HIV/AIDS is serious business in South Africa. I mean this in every sense that it could possibly be ambiguous. People are dying, suffering and being orphaned, stigmatised and ostracised. Other people are becoming wealthy, developing careers and securing the subtle glow that goes with the activists’ position – a position that they vehemently insist is the moral high ground.
Any discussion of HIV/AIDS in this country is thus located in the virtual, contested and shifting topography of a landscape of ravaged lowlands, and competing mountaintop citadels of humanism and enlightenment. Atop the two most prominent peaks, each surrounded by loyal foothills sit the Treatment Action Campaign (TAC) and the South African government. And from these positions, like the ‘worms’ of the classic computer game each aims and launches weapons from their arsenal in an attempt to blast the ‘moral’ out from under the other’s lofty position.
This split between the state and civil society in this case dates back to President Thabo Mbeki’s controversial statement that HIV does not cause AIDS, and the government’s perceived foot dragging with the provision of free antiretroviral treatment.
One of the weapons these ‘worms’ of the moral high ground have regularly resorted to is the much vaunted and feared media statistics bomb. More diffuse an attack than the satirical political cartoon; the statistics bomb is the equivalent of the cluster bomb in this campaign. And like the cluster bomb it is somewhat difficult to control, not all of the mini bombs designed to send ripples through the foothills are accounted for, and they don’t always all go off at the same time. But most significantly, many of the small bombs fall outside of the target area, so that the people populating the low lying areas of the HIV/AIDS landscape become collateral damage in what boils down to a high stakes game of ‘worms’.
How do they become collateral damage? And how, with all the munitions flying through the media, are we spectators of and participants in this war in/on HIV/AIDS supposed to make sense of the pandemic and our place in it? The obvious answer to the second question is to pick a side – if both so strongly claim their high ground is the moral one, democratic common sense would suggest that we should pick one. Evaluate each, and choose. But the fall out from the statistical bombs make this difficult if not impossible by way of the same mechanism that sees the citizens of the lowlands become collateral damage.
These bombs, like so many others, are launched with a rhetoric proclaiming the best and most noble of intentions. What Bush’s cluster bombs are to the spread of democracy and human rights, the statistical media bombs are to the spread of ‘awareness’. In a paradoxical twist, these munitions in the war in HIV/AIDS become the ‘intelligence’ basis for the ‘targeting’ of interventions in the war on HIV/AIDS. And the intelligence here is not dissimilar to that presented on Iraq’s chemical and biological weapons programme to the UN by Colin Powell – inaccurate, speculative, and motivated by interests other than the plainly stated – sustained and purposeful misinformation.
By way of an example let us examine some of these statistics. Earlier in the year, on the eighteenth of February at 2 o’clock, Stats SA (a statistical branch of the state) launched figures drawn from issued death certificates under the title ‘Mortality and causes of death in South Africa, 1997–2003’. These figures suggest that 448 308 South Africans died in 2001, 9 479 of them as a result of HIV/AIDS. This which boils down to an overall mortality rate of about 11/1000, if we accept the 2005 Central Intelligence Agency’s estimate of the South African Population at 44 344 136. These findings lead Stats SA to conclude that for the years 1997-2003 AIDS contributed to about 2% of total annual mortalities, and 3,8% of mortalities in 2001 for the age group 15-49.
The Medical Research Council (MRC) and TAC immediately condemned these figures in an attempt to minimise damage to their moral base, and the MRC has since counter-launched its own figures under the title ‘The Impact of HIV/AIDS on Adult Mortality in South Africa’, asserting that AIDS accounted for an amazing 40% of mortalities among people over the age of 15 in 2000. If we are to believe these figures, our annual mortality rate would drop to roughly 5/1000 were we to overcome HIV/AIDS – an unlikely figure given that Canada only managed an estimated death rate of 7,73/1000 in 2005 according to the CIA; this despite their lack of widespread poverty, unemployment, and the other mortal threats South Africans are subject to.
What are we to conclude from this enormous discrepancy between Stats SA’s improbable 3,8% and the MRC’s equally unbelievable 40%? I think this confirms my suspicion; these statistics are circulated as the machinery of HIV/AIDS terraforming projects. In bids to reform the landscape of the pandemic in ways which suit the two competing centres of the conflict, the shape and extent of the ravaged lowlands are being manipulated in attempts to attack and defend the mandates that give either side their seats on the high ground. We can’t choose between them, and nor can we be asked to believe that the truth lies somewhere in the middle. But can we ignore them? I think not, because by association we would then be ignoring the inhabitants of the lowlands, where HIV/AIDS may or may not be the biggest problem. We would in effect be following the statistical munitions wizards in their rhetorical silencing of the many so that each side can continue to pretend that it represents their best interests, and hold on to their status as HIV/AIDS elites. I say pretend because if we never hear from those most affected, we have no way of evaluating the position of either side.
So what is my point? My point is that all this statistical mumbo jumbo isn’t actually helping anybody except those earning salaries and securing funding by positing themselves on the frontline in the war on AIDS. The statistics seem only useful in the role they play in the battle to see which organisations deserve the salaries and the funding and the plane tickets to global conferences. Speaking about HIV/AIDS in the garbled tongue of statistical projection means that only a select few are able to have their voices heard – namely the elites that employ the numbers alchemists and the researchers that fuel their sorcery.
I am suggesting that we collectively reclaim the landscape of HIV/AIDS in South Africa. If it is our best interests that provide the high ground, then we need to reclaim it. We need to insist upon a new way of talking about the pandemic: reject the stats as part of the problem; and reject the statistics producers as misinformation specialists. What did it cost to produce these statistics? I don’t know. And what did we learn from them? Only that we can trust neither them, nor those who produce them to give us an accurate picture of the scope of the problem or a useable statement as to the shape of a solution. Lets collectively turn off the game, retire the ‘worms’ and their statistics bombs, and come up with a new approach – like maybe letting people speak to each other.
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