Bills Clinton and Gates were the headline
acts at the recent International Aids Conference in Toronto. Susan
Cole provides an insight into why
Photo: Lise Beaudry/IAS
At
the most high profile session at the largest ever Aids gathering, the air
crackled with excitement and anticipation as the world’s richest man,
Bill Gates and the world’s former most powerful man, Bill Clinton, prepared
to mount the stage together.
Almost all 24,000 delegates clamoured to get into the session but it soon
became apparent that was not going to happen. Heaving crowds were corralled
behind barriers as half of the conference centre where the Bills were to speak
was closed to any more delegates.
Traditionally, the British are known as a race of queuers but Londoners, faced
with the daily battle of squeezing onto the overcrowded Hades of the Underground,
are a ferrel warrior race adept at pushing and squeezing into impossible places.
Armed with a press pass and my Londoner’s steely determination, I barged
and cajoled my way into the session. Gates and Clinton is an unlikely pairing.
During his presidency, Clinton’s administration launched an antitrust
action against Gates’ Microsoft, but fighting HIV in Africa has brought
them together.
Bill Clinton
Earlier this year, they travelled together across Africa, highlighting the
insurmountable human tragedy caused by the disease and all the work that needs
to be done to fight it. Gates brings money and scientific knowledge, Clinton
charisma and political kudos. Together at the same event, the fuel of publicity
ignites the conference, overshadowing any scientific advances and reducing
other political messages to insignificance. The world’s media seemed
only interested in the circus of celebrity created by these two men together
in the same place.
It is difficult to question the Bills’ commitment to the fight against
HIV and Aids, as a week before the conference, Gates, through his foundation,
pledged $500 million to the Global Fund to fight Aids, TB and Malaria.
At the opening ceremony, Bill Gates and his wife Melinda addressed the huge
crowd. “Melinda and I have made stopping Aids the top priority of our
foundation,” he said.
This is true, as the Gates Foundation has provided a lot of funding to support
research on new HIV prevention tools including $287 million donated in July
to advance vaccine development. It is also committed to empowering women in
HIV prevention.
Gates said: “We believe microbicides and oral prevention drugs could
be the next big breakthrough in the fight against Aids.”
Bill Clinton seemed equally committed to fighting Aids, albeit without the
staggering financial commitments that only the unfeasibly wealthy Gates is
capable of. Following the Barcelona International Aids Conference in 2002,
he began the Clinton Foundation HIV/Aids Initiative to help countries implement
large-scale care, treatment and prevention programmes. His campaign has made
a significant impact in Africa. By channelling his presidential prestige and
humanity into this area, Clinton has raised awarenesss about the fight against
Aids.
However, even smiling Bill has his detractors who accuse him of failing to
do enough during his presidency to tackle access to HIV drugs. His regime
also backed American pharmaceutical firms blocking South Africa from producing
cheaper generic drugs.
Also, Clinton’s administration did not permit free needle exchange programmes
that would limit transmission among drug users and he never revoked the visa
ban for people living with HIV to travel to America.
After a frenzy of pushing, the special session, titled Priorities in Ending
the Epidemic began and the two Bills walked onto the stage. Clinton strode
on with supreme confidence, the ultimate glorious alpha male. Gates shuffled
on with the demeanour of a school geek, anticipating a wedgie and head-down-the-toilet
flushing from the classroom bullies. Despite being the world’s richest
man, he looked like he shops at Mr Buyright and has his hair cut by his mum.
They were initially asked why they had decided to focus on Aids. Before they
could answer, protesters leapt to their feet, chanting about the need for
more medical staff. Clinton immediately and effortlessly diffused the situation
by speaking directly to the protesters. He said: “Actually, I agree
with you on that one. We do need more doctors and nurses.
“Aids is a breathtaking human tragedy. In rich countries people don’t
die of Aids, in poor countries they do. Lots of countries don’t have
organised responses, the cost of paediatric medicine is prohibitive and the
cost of second line therapy is high. I want to help treat more people. What
I want is to stop more people dying who don’t need to.”
Unsurprisingly, Gates used science-speak when he talked. “Despite advances
in biology, there’s a big disparity between the developing world and
the rich world. The sooner you act, the better it is. Aids is one of the cruellest
diseases. We need to give poorer countries a chance,” he said.
Delegates asked the two Bills why infections were still on the rise in most
countries and what they thought was the way ahead?
“It’s going to be a rocky road until we get a vaccine. The Caribbean
is the only region where rates are falling,” answered Clinton.
He added: “In the US it’s going up, particularly among women of
colour. Ninety per cent of people who are positive don’t know it. Only
20 per cent of people who need medication get it – only 10 per cent
of children.
Bill gates
People won’t want to get tested if they don’t think they can get
medication or face stigma.”
“Having treatment in place encourages people to get tested. This was
seen in Botswana. It’s impossible to change things without new tools.
If we had microbicides it would change the course of the disease,” replied
Gates.
“Microbicide trials are going on now but Melinda is better at answering
about practical issues. The first generation won’t give protection as
hoped and the second line is about four years away.”
Members of the audience were invited to write down a question to ask both
or either Bills. I ignored the voice in my head, urging me to ask Gates, as
suggested by my sons, what they could do to get their Xbox 360 working properly.
Instead, I asked about the controversial Presidential Emergency Plan for Aids
Relief (Pepfar) and whether it was helping or hindering. Pepfar is the main
way America funds the fight against Aids and it has come under heavy fire
for not funding programmes that fail to push abstinence or those that work
with commercial sex workers.
Gates’ answer side-stepped the issue. He said: “Pepfar is very
helpful. It’s a very measurable thing. On the treatment front it’s
a great success and we need to get the story out there that lives are being
saved due to Pepfar. On the prevention side it’s more complex.”
Clinton agreed but was more direct. He said: “I agree that Pepfar does
a great deal of good. Research seems to show that abstinence programmes make
people delay sex but when they do, they’re less likely to use protection.
An abstinence-only campaign is going to fail. On balance, this programme has
done way more good than harm.”
Someone asked Clinton why he did so little to fight Aids when he was president.
“That isn’t so,” he responded with confidence and a glimmer
of indignation.
“We created the Global Fund. We gave 25 per cent of what the world gave.
I trebled overseas aid when I was in power. I did make a lot of mistakes when
I was president but that wasn’t one of them!” The audience, perhaps
initially sceptical, seem to melt at his disarming candour and whoop with
delight and appreciation.
I continued to stalk the Bills throughout the conference, attending every
session and press conference they spoke at, desperate yet unsuccessful in
my attempts to secure a one-on-one. Gates was flanked by his more personable
and presentable wife Melinda, who did most of the talking. “Wow! What
great shoes she had,” enthuses my colleague John after getting up close
to the Gates to get their photo.
I managed to get close to Clinton at a press conference, using my Londoner
skills to barge through the other baying, wild-eyed journalists, hungry for
a taste of the legend. Suddenly, inexplicably, I’m shaking his hand
and looking directly into his consuming hypnotic eyes. My resolve and scepticism
melt and all at once I’m a member of Cult Clinton, dazzled by his blinding
charisma.
“I’m never washing my hand again,” I muttered as I left.
As I turned the corner, some protesters chanted: “Two pills not two
Bills” and I was jolted shamefully back to reality, reminded what this
conference was really about, why I was there and the reality of living with
HIV in the developing world.
Did the two Bills distract from the real issues or give desperately needed
publicity to a disease the public may be tiring of? I look at my hand again,
still warm from his clasp. Never wash it again. Or, on second thoughts, considering
where it has been, I ask myself whether I should give it a thorough scrubbing
with bleach instead.
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