Global AIDS and the Imperialist State: The Ends of Bourgeois Moralism

Global AIDS and its massive human and social destruction, having long been treated by the governments and media of the metropoles with systematic silence or occasional grim reportage as a new "plague" beyond human intervention, has, suddenly, become a cause célèbre among government and media figures of the North. This apparent attention, in fact, is being touted as such a profound and sudden reversal from inattention and inaction that it can only be understood on the terms of a (religious) "conversion" experience.

Take, for instance, the New York Times article, "With Convert's Zeal, Congress Awakens to Global AIDS Crisis", which tells various stories of conversion among US Congressmen. Representative Gephardt, we are told, is "[a]mong those who have undergone an awakening". Gephardt's awakening is attributed to a trip he took to Africa in 1999 where he had intended to "learn about economic and political conditions" but instead "came away with a single message: 'AIDS, AIDS, AIDS, AIDS. I came away knowing and believing that this is the moral issue of our time'" (New York Times, 5/12/02).

It is not only such liberal democrats, however, who have "seen the light". Senator Jesse Helms, who is well known for his racist and homophobic views in relation to AIDS in the US and who has vehemently opposed foreign aid as a "rathole", is apparently one of the "leaders" of the recent surge in Congressional support for funding to fight global AIDS. Helms' "conversion" is attributed to a seemingly "postmodern" pastiche of influences—from the rock star "Bono" (whose lobbying and public relations efforts around the cause of aid to Africa have become a fetish of the media) and Samaritan's Purse, a Christian relief organization, to a "redemptive" fervor in the wake of Helms' recent heart surgery and anticipation of his retirement from the Senate.

While seemingly progressive, the narratives of personal conversion to the "moral cause" of AIDS repeat (through a simple inversion) the Bush administration's "missionary" approach to global AIDS prevention. That is, an approach which severely restricts the possibilities for HIV/AIDS prevention by successfully imposing—in the name of Christian "morality" and against the overwhelming support for such programs among EU and other nations—a ban on sex education within UN AIDS prevention programs in favor of "abstinence education".

One of the dominant, apparently "dissenting", positions in the debates over the politics of global AIDS has been that the US and other rich nations have not, as argued by Dr. Paul Zeitz, executive director of the Global AIDS Alliance, had "the political will" to stop global AIDS. From this view, the recent "shift" in the "attitude" of some US Congress members towards funding to fight AIDS in Africa—whatever the religious or "pragmatic" reasons behind it—marks an important step in the fight against AIDS ("With Convert's Zeal", The New York Times, 5/12/02).

If, however, we look at the actual results of this "conversion", it becomes clear that the rhetorical attention that is being paid to global AIDS, and particularly its manifestation in Africa and other Third World nations, is in striking contrast to the actual policies of the industrialized states. The recent meeting of the G8 in the Canadian hideaway of Kananaskis is exemplary of this contradiction between the "new" rhetoric and the same-old policies. For instance, while the leaders of the African nations who were given special invitations to the summit were asking for $35 billion in aid and investment (based on UN estimates that it would cost $25-$35 billion to get "Africa on track to meet its internationally agreed anti-poverty goals"), by the end of the summit the EU and US had pledged only $6 billion for Africa—over the next four years ("Africa Betrayed: the aid workers' verdict", Guardian 5/28/2002). To put this in perspective further, the US alone has devoted $180 billion dollars of US taxpayer monies over the next ten years for farm subsidies whose primary beneficiary is Big Agribusiness ("Rich States leave Africa in the slow lane", Guardian, 5/26/02).

According to the British Guardian, given these farm subsidies (and those of Canada), the trade situation for Africa has not only not been improved by the G8 this year, but has actually worsened. While Tony Blair, supposedly one of Africa's most committed allies of the G8 leaders, nonetheless insisted the $6 billion in aid was a "significant uplift in aid", aid agencies denounced the G8's policy statement on Africa, calling it a "vacuous" "inaction plan" that offered Africa "recycled peanuts". The leaders of the African nations invited to the summit were equally unimpressed by this (not so) grand gesture, with sources from these contingencies stating that the text (on Africa) is "absolutely empty" ("Africa Betrayed: the aid workers' verdict", Guardian, 5/28/2002).

As Zeitz suggests, the governments of the "rich" nations have in fact known about the pandemic and its proportions for some time. Contrary to the dominant, subjectivist perspective represented by Zeitz, however, the role of the imperialist state is not determined by the attitudes of the particular politicians in power but is structurally necessary to sustain the imperialist economic system. Theories of the state as "contingent", open to re-articulation or "negotiation", etc. ideologically obscure the role of the state, and particularly the imperialist state, in providing the political arm of the ruling class. Zeitz himself, in fact, points to the economics of "will" when he points out that the CIA has reported that countries heavily impacted by AIDS are susceptible to "political instability" (a bourgeois code for social struggles over the social wealth and resources) and that this report "provides a clear link [from AIDS] to the war on terror" ("With Convert's Zeal", The New York Times, 5/12/02).

The framing of AIDS (and the response to AIDS by the imperialist state) as a matter of "morality" is, in fact, a cover story; it is necessary because it works to hide the actual, historical role of the state in supporting ruling class interests.

Gephardt's comments are exemplary here. For Gephardt, AIDS became significant only when it had exceeded the crude materiality of economics: he expected while in Africa to confront "economic and political issues" but instead found the surprisingly urgent "morality" of AIDS. In other words, it was not the structural relations of the world economy that position Africa as the most brutally underdeveloped continent which interested him. Rather, it was the spiritual experience of others' pain that turned him into an AIDS crusader. That is, it is not the causes of AIDS (and by extension not its solution) that counts, but "moving" people with narratives about the terrible suffering he witnessed.

While such conversion narratives have become very popular on the left and right as a sign of one's deep commitment to social issues, it is precisely because they convert economic issues into subjective ones that they actually prevent serious analysis and forestall structural change. AIDS however is a class issue: the rich have access to the available cures as well as the means of prevention, while the poor are denied both and forced to live under intolerable circumstances. Gephardt's arguments violently obscure the economics of AIDS—the relation between access to social resources and health—and the role of the US in producing genocidal health crises in Africa and throughout the world. In doing so he justifies, on behalf of corporate interests, denying millions of people the funds and conditions necessary to obtain medical treatment and ensure the eradication of AIDS. It is moral support, he suggests, that is the real, even honorable role of the state and concerned state officials.

"Morality" renders objective, structural relations a matter of individual, subjective relations in order to distract attention from the structural relations of imperialism that (re)produce global AIDS as a social crisis. Contrary to the endless repetition of clichés about the new "post-class" economy that constitute the dominant "globalization" theory and which are almost comical when one looks at the actual historical record of the widening gap between rich and poor, the state provides crucial support to global, monopoly capital by backing (if necessary by military force) the economic aggressions of imperialism in its endless quest for expanding profits in the face of the tendency towards a falling rate of profit. Given this directly economic role, the imperialist state must also provide ideological (and if necessary repressive) containment of the struggles that such economic aggressions produce.

The effectivity of framing the apparent shift in "attitude" and/or policy recommendations as a (moral/pragmatic) "conversion" is that it posits the social as aleatory, a series of distinct "events" rather than a totality of relations. It, in other words, abstracts the "events" of today from those of the past rather than explaining the parameters of the contemporary struggles as determined by the history of struggles, and it posits the social as a series of autonomous individuals, autonomous nation-states, etc.

The idea of a "conversion" (to a new empire/imperialism which is beneficial to all) works, for one, by positing the imperialist nation-state as autonomous/separate from all other nation-states and the world economy in which all nation-states are embedded. In the case of global AIDS, this is evident in the way in which the ideologists of imperialism (such as Gephardt, Helms, Biden and those who serve these servants at the New York Times) leave out imperialism and the imperialist state's role in PRODUCING global AIDS in the first place, and their continuing centrality in ensuring that Global AIDS cannot be effectively combated by prioritizing monopoly corporate profits over human, social needs.

Contrary to the ongoing, racist representations of Africa as the "dark continent" with an "exceptional" set of problems, Africa, and especially sub-Saharan Africa, where the AIDS pandemic is having the most devastating effects, is the exemplary instance of the relations between imperialism and AIDS which is now being repeated, for instance, in the former Eastern block nations where AIDS, alongside global sex work, is on the rise. Poverty, malnutrition and lack of health care that are the result of the exploitation of African labor and resources (such as gold, minerals, rubber and oil) have provided conditions where AIDS both spreads and kills at a rapid rate. Africa Action reports that over 17 million Africans have died of HIV/AIDS and that "more than 28 million of the 40 million people living with the disease worldwide are in sub-Saharan Africa" ("Hazardous to Health: The World Bank and IMF in Africa", Africa Action Position Paper, April 2002). Moreover, these conditions are not merely a residual effect of European colonialism, but are being reproduced and deepened by neo-colonial and other imperialist attacks on the material conditions of the African people in the name of "globalization" and capitalist "development". For instance, the structural adjustment programs imposed on African and other "developing" nations have caused a rapid deterioration in terms of access to medical care and reproductive health services. At a time when AIDS-related illness has made access to healthcare more urgent than ever, African countries have actually had to cut their health expenditures under IMF programs. In many of these countries, the money spent on debt repayment far exceeds the money spent on healthcare.[1]

These conditions, as elsewhere, have hit women and children particularly hard, both because they are most impacted directly by poverty, and also because these conditions reinforce and reproduce in new forms patriarchal structures of oppression which compound the effects of exploitation and racial oppression. In particular, women are forced into prostitution and sexual slavery. In addition, compelled migrant labor on the part of men works against marital fidelity. Under such conditions, the Bush administration's "conservative" cultural policy, which assumes that sexual "abstinence" or marital "monogamy" is a "choice" for all men, women and children rather than for a handful of privileged men and women in the North—and denies adequate reproductive health services on this basis—is tantamount to a death sentence for millions of African women, children and men.[2]

Moreover, the imperialist state has not merely been complicit in the development of this world health crisis by refusing to provide anything but token economic aid to the countries most hard hit by the pandemic, but, for the sake of buoying the profits of monopolistic corporations, has actively worked to block access to treatment as well as prevention of the disease. For instance, the imperialist states of the US as well as Britain have intervened repeatedly to block Third World countries from producing and buying AIDS medications at affordable costs. For instance, as president of the U.S.-South Africa Bi-national Commission, then Vice President Gore threatened trade sanctions against South Africa if they tried to buy inexpensive generic versions of drugs which US companies had patents on—despite the fact that there is in fact international policy developed by the WTO and agreed to by the US government as part of WTO which allows for "compulsory licensing" of drug production in cases where people's lives are threatened.[3]

The "humanitarian" "donations" of drug companies such as Pfizer and imperialist governments such as the US are not only completely inadequate for addressing a crisis systematically produced, but are aimed at maintaining the monopoly pricing and concomitant super-profits reaped by drug companies from sales of their brand name drugs under patents which last for decades. In other words, US workers are taxed not to help alleviate the suffering of their fellow workers around the world, but in order to buoy the profits of monopolistic drug companies and to maintain the system under which they are exploited and oppressed and workers in the developing nations and regions are super-exploited and viciously oppressed.

In fact, there is nothing more symptomatic of the violence of imperialism and the cynical mystification of this violence than the way in which what is called "international" or even "humanitarian" aid is, in the hands of monopoly capital, not a matter of "charity" (Christian or otherwise), but a tool to be used as part of its systematic, imperialist expansion of for-profit, commodity production at the expense of production for human needs.

In other words, behind the so-called moral "conversion" among some US government officials to the cause of battling global AIDS are economic and political conditions which threaten profit accumulation. This becomes clear in reading the bourgeois media and policy documents regarding Southern Africa. For instance, in May 2002 Business Week reports that Business Maps, an investment advisement company, put out a report indicating that the climate for foreign investment in the Southern African Development Community (SADC) has declined precipitously. The reasons they give for this decline include the political "instability" in Zimbabwe, the impact of HIV/AIDS on this area, and the "cautious" pace of privatization in South Africa. A survey conducted by Business Maps found that "because of the increased risk perceptions, rates of return above 25% were now required by some investors". Whatever individuals subjectively believe, it is this political-economic interest that has prompted this phenomenon of "conversion" of Congress members such as Jesse Helms along with the enthusiastic reception of celebrities such as Bono in the halls of Congress as well as the spike in (rhetorical) attention and commitment to fighting global AIDS.

Thus, one of the issues is that "aid" to Southern Africa is given with the aim of shoring up the social and political situation in these countries so that the climate is better for "foreign investment" by capital. Because such "aid" is aimed at short-term stabilization of the investment climate for profitability, it will not resolve but will in time lead to worsening conditions and greater "instability" (which is the code word in the bourgeois media for struggles over socially produced wealth and resources). This irresolvable contradiction explains why it is that "aid" has also become a political weapon in the social struggles. "Aid" is not given freely to meet human needs, but is rather given to countries and/or regions whose ruling elites will commit to economic policies (free trade for the already rich) that benefit transnational, monopoly capital and can follow through on this commitment "by whatever means necessary". In other words "humanitarian aid" becomes a form of bribery.[4] The working of aid-as-bribery is evident in Africa, for instance, in terms of the way in which the aid is disproportionately channeled towards South Africa because South Africa is proving to be an important "subhegemon", or an important ally of the US and other imperialist states in the struggles to impose neo-liberalism on the Southern African people despite the proven devastating effects of "free trade" (or freedom for capital) on the living and working conditions of the people of Southern Africa.[5]

Thus, it is, as various progressive organizations of citizens and health professionals have argued, necessary to struggle for reforms in order to make it possible for all nations and citizens to gain access to effective AIDS education and medications. What is necessary for such access is to contest the monopoly ownership and control of life-saving drugs and reproductive and other healthcare. Global citizens must insist, for instance, that all nation-states and all companies follow and expand the existing international policies which allow for licensing of production of generic drugs in cases where lives are at stake—in other words in virtually all third world countries for all the drugs to combat aids and aids-related illnesses, tuberculosis, malaria, etc.—and for immediate, unconditional cancellation of Third World debt (the principle of which has already been repaid many times over) so that the resources of these nations can be used to provide the necessary healthcare and not for (further) lining the pockets of finance capital.

However, the only way to ensure a world in which suffering and disease are not produced for the sake of profit and then commodified in order to reap further profits for the few at the expense of the many is to engage in all struggles, including struggles for reforms, as part of the struggle for international socialism—a world where production and its socially produced wealth is for needs not profit.

[1] In Tanzania, for instance, the expenditure for debt repayment is three times the $3.20 per person per year expenditure for healthcare. When the cost of AIDS medications is $2,000 per year, the effect of such limits becomes clear—it means that few if any African people, even those of the "middle class", have access to the medications to treat the effects of and reduce the transmission of the virus. See, for instance, "Imperialism and AIDS in Africa", Revolutionary Worker, 8/6/2000.

[2] The ideological determination of this approach is evident, for instance, in that extra-marital access to sex for Western men is accepted and encouraged as a compensation for exploitation (hence the way in which the US government becomes "concerned" about AIDS when it emerges within women in the sex industry around bases such as those in the Philippines), but is implicitly criticized as immoral on the part of Africa men.

[3] See, for instance, "'One World, One Price' Means Death for People with AIDS in Poor Countries", Doctors Without Borders, press release, 3/13/2000; and "AIDS Drugs Imperialism", Socialism Today, October 1999.

[4] The role of the state in administering such bribes is codified in the bill recently introduced into the US Congress, H. R. 4877, called the "Foreign Aid Impact Assessment Act", which lists eleven "legitimate" aims for foreign aid, which include 1) to assist the development and economic advancement of friendly foreign countries and peoples, 2) to promote the freedom, aspirations, or sustenance of friendly peoples under oppressive rule by unfriendly governments 3) to promote international trade and foreign direct investment as a means of aiding economic growth, and 11) to otherwise promote through bilateral foreign economic assistance the national objectives of the United States of America.

[5] The role of South Africa, and particularly its ruling elites, in facilitating imperialism can be seen, for instance, in its role in the G8 summit. Based on the promises of aid made during last year's summit in Genoa, South Africa's President Mbeki and three other African leaders drafted the New Partnership for Africa's Development (NEPAD), basically the same old free trade policies that have devastated Africa in an updated package. NEPAD constitutes, in effect, the acceptance, by these leaders, on behalf of their people, of "aid" as a remedy for the devastation of imperialism. The class interests of such a subhegemonic role in imperialism, like that of the industrialized states, is made clear by the results of such "bargaining" (again, the G8 is exemplary here—in exchange for their people's suffering, the African leaders at the G8 received only more promises). For a discussion of South Africa's role as a subhegemon, see Patrick Bond's "Zimbabwe After the Elections", Monthly Review, May 2002.