Seeing the True Surroundings
Hilton International has a new hotel. It's a beautiful 16-story, 327-room property with a fully equipped fitness center, an outdoor swimming pool, and a shopping arcade. The new Hilton is located in Durban, South Africa, the site of the 13th International AIDS Conference. The black township of KwaMashu, a place so beaten down people look for someone else to kick, lies less than 30 minutes from the Hilton. Two years ago Gugu Dlamini, a small, soft-spoken woman, was stoned to death by her neighbors when she disclosed she was infected with HIV.

I'm writing this column on the eve of this year's International AIDS Conference. For the first time in the history of the HIV/AIDS pandemic, this meeting is being held in Africa. It makes sense for the first conference of this millennium to be held on the continent where the vast majority of people infected with HIV live and where the virus almost certainly originated.

There are an estimated 4.2 million South Africans living with HIV/AIDS. One person dies of AIDS every ten minutes here. In fact, given how slowly I write, by the time I finish writing this column, 12 South Africans will have died of AIDS and I can't imagine how many will have died by the time you actually read these words.

Durban 2000 presents extraordinary opportunities and challenges for those interested in really ending the global plague called AIDS. Unfortunately, the reality of AIDS is likely to remain unseen, unheard, and unspoken. The theme of the conference is "Break the Silence," but it could well end up being more like the title of Charles Dickens's famous novel A Tale of Two Cities. It is easy to be in Durban and think you are in Miami: There are five-star hotels, perfectly maintained beaches, and massive mansions. At this conference it will be all too easy to sit in rooms adorned with abstract art and see only abstract statistics. But there is nothing abstract about KwaMashu. AIDS is real in KwaMashu.

The poverty in KwaMashu attacks the soul. It's a gloomy, dusty place with bars on all the shop windows. The pain and despair feel communicable. Amid all this, Gugu Dlamini knew that the silence surrounding AIDS made the suffering worse–it made it lonelier, more isolated, and more hopeless. But despite the despair of KwaMashu, Gugu didn't believe it had to be that way. She joined the National Association of People With AIDS and announced to the press that she was living with AIDS. She broke the silence.

And several local men broke her. They harassed her, followed her home, and stoned her. A friend ran away as the men were bashing Gugu's head on the ground. After Gugu was dead, her family was threatened by the murderers, who said that if they were identified, they would come back. Gugu's killers remain free and still threaten her family.

It's realities like this that make some of the debates surrounding AIDS obscene. Several California scientists have been arguing for years that AIDS doesn't exist in Africa. As an African-American, I feel the actions of these mostly white "AIDS dissidents" are criminal and tantamount to genocide. There's a legacy of medical mistrust in black communities worldwide. HIV and AIDS are so overwhelming that many people of African descent are desperately searching for any way to look away from the horror. It's cruel and inhumane to prey on people's desperation this way.

But there are many ways to look away, and one way is to jet in to Africa for an international conference. The challenge of Durban: Will we be lulled into just noticing the postcard South Africa of luxury hotels and sandy beaches, or will we have the courage to confront what millions face every day–not only in townships and Third World villages but in the ghettos and barrios of America? We could decide that AIDS is not so bad after all. Or we could remember how it felt to watch people we loved get sick and die–and know that there are millions too many who are still having the same experience.

Belynda Dunn has both HIV and hepatitis, a liver disease that makes it impossible for her to take AIDS medication. There are other Americans whose viruses have become resistant, rendering the drugs ineffective. They too are facing death. Yet these are the lucky ones; 95% of all people with HIV/AIDS live in the developing world, where access to even the oldest and cheapest drugs is only a pipe dream, and a vaccine seems more than a decade away. The only thing worse than having an incurably fatal disease is having a treatable disease without access to treatment. Treatment without access is no treatment at all.

The quality of life for many people of all races living with AIDS continues to improve the longer they adhere to their treatment. The regimens have become simpler, and researchers are steadily improving the therapies. Recent studies, however, show that up to half of HIV patients "fail" on their drug cocktails. There is not a day that goes by when I don't hear of someone who has "broken through" or who is experiencing some scary consequence of taking HIV chemotherapy.

AIDS can be so overwhelming–12 million orphans–that people just turn away. Will AIDS become yet a different "tale of two cities": one healthy, prosperous, and distinctly white; the other increasingly sick, desperate, and overwhelmingly black, brown, red, and yellow? You can't see KwaMashu from the Durban Hilton, but we can infuse this year's AIDS conference with the spirit of Gugu, feel KwaMashu, take action in our own backyards, and refuse to turn away.

Wilson is the executive director of the African-American AIDS Training and Policy Institute at the University of Southern California. He has held the positions of AIDS coordinator for the city of Los Angeles and the director of policy and planning for AIDS Project Los Angeles.