Beyond the breakthroughs

Love is the Cure: On Life, Loss and the End of AIDS, by Elton John, Hodder & Stoughton, RRP£20/Little, Brown, RRP$27.99, 288 pages

Our Kind of People: Thoughts on the HIV/AIDS Epidemic, by Uzodinma Iweala, John Murray, RRP£17.99, 240 pages

At last month’s international Aids conference in Washington DC, there was much buzz about breakthroughs in tackling the disease. Since it was first identified in 1981, HIV/Aids has killed about 35m people. Today, a single daily pill can prevent infection, more than 9m people worldwide have access to effective HIV drugs and scientific discussion of a cure is back on the agenda. Indeed, the falling rate of new infections has led to bold – if somewhat premature – talk of “the end of Aids”.

One of the star turns at the Washington conference was the musician Elton John, who has been working since 1992 to increase awareness and funding through his Elton John Aids Foundation. This has so far raised an impressive $275m, and gives much of its support to stigmatised groups: gay men, drug users, the poor, prisoners. The title of his new memoir Love is the Cure outlines his philosophy.

While much of the book comes across as a standard celebrity ghost-written tale, the best parts transcend this – for example, when John describes his own belated epiphany: “I was a gay man in the ’80s who didn’t march ... instead, I was consumed by cocaine, booze and who knows what else,” he admits.

His turning point came after he read about the vicious discrimination suffered by Ryan White, a young American who contracted HIV through a blood transfusion. John contacted White’s family, provided support to them and ended up staying by the teenager’s bedside during his final hours in 1990. Two months later the star entered rehab and turned his life around.

However, such intimate details are too rare. Even when other celebrities enter the narrative – from Princess Diana to Elizabeth Taylor – there is little colour in John’s anecdotes. He also veers too far towards “Aids exceptionalism” – understating the claims of other health problems on resources and overstating his case that with more love and understanding, HIV could be vanquished more quickly than cancer or cardiovascular disease.

In Our Kind of People, Nigerian doctor and novelist Uzodinma Iweala takes a similarly personal approach, exploring the impact of HIV/Aids in his homeland. Where John singles out the death of actor Rock Hudson in 1985 as a turning point in western attitudes to HIV, Iweala highlights the pivotal moment as the 1997 death from Aids of Fela Kuti, the Nigerian musician and political activist.

Iweala rails against stereotypes of Africans as perpetual passive sufferers and victims of disasters, highlighting the abstract and patronising approach to HIV of many western experts. Yet he does not flinch from discussing what he sees as a dangerous local cultural denial of the realities and burden of the disease. In a country with one of the largest – and most poorly controlled – epidemics, the tight geographical focus is valuable.

He begins with a beautifully written fictional account of a man who becomes infected in Abuja. Much of the journalistic work that follows is less successful, however, and Iweala never really articulates a clear theme or goes into sufficient detail on the lives of those he meets.

Both authors share a focus on the human dimension, the foibles and prejudices that influence how the disease spreads and all too often hinder its treatment. For his part, John admits that he engaged in unprotected sex and it was “not a minor miracle” that he escaped infection.

Human actions are indeed at the centre of this disease, as they are with so many others. And whatever the medical advances, it is only through better understanding our behaviour in all its diversity that we can ever hope to conquer HIV/Aids.

Andrew Jack is the FT’s pharmaceuticals correspondent

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