2011 marks the 30th year of AIDS. "The View from Here" is a special year-long series to mark the anniversary. Leading advocates, doctors, researchers, politicians, philanthropists, educators, public health professionals, journalists and celebrities are answering the same set of questions each month. This month, we feature two individuals from two of the world’s leading philanthropies currently supporting the issue of HIV/AIDS: David Furnish, chairman of the Elton John AIDS Foundation, and Bob Haas, president of the Levi Strauss Foundation and chairman emeritus of Levi Strauss & Co.
We’ve learned a lot in 30 years. What do we have yet to learn?
Furnish: We haven’t yet figured out how to keep HIV/AIDS awareness top-of-mind in the media, among the general public, and especially among populations and communities most at-risk of acquiring HIV infection. I think all of us at the Elton John AIDS Foundation, and at other organizations devoted to HIV prevention, share a sense of frustration over the mounting numbers of new infections – around 56,000 in the U.S. every year – especially when polls show us that fewer and fewer Americans regard HIV/AIDS as a significant public health concern. Complacency, both in the media and in the general public, is quite literally killing us.
Haas: HIV/AIDS presents us with two interrelated issues: a medical epidemic and the associated scourge of stigma and discrimination. To make matters worse, the brunt of this stigma and discrimination impacts women, the poor, drug users, prisoners and people who are gay or transgender.
Other viruses and plagues caused waves of fear and ostracism because they were extremely contagious and deadly. Nevertheless, people who died due to the plague or tuberculosis have been regarded as ‘innocent victims.’ Rarely is this pronouncement made of people living with HIV/AIDS. Why is this? Because unlike other deadly diseases – spread through the air or casual contact – becoming infected with HIV requires an action – such as sex or venous injection – that is freighted with the baggage of social taboo and moral judgment.
Consequently, with HIV/AIDS we need to go beyond addressing a medical condition. We must stand up in the face of hostile social pressures and cultural norms and take vigorous action to protect the human rights of marginalized groups who bear the brunt of this epidemic—especially gay men, sex workers and people who use drugs.
What was your deciding moment, when HIV/AIDS became an important issue in your life?
Haas: One day in 1982, at the close of an Executive Management team meeting at Levi Strauss & Co., a colleague pulled me aside and said, “Bob, we have a problem. Some of our employees want to pass out leaflets in our Atrium warning other employees about an unknown but potentially deadly disease. The problem is that this disease seems to affect gay men. The employees fear that if they pass out these leaflets, they will be stigmatized because other employees will assume they are gay. What should we do?” We agreed that we should not only grant permission to the employees but join them in distributing the information.
The next day, during the lunch hour, I joined other members of our management team in passing out the leaflets. Because of our presence, more employees than usual stopped to take and read the handouts. Importantly, our presence and support reassured the employees who were distributing the leaflets, and to my knowledge there were no consequences from their involvement. Little did we know that our actions comprised the first corporate response to this inchoate epidemic.
Furnish: The initial outbreak of AIDS came during the time I was trying to come to terms with my own sexuality. All of the news stories were talking about a “gay plague,” which automatically made me feel very stigmatized and just horrified by the negative way people who were already sick or perceived to be infected were being portrayed in the media. So often, vulnerable people were being blamed for their illness or portrayed as disposable or less than human. It was a terrifying time, and for me, it was just a million times harder to come to terms with my sexuality and my feelings about myself. Looking back on that time, it becomes even sadder to realize that today so many people continue to avoid learning about their HIV status – not because they fear the disease – but because they fear the stigma that is STILL attached to this disease. At the Elton John AIDS Foundation, we feel very strongly that stigma continues to be the greatest barrier we must overcome in order to make greater inroads against this epidemic.
Haas: Over the years, four institutional values at Levi Strauss & Co. – originality, empathy, integrity and courage – have served as the guiding light for our response to HIV/AIDS. Driven by these values, we have sought to be bold and honest, extended compassion and support to those who bear the brunt of stigma and supported proven prevention methods (including access to sterile syringes), even in the face of controversy.
With ever-increasing public health issues to contend with, why should anyone still prioritize HIV/AIDS?
Furnish: HIV/AIDS is a deadly COMMUNICABLE disease for which there is still no cure and no preventive vaccine. As Chairman of the Elton John AIDS Foundation, an organization focused on HIV prevention, I think it is very important to emphasize this distinction about HIV/AIDS – it is a COMMUNICABLE disease – unlike cancer or heart disease or Alzheimer’s disease or many other serious health conditions. According to UNAIDS, there are currently over 33 million people worldwide living with this communicable disease, over 1.1 million here in the U.S. Many of these people are UNAWARE that they have the disease, making it far more likely that they will transmit it to others. Because HIV/AIDS primarily strikes people in the prime of their working lives, it is therefore both an important health priority and an important ECONOMIC priority to emphasize and fund HIV/AIDS prevention, research, and treatment efforts.
Haas: Because HIV/AIDS disproportionately affects society’s most marginalized groups, at Levi Strauss & Co. we feel an obligation to continually to push the limits of the response.
That is why the company has made a commitment, through the Clinton Global Initiative, to provide comprehensive prevention, treatment and care to all employees, retirees and dependents – a workforce of over 11,000 that spans 45 countries. We hope other companies will step up and provide treatment to their employees. Along the way, we seek to help ‘change the game’ around the provision of insurance benefits – perhaps one of the final frontiers in the global battle against AIDS. Only when corporations, who are key buyers of insurance, insist on coverage can we hope to tip the balance.
Likewise, private foundations are uniquely positioned to address pressing and politically sensitive issues that cut against the mainstream, especially given the nexus between HIV/AIDS, sexuality and drug use. From the onset of the epidemic, foundations have been responsible for key advances in HIV/AIDS policies and program development. They have enabled critical voices speaking on behalf of highly marginalized groups to be heard. They have supported the creation of organizations and programs that governments and businesses were not willing to underwrite.
Furnish: Pulitzer Prize-winning reporter Laurie Garrett has recently calculated the worldwide cumulative numbers of HIV infections and the cumulative numbers of deaths due to AIDS since the beginning of the epidemic in 1980. These are figures that UNAIDS and the World Health Organization no longer publish, but they are shocking, and I think it is important to keep them in mind when we ask questions like “Why should we prioritize HIV/AIDS?” Worldwide since 1980, 75 million people have become infected with HIV, and 34 million have died of AIDS. If you subtract those numbers from each other, this leaves us with 41 million people living with HIV/AIDS, a deadly COMMUNICABLE disease. I’d call that an important health priority!
Hass: Let’s face it: HIV/AIDS will be around us for decades to come, so our work is far from finished.
What keeps you up at night?
Haas: The spread of new infections continues to outpace the extension of treatment to those in need: for every two people who start treatment around the globe, another five are newly infected.
Furnish: Both personally as a gay man and as the Chairman of the Elton John AIDS Foundation, what keeps me up at night is the continued stigmatization of HIV/AIDS and the people living with and affected by this disease. Nothing positive is accomplished by stigmatizing and marginalizing vulnerable people. Absolutely nothing. It is a thoroughly self-defeating process. All it does is further exacerbate the spread of the disease by preventing vulnerable people from seeking and obtaining the testing, counseling, and treatment they need in order to find out their HIV status, come to terms with their illness, manage their health, and learn how to prevent the further spread of the disease. Stigma only drives the disease further underground, making it more difficult to reach fearful, at-risk people with important prevention and education messages, as well as health and social services. For me, the word has become almost like a death-bell ringing in my head – stigma, stigma, stigma.
Three decades into the epidemic, what gives you hope?
Furnish: Although the challenges before us are significant, as Chairman of the Elton John AIDS Foundation, I see hope every day. I see it in the loyalty, generosity, and commitment of our donors and friends who have unswervingly supported EJAF’s work year after year. I see it in the tireless commitment of our grantees working at the frontlines of the epidemic across the U.S., the Caribbean, and the Americas, who are making a difference in the lives of their clients every day. It’s easy to become discouraged by the mind-numbing statistics and the enormity of the problems that must be faced. But every time I go into the field and visit with our grantees and the people they serve, I am always amazed and overwhelmed by the strength of the human spirit, by the commitment and determination of people in the direst of straits to overcome adversity and to find the simplest joys in life. And I also get to see first-hand how the smallest amount of money can so drastically change lives and make an enormous difference to people in need. Working together, each and every one of us can truly make a difference. Working together, we have the power to end this epidemic. That gives me tremendous hope.
Haas: HIV/AIDS is not just a medical condition that can be solved by resourceful scientists and compassionate caregivers. As Nelson Mandela reminds us: “AIDS is no longer a disease. It is a human rights issue.” At the end of the day, to end the epidemic we must find a cure for the disease and, at the same time, make our communities more equitable and compassionate.
Elton John AIDS Foundation (EJAF): Established in the United States in 1992 by Sir Elton John. EJAF's U.S. office is located in New York City. In 1993, Sir Elton also established the Elton John AIDS Foundation (EJAF-UK) in the United Kingdom, headquartered in London. These two organizations function as separate entities with their own distinct grant-making portfolios, but both pursue similar missions - to support innovative HIV prevention programs, efforts to eliminate stigma and discrimination associated with HIV/AIDS, and direct care and support services for people living with HIV/AIDS. Collectively, the two organizations have raised over $220 million since inception in support of projects in 55 countries around the world, including significant funding dedicated to programs in their respective home countries.
Levi Strauss Foundation: In 1983, the foundation made the first corporate grant in the fight against the epidemic with a donation to the Kaposi Sarcoma Clinic at San Francisco General Hospital. Since then, over $45 million in social investments from Levi Strauss & Co. and the Levi Strauss Foundation have helped build many HIV/AIDS service and advocacy organizations from the ground up – not only in San Francisco but also in more than 30 countries. This year, the foundation will donate more than $2 million to support legal and policy reform in China, media campaigns to address AIDS-related stigma in Russia, advocacy for treatment access in Thailand and India, syringe access programs in the United States and testing and treatment for apparel workers in Lesotho and Haiti.
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