Still fighting for HIV/AIDS

In 1982 a young Belgian microbiologist was working at the Institute of Tropical Medicine in the picturesque port-city of Antwerp when he first noticed an increasing number of patients from what was then known as Zaire and who were presenting with mysterious symptoms of an illness that was ravaging their bodies.

Belgium, a small country around the size of the Kruger National Park, had had a long and bloody history in Africa.   Its brutal King Leopold II had annexed the Congo in 1885 as a personal fiefdom and later handed it over as a ‘€œgift’€ to the Belgian people.

Since independence and a name change from the Belgian Congo to Zaire in 1960, a large community of immigrants had settled in Belgium, particularly around the capital Brussels.

The first recorded case of what we today know to be HIV/Aids was in 1981 and the 23-year-old bearded and bespectacled Piot had no idea at the time of what it was that was causing the rapid weight loss in the patients he was seeing at the Institute.

‘€œWe thought if we were seeing so many in Belgium, imagine how many more there might be back in Zaire,’€ he recalls.

In 1976, the young Dr Piot worked at the Mama Yemo Hospital in Kinshasa when there was an outbreak of Ebola fever. He is credited with being the first to identify the virus.

When he visited the same hospital in 1993, the impact of HIV/Aids was immediately visible.

“In 1976, there were hardly any young adults in orthopedic wards,” Piot said at the time. Suddenly – boom – I walked in and saw all these young men and women, emaciated, dying.”

Tests then confirmed his worst fear; the mysterious new disease was present in Africa, and its victims were heterosexual.

Twenty years later Peter Piot’€™s beard is more than flecked with grey. He is a tall, intense man who, as the Executive Director of UNAIDS, is still fighting to place HIV/Aids on top of the international political agenda.

He was in South Africa recently to address the World Summit on Sustainable Development where he criticised planners of sidelining ‘€œthe most important issue facing Africa’€™s development ‘€“ HIV.’€

Trying to make the world pay attention to Aids is a task that is often frustrating.

‘€œIt seems that it is not enough to have eyes to see and not enough to have ears to listen,’€ he says of a world that has found it easier to look the other way.

But what keeps him going, he adds, is his constant contact with people in the communities deeply affected by Aids.

‘€œI have always been interested in people and in science, and I always wanted to know the people we were dealing with. I have worked in poor rural districts in the Congo and with Aids activist groups, so I am not easily fooled by bureaucratic words that hide what’€™s going on.

‘€œWherever I go I meet with groups of people living with HIV. The work is very often frustrating and I need that personal reality to keep going. It reminds me every time that we are not dealing with statistics and economic impacts,’€ he said.

He said one of his key frustrations was what he described as ‘€œthe high levels of hypocrisy when it comes to sex, it touches on our collective hang-ups’€.

The other, he added are the prejudices that stubbornly still exist.

‘€œThere is still so much blaming and stigmatising. I have to admit it is a mystery to me, why would anyone care about how others are? You care about how you are and after that it doesn’€™t matter.’€

Is he really so free of prejudices himself?

‘€œWell of course I have my own prejudices, if someone arrived in a Ferrari, for example, I would be suspicious,’€ he says.

It’€™s been a long hard road, but he describes himself as more of a marathon runner than a sprinter.

‘€œWhen I was in Mali I was told the story of how boys have to sit and watch a chameleon for five days as part of their initiation. And the lesson they learn is that while the chameleon may change colour, and its eyes look all around, its head never moves from its position looking straight ahead.

‘€œI am like that in my work. I may have to change colour and change the way I talk with people, for example I will be different if I am talking to the Pope or to an activist group, and I have to take in everything around me and adapt, but my focus never changes. I keep looking straight ahead.’€

The first years in his job as head of UNAids were the toughest, he reckons.

Making different UN organisations put the cause of Aids ahead of their own agendas was a challenge and there was a lot of institutional politics to deal with.

But there is a lot to give him hope.

‘€œAids is now on the agenda for more people. African leaders are now convinced of the problem which is not how it was in the beginning. I have even just met the patriarch of the Russian Orthodox Church in Moscow.

‘€œSo there are some results. If I had the feeling that this was totally impossible I wouldn’€™t be in this job.’€

South Africa remains one of the most interesting places for him to visit. ‘€œNothing here seems to be simple.’€

Rather than dwelling on the controversial statements coming out of the president’€™s office, he focuses instead on what is positive in South Africa.

‘€œSouth Africa is quite a democratic country with strong debate and a strong civil voice and that is a source of inspiration. I have learnt to appreciate that there are many good things going on here. There are excellent prevention programmes such as loveLife which serve as good examples for other countries. But the challenge now is to get on to the road of giving treatment to people. The question is not whether to give treatment, but how. It should not be an all or nothing approach and it must be equitable, otherwise the brutal market forces will prevail.’€

However, he says there does seem to be a lack of dialogue between different parts of society such as government and businesses such as Anglo American which is providing free antiretroviral therapy to all employees who need it. These groups seem to talk to each other more through news reports, he says.

Faced with such an enormous task, Piot says he deals with the danger of burnout from both the difficult emotions and the tough politics of his work by retreating to his home in a French village, just across the border from Geneva, where he grows vegetables and cycles.

But he feels privileged to be working in such an important field. ‘€œThere are few issues in the world that are more important than this. There are millions of people infected and I can’€™t forget and I don’€™t want to forget.’€


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