Cover of book: AIDS: Don’t Die of Prejudice

Norman Fowler
AIDS: Don’t Die of Prejudice

During Norman Fowler’s years as Thatcher’s health secretary, the world was beset by a virus that demanded an urgent response. His new book mostly elides the history of HIV, but quotes the founding director of the Global Fund on the worldwide reaction: “Let’s see what happens if we all deliberately decide to do nothing and let the virus take its natural course.”

Fowler led Britain’s Don’t Die of Ignorance campaign, almost as renowned as Australia’s grim reaper advertisements. “My (doubtless naive) ambition in 1986 was to make Britain an example of what could be achieved in tackling HIV and AIDS,” he explains.

The rest of the world is in worse shape. Fowler devotes chapters to Geneva, Entebbe, Cape Town, Moscow, Kiev, Washington, Delhi, Sydney and London, using each city as a means to explore a specific obstacle in eradicating AIDS and HIV. Perhaps due to the task’s complexity, many aspects are simplified. Mostly though, Fowler is an astute guide to the epidemic.

The richest part of the book is formed of his sympathies for the disenfranchised, and therefore the most at-risk. For Ugandan fishermen who fish at night and cannot swim, danger is a condition of everyday life, which makes HIV “just one more risk”. The author feels especially deeply for anyone whose sex life makes them vulnerable. About sex workers, the book is littered with grisly ironies: in Russia, for instance, prostitutes rarely possess condoms because police use them in court as evidence of sex work.

Fowler cites Sydney as a model city. Because sex work is legal, the HIV rate in the industry is less than 1 per cent. The picture is worse in Queensland and Victoria, where more sex work is forced underground. Yet he also quotes a doctor who is “slightly aghast at the prospect of Sydney being set up as the promised land”, as the biggest threat facing Australians is complacency.

The life expectancy of an Australian living with HIV is only a decade below average, thanks largely to antiretroviral therapy. But in this country, as elsewhere, infection is on the rise. About half of all people worldwide with HIV are undiagnosed (and thus can spread it easily); for every one receiving treatment, nearly two people acquire HIV.

While not comprehensive, Fowler’s book joins the essential texts for anyone hoping to understand AIDS and HIV – the epidemic’s present and, especially, its future.  CR

Biteback, 320pp, $29.99

This article was first published in the print edition of The Saturday Paper on July 18, 2014 as "Norman Fowler, AIDS: Don’t Die of Prejudice".

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