With 9 months to go before one of the targets set under the United Nations Millennium Development Goals (MDGs) is supposed to be achieved, we are still a long ways away.

In 2000, the world’s countries agreed upon 8 MDGs to be achieved by 2015: eradicate poverty and extreme hunger, achieve universal primary education, promote gender equality, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainable and develop a global partnership for development. These are ambitious goals aimed at drastically improving quality of life for people worldwide and they require substantial global cooperation to share expertise and funding amongst countries.

Specific targets were set for each goal, one of which is to achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. This goal, getting people who need it on antiretroviral (ARV) treatment is brilliant: like most of the MDGs, it has a ripple effect that means improvements in more than one area. ARV treatment means fewer people suffering from illness and unable to work, mothers and fathers for children, professionals who live long enough to train others, more people to tend fields and feed their families, fewer new infections, more activists to advocate for political accountability and action on pressing issues throughout the Global South.

Antiretrovirals (ARVs) are used to treat HIV, but there is no cure. They are severely expensive drugs, costing between $10,000 and $15,000, primarily as a result of pharmaceutical patents; although there is nearly universal adherence to ARVs in the Global North where individuals and/or governments are able to afford the drugs. These countries also have extensive health care networks, with medical professionals relatively readily available to diagnose and treat patients – all factors absent in many developing countries that are further complicated by limited budgets.

Clearly, when these goals were set, those involved knew they were ambitious. But “ambitious” should not be conflated with “impossible”: there are examples of countries that have overcome the barriers that people so often accept instead of challenge: absent health infrastructures and personnel, illiterate patients not used to regimented prescriptions, growing numbers of HIV+ people needing drugs, expensive medications protected by international intellectual property rights organizations that are impossible to afford in the world’s poorest countries. Brazil is one place that has reduced the cost of drugs to an average of $3,000. This is not a new development – this program has been in place since the late 1990s.

Less than one third of those needing treatment are receiving ARVs according to The Millennium Development Goals report from the United Nations. While more people are being able to access drugs through innovative programs provided by governments and civil society organizations like Médécins sans Frontières (MSF) alike, new infections are outpacing gains in treatment.

Worse is that with 9 months to go, this is not being talked about in the media, in parliaments, in the UN Assembly. Meanwhile, 9.7 million people needing HIV treatment will die, leaving countries struggling to staff their departments and provide programming, children without parents, and in some cases, a number of newly infected people.

This goal is ambitious, but it is also achievable: Brazil is widely acknowledged as the model for achieving ARV adherence. Since 2the late 1990s, the country has provided ARV treatment to all those for whom it is medically necessary. It was the result of political commitment – in Brazil itself, and from international partners such as the World Bank that financed the initiative, and willingness to challenge the power pharmaceutical companies wield.

With 9 months to go, the UN, governments, civil society organizations, corporations and individuals should be doing all they can to say to people living with HIV worldwide that they will not be left to die in a world that has the treatment they need.

"Just"

When I visited Swaziland, I met at length with the king in private, and attempted to persuade him, with a combination of subtlety and argument, that the world was increasingly impatient, his people were decimated, and his behaviour was unacceptable. Then we held a press conference together and I held my tongue. 

I have felt guilty about that to this day. Whom did it serve by the bloated ego of the monarch? So I’ve rationalized my actions: I’ve persuaded myself that it’s not for me to do, that it should be done by UN officials with far greater authority. I’m merely a part-time envoy.

But I know my excuses for remaining silent in the face of such behaviour don’t wash.  -p. 184-185, Race Against Time

Stephen Lewis - possibly the best known and longest-standing advocate for HIV/AIDS prevention and treatment - said "I'm merely a part-time envoy." It was an excuse, a rationalization. A way to make the pain of complicity, of doing 'nothing' (and I don't use that word lightly) when words could have been spoken go away. Make the questions of "what if?" and the statements of "if only.." stop coming. Yet the choice not to speak out and stand up left him feeling guilty - guilt he still feels. 

What it comes down to is that we are all "merely" someone. I'm 'just' a twenty year old, I'm 'just' a student, I'm 'just' a mother, I'm 'just' an employee, I'm 'just' an employer, I'm 'just' an executive, I'm 'just' a politician, I'm 'just' a teacher, I'm 'just' one person

To dismiss the power that we have as 'just' one person - no matter who that person is - is to rationalize the impossible. I cannot rationalize my choice to do nothing on so many fronts because I'm 'just' a student, to be complicit in all the ills of the world because I'm 'just' a student.  

To wait until I'm something 'more' than 'just' a student reinforces messages our society is insistent on sending: that powerful and influential people are more than 'just' a person; that they are somehow better than the rest of us, that they have done something to deserve the power they hold. But we need to ask why they hold that power - and the answer lies (partially) in the fact that we are willing to give it to them, to accept their ideas and their judgements about what and who is important and will get funding and be noticed. Waiting also fundamentally undermines the value of the person I am in the present (student, mother, politician) - while that person is worth no more than anyone else, neither is it worse any less.  It concentrates power in the hands of those who society has collectively agreed (implicitly or explicitly) has power because I am one less voice challenging and questioning if I wait. 

We are all "just" one person. We are all oppressed in one way or another, we all have things working against us taking ourselves and our ideas seriously. It is easy to buy into those belittling messages that rob us of self-confidence and self-esteem because they are pervasive, and because to some degree, they make it easier to sleep.  As "just" one person, I'm not complicit in anything. 

But, if we can take ourselves seriously and question and challenge and critically think about what is going on and refuse to be too busy to tell others what we think the face of the world will change. We have to stop writing ourselves off as "just" someone and we have to realize that collectively, and as individuals, we have more power than we realize, our ideas are more valid than we realize, and our concerns - whether they be about food, poverty, health, the environment, human rights, women, education, children, sex workers, soldiers domestically or internationally - our concerns are the ones that should be on the agenda. We have to stop waiting.

"It’s not possible...to grab the heads of state by the scruff of the neck and shake them into equality. But it should be the role of the UN family to shame, blame and propose solutions, all the while yelling from the rooftops that inequality is obscene.  Only then will change have a chance.” –p.143-144, Race Against Time

Born into Brothels

Tonight I chose to watch the documentary "Born into Brothels". Its about a Londoner moving into India's infamous Red Light District to document the lives of women living there. Quickly, it turns into a story of her teaching the children photography and trying to find places for them in schools.

Essentially, because their parents are sex workers (criminals, in the eyes of the government), many schools would not take them . As well, it made it challenging to acquire necessary documents - birth certificates, passports, etc. Even worse, schools required negative HIV tests before they would accept the students. The stigma of HIV in India must be huge, as here we know (although we don't always practise) that HIV is cannot be transmitted through casual contact. The school the journalist found for the girls would not allow the girls to go home, even for things such as a new birth, or a death, or a wedding. They were allowed visitors and had scheduled 10 day breaks three times per year. Yet school is the only way for these children to have a chance to become something other than a sex worker. The girls, even at 10, understood this, as did their mothers. The boys too understood this reality.

In the end, most of the children were not allowed to go to school (by their families), or left school, some, according to their own will, and others at the insistence of their families. The documentary only portrayed the one girl who stayed in school in a positive light. The journalist was upset with the children because some were resistant to all her help, including one boy who became less engaged after losing his grandmother. She can be frustrated that she can't do more, but she cannot except that placing them in schools which give them little freedom will solve all their problems. Education can help break poverty cycles, but these children still need their families. In this case, it may be more that their families need them: these children are very aware of the challenges their families face daily, even just in having food to eat. They know that by being at school, they are not contributing to their family's income, and are in a safer, cleaner and healthier place. It seems that they carry a certain amount of guilt. And so, for the most part, they end up back in the brothels from which they came.

What does all of this say about the world? About breaking poverty cycles and development? The West doesn't have the answers and the problems go so much deeper than can be captured on film or in words. Families have to be the focus of solutions, not just children. Schools have to allow children flexibility, and more importantly, the world needs to care for their families. Women should not ever need to sell themselves to give their families the basics, nor should children have to shoulder the burden of providing for their family. That kind of poverty is unnecessary in a world were so many have so much.