to one theory, it is here that Africans first were exposed to SIVs, as workers made desperate by starvation had to hunt apes as food.
Another theory places the origin of AIDS in the Belgian Congo and neighboring countries. In his thoughtful book, The River, Edward Hooper argues that HIV spread to humans through racist trials of polio vaccines. During the late 1950’s, Hilary Koprowski of Philadelphia’s Wistar Institute gave an experimental oral vaccine to over 300,000 Africans, using them as guinea pigs. Hooper suggests that Koprowski may have grown vaccine poliovirus in chimp cells contaminated with the SIV ancestor of HIV. Hooper’s ideas lack solid evidence, but they are being taken seriously enough to prompt testing of remnant vaccine stocks.
Whichever theory turns out to be true, it is clear that the crossover of the virus was a result of conditions created by colonialism. But what caused HIV’s later explosive growth?
Starting in the 1960's, African societies changed from colonialism to rule by indigenous nationalist or fascist rulers allied with imperialism. For example, the Belgian Congo became Zaire. Patrice Lumumba was assassinated by the CIA. They installed Mobuto, a worthy successor to King Leopold in greed and bloodthirstiness. South Africa and Rhodesia (later Zimbabwe) remained under fascist apartheid throughout this period. Armies of male migrant workers left the countryside for the newly-crowded cities, while their wives remained behind in remote rural areas. Prostitution became a major growth industry, some European companies even setting up whorehouses near their factories for their workers. A seemingly endless series of nationalist and inter-imperialist wars sent millions of soldiers and refugees all over central Africa.
Enslaved by the global market economy, conditions created by colonialism continued and worsened in "post-colonial" African societies. HIV spread like wildfire through populations ravaged by poverty, war, famine and disease. HIV spread to Europe and the U.S., and then to Haiti and Thailand, primarily through sex tourism, often child prostitution. Prostitution and dirty needles spread it to Latin America, India and Eastern Europe, centers of new epidemics. The IMF's (International Monetary Fund) stranglehold on poor countries caused massive unemployment, promoted prostitution, imposed cutbacks in health care and education and made life-saving drugs unaffordable.
Sexism kills, just as surely as--and combined with--racism. In Africa, traditional oppression of women has meshed with new, profit-driven forms of oppression. In southern Africa, married women often don't dare ask their husbands to wear condoms, and are pressured by relatives to stay unprotected for maximum fertility. Husbands are expected to have many sex partners while their wives are expected to be monogamous.
Some day the HIV pandemic will be known as one of imperialism's worst crimes. Rulers in both Africa and the U.S. claim that the situation is hopeless, and that millions are doomed. Yet the money it would take to provide effective prevention and therapy now ($100 billion yearly) is only a small fraction of what imperialists spent on wars against Iraq and Vietnam. It is an even smaller fraction of the profits they've made from African rubber, diamonds, gold, copper, oil and slave labor. In a few countries (like Uganda and Thailand) even simple prevention campaigns have had a big impact. So building a larger movement now, that refuses to accept rules protecting the bosses' profits, can save many more lives. Mass production and distribution of pirated anti-AIDS drugs, in collaboration with medical workers in Africa, can prevent transmission and provide treatment for millions.
A larger movement must also lead a sharp and prolonged struggle against sexism in order to transform relationships between men, women and children, ending prostitution and sex slavery. It must fight to end the super-exploitation of migrant labor. These goals can only be achieved through the revolutionary destruction of capitalism. The experience of once socialist China in eradicating prostitution, syphilis and drug addiction (which have all returned in now capitalist China) shows that revolutionary communism can, even in poor societies, solve massive public health problems.
Sources: Hahn, B.H. et al. (2000); Korber et al. (2000); Science 287: 607 Chitnis et al. (2000), AIDS Res. Hum. Retroviruses 16: 5-8; Gao et al. (1999) Nature 397: 436-441; Hooper, E.M. (1999) The River; Schoofs (2000) "The Agony of Africa" (at http://www.villagevoice.com/specials/africa) ScientificAmerican, January 2000; New York Times, 6/28/00 and 7/9/00. Recommended background: A. Hochschild King Leopold's Ghost; W. Rodney, How Europe Underdeveloped Africa; B. Davidson, "The Black Man's Burden: Africa and the Curse of the Nation-State"
"That mother is going to die and that HIV-negative child will be an orphan. That child must be brought up. Who is going to bring the child up? It’s the state, the state. That’s resources, you see."—Parks Mankahlana, spokesperson for South African president Thabo Mbeki, explains why his government won’t provide nevirapine to prevent mother to child transmission of AIDS. The government would rather have the child die of AIDS than use state resources.
During the recent AIDS conference in Durban, South Africa (SA), Pres. Thabo Mbeki questioned whether HIV causes AIDS, and invited a group of crackpot "AIDS dissidents" from the U.S. to serve on an AIDS panel. The South African AIDS calamity is part of a general catastrophic failure to improve workers’ lives since the end of apartheid. International corporations and banks, the International Monetary Fund (IMF), and the World Bank, together with South Africa’s reconfigured post-apartheid black and white ruling class, have preserved the worst features of apartheid.
In 1991, a CIA document predicted 45 million HIV infections by 2000, the majority in Africa. (Present over 50 million people are believed to have been infected; 19 million have died.) Faced with these figures, the U.S. rulers cold-bloodedly debated whether it was "worth" it, from a military standpoint, to combat AIDS. One security official commented, "Oh, it [AIDS] will be good, because Africa is overpopulated anyway." This became the unofficial line of USAID, the State Department’s international "aid" agency, and of the World Bank. When it became obvious the U.S. didn’t face a runaway heterosexual epidemic, further action was shelved. The World Health Organization, the Center for Disease Control and the UN all actively resisted paying for AIDS prevention.1 People who believe HIV is a CIA plot are wrong about the facts, but they’re right that capitalists consider millions of African workers expendable.
Why has Mbeki lent an ear to HIV deniers? The initial quote above suggests he’s trying to save money by preventing the birth of HIV-negative orphans. Last year Mbeki’s government refused to spend nearly half of the money in its AIDS budget and blocked the purchase of relatively cheap drugs that prevent maternal transmission of AIDS. Or Mbeki, by appearing stubborn, may be jockeying for a better deal in international aid and drug prices. Either or both of these cynical motives would be consistent with Mbeki’s role in the "new" South Africa.
Liberals praise SA’s "peaceful transition" from apartheid, as though power had actually changed hands in 1994. Power never changed hands. The heroic struggle against apartheid was co-opted to smooth the re-entry of SA’s biggest bosses into global capitalism. By 1990, the more powerful, "forward-looking" wing of the SA capitalists were frustrated by a recession brought on by international sanctions. Led by Harry Oppenheimer (owner of de Beers diamonds and SA’s gold mines), they made a deal with leaders of the African National Congress (ANC) to dismantle the surface aspects of apartheid, while leaving its base in super-exploitation intact.2 By assuring stability, Mandela and Mbeki made SA safer for capitalism.
Mandela, of course, was a hero to millions, and had spent 30 years in prison for defying a fascist court. Like Mandela, Mbeki was a leader of the ANC, then influenced by the SA Communist Party. In 1970 Mbeki visited the Soviet Union for military training. By the 1990s, Mbeki had morphed into a business technocrat. According to a pro-ANC commentator, "Mbeki had been the darling of South Africa’s business community for years, a champion of the type of neo-liberal economics that pleases cheerleaders for globalization. A close friend of the Clinton Administration, Mbeki was considered a man ‘we’ could work with."3
When Oppenheimer died this year, Mandela and Mbeki eulogized him in glowing terms. But Oppenheimer was apartheid’s biggest profiteer, notorious for racist wage differentials and appalling working conditions. Oppenheimer’s gold mines set the pattern for migrant industrial labor that first spread the AIDS pandemic. Men were recruited from all over SA to work in the mines and housed in single-sex hostels. Their wives had to stay behind in the so-called homelands. The bosses encouraged prostitution, and men who became infected with HIV took it home to their wives in remote rural areas.
Life for SA workers has become ever more desperate. Apartheid still rules in the townships, where red-lining (racist housing practices) and loan-sharking have deepened the housing crisis. As formal apartheid ended, South Africa was already in debt slavery to the IMF and World Bank. "Structural adjustment" programs forced dismantling of the public health system and provoked mass unemployment (and prostitution). As a good businessman, Mbeki cheerfully enforced the "belt-tightening."4
These actions fueled the skyrocketing AIDS epidemic. Despite warnings from SA physicians and scientists, Mandela ignored the growing HIV danger, scuttling even safe-sex messages when he was advised that it would be political suicide to mention AIDS. From 1990 to 1999, HIV infection increased from 0.8% to 22%, until today SA has over 10% of the world’s infections.5
Most drugs used to treat HIV are vastly over-priced and out of reach in the developing world. As an HIV-positive SA judge said recently, "On a continent in which 290 million Africans survive on less than one U.S. dollar a day, I can afford monthly medication costs of approximately $400 per month.…I am here because I can pay for life itself. To me this seems a shocking and monstrous iniquity."6
Pfizer’s fluconazole is used to treat cryptococcal meningitis, a brain infection in people whose immune system has been weakened by HIV. In 1997, South Africa tried to buy an equivalent drug from Thailand at 1/20th the cost, challenging World Trade Organization patent rules. Al Gore acted as Pfizer’s pimp, threatening trade sanctions if SA didn’t respect patents. Recently, Clinton-Gore, drug companies and Mbeki have been performing a complicated dance. The U.S. has backed down somewhat, as Gore pretends to campaign against "big drug companies" in the election follies. Drug mult-inationals have started to offer South Africa special deals and give-aways, none of which has yet materialized.7
The decades-long struggle against South African apartheid, which was led by millions of SA workers and students, inspired the world. Many of the most committed leaders were black and white communists, but their goal was "black majority rule." They believed that fighting for socialism and then communism would have to come at a "later stage." This reformist and nationalist "stage theory" undermined the possibility of workers’ revolution and is now contributing to tens of millions of deaths. AIDS and poverty holocausts in South Africa and the rest of the world can only end with communist revolution.
1. Gellman, WASHINGTON POST, 7/5/2000, p. AO1
2. Patrick Bond (July 2000), "A Political Economy of South African AIDS" (http://www.zmag.org/AIDspage.htm)
3. Danny Schechter, "Mbeki’s Muddle.
4. Patrick Bond (2000) Elite Transition: From Apartheid to Neoliberalism in South Africa
5. Jon Cohen (2000) SCIENCE, 288: 2168-2170
6. Speech by Edwin Cameron, Durban conference, 7/10/2000
7. Chirac, et al. 8/5/2000 — AIDS: patent rights versus patients’ rights, The Lancet, volume 356, number 9228