Whatever happened to the AIDS apocalypse?

When I first started working in the AIDS movement in the mid noughties the picture was plausibly apocalyptic, but on World AIDS Day 2012 we are celebrating that an AIDS-free generation is now within our grasp. So what happened?

The acceleration of the science is one huge part of the story, but the effectiveness of the AIDS movement is at least as important and future campaigners can learn a lot from one of the most successful global mobilisations of the last few decades. For me four main lessons stand out:

1)      It starts with rights. Determining when to claim partial victory is the sort of thing that keeps movement leaders up at night. Overstate it and you lose the incentive for supporters to act, understate it and you lose the incentive for policy-makers to act. The moral and strategic tensions are captured in a (no doubt apocryphal) story told about a dispute inside the debt movement where one staffer accused another of being ‘the kind of person that during abolitionism would have been lobbying for more comfortable boats’. AIDS activism has successfully defined those tensions away by being more of a human rights movement than a development one. With early roots in gay liberation politics, the movement has always focused on those whose needs are greatest, not those whose stories are easiest to sell. It takes real courage to advocate for heroin addicts and sex workers at the same time as orphans and infected newborns, but unflinching honesty about the true nature of the epidemic has been, in the end, one of the movement’s great strengths.

2)      Injustice speaks for itself.  From the UK’s Terrence Higgins Trust to South Africa’s Treatment Action Campaign, the highest impact organisations have not been founded in solidarity by the charitable but in fury by the affected. I have written before about the importance of advocacy’s amateurs and for me the history of AIDS is the clearest example of why the advocacy ‘professionals’ should get out of the way and let the people who need to know ask the powerful how much they think their lives are worth.

3)      Institutions matter. The Global Fund, for all its faults, is multilateralism’s great success story. Its record is a triumph of institutional design, the result of a very special chemistry between the public, private and third sectors and people affected by the three diseases. While some education advocates have already started pushing for a replica for education, there is no other institution quite like the Global Fund, and no particularly good reason for that to be the case. The case for reform of global governance is painfully familiar to Global Dashboard readers, but we should try to learn at least as much from what we’ve got right as what we’ve got wrong.

4)      It takes coalitions of the willing. It bears constant repetition that the man behind the world’s first government anti-AIDS campaign was a minister in Margaret Thatcher’s cabinet. Likewise, while the global AIDS fight is now one of the few areas of bipartisan consensus in the United States, it was a Republican rather than Democrat incumbent of the White House who first initiated a scaled emergency response and a distinguished veteran of George Bush’s PEPFAR who will now be leading global efforts at the new chief of the Global Fund.

We still have a long way to go but at a time when so many promises are being broken, tomorrow provides a good chance to remember that, just sometimes, campaigning works and the results can be spectacular when it does.