Silence Equals Death

By Gerry Scoppettuolo

I visited Jack (not his real name) at Boston’s Tufts Medical Center Hospital in 2005.He was near death from AIDS-related opportunistic infections caused by the collapse of his immune system. He was one of the many people at risk for HIV that I knew in my HIV work since 1985. He had responded online to the remote HIV program my agency offered by stating that he had been routinely tested for HIV by his life insurance company without his consent only to be informed by mail that he had tested positive for HIV. “What does this mean?” he asked me. I was shocked by this young man’s question. How could he not know, I asked myself. Had he not received any of the prevention messages that saturated my gay community?

My dismay increased when I learned that he had been infected with a drug-resistant strain of HIV from a sexual partner. Had he known his HIV status earlier, he might have had a chance for survival. He could have entered treatment and accessed the new anti-retroviral protease inhibitor drugs available to him, reduced his viral load (the amount of virus in a cubic mL of blood) and delayed his progression to an untreatable level of AIDS.

Of the eight HIV positive results I have given out, over the years, Jack’s was the hardest to take. His death was entirely preventable. He never had a chance. He was 24. The entire issue of preventable HIV deaths is a horrible chapter in the future (and hopefully final) history of the epidemic if it is ever written. Indeed, there have been many such studies in medical journals already. However, only a few of these reports mention how the economic penetration of white European and North American powers set the stage for what was to follow.

An historical materialist history of the origin of AIDS provides a roadmap to the human disaster of HIV/AIDS. It is now a well-established fact that in the 1920’s Belgian colonial conditions of forced working conditions and unsanitary public health practices unleashed HIV on the world. After the “scramble for Africa,” at the Berlin Conference of 1884, European powers agreed on spheres of colonial conquest. King Leopold of Belgium claimed the Congo as his own personal property. He named it the Congo Free State. It was 85 times the landmass of his native Belgium.

By the turn of the century the specific material conditions necessary to enable an epidemic were then set in motion in what is now the Democratic Republic of Congo. The barbaric treatment of African workers became the framework for what would follow. A new industrial labor force was necessary to mass produce rubber and ivory for a new global market which could generate super profits for European imperialist nations. In the Congo and nearby areas, villages were scoured for workers who were dragooned from the countryside for forced labor by King Leopold’s Force Publique military police who committed unspeakable atrocities.

Labour was accumulated along perceived family and tribal lines. Villages were presented with terrible demands, which could only be paid if the men of the village gave themselves over to forced labour. Where villages refused, Léopold’s army, the Force Publique, was employed.  Homes were burned and the hands of the victims were taken for payment, as evidence of successful kills.   (The Congo: Plunder and Resistance. London: Renton and Zeilig, 2007).

A next to final step to the eventual epidemic occurred when a virus unique to chimps and gorillas, SIV (Simian Immunodeficiency Virus) jumped species during the bloody slaughtering of apes for meat. SIV could then enter the blood and immune systems of native workers.  Eventually SIV – nearly identical to HIV in genetic structure –  mutating into a new virus, HIV, the Human Immunodeficiency virus.

In the 1920s a next to final set of conditions would eventually launch an epidemic when Belgian health workers immunized thousands of Congolese against sleeping sickness and other diseases, using and reusing unsanitary needles in mass inoculation programs. Small amounts of HIV infected blood left in the unsterilized needles spread the new virus silently among the unwitting masses. This happened in Leopoldville (now Kinshasa in the Democratic Republic of the Congo). Once HIV entered the population, human to human transmission was then possible during sexual relations and the sharing of needles during drug use. This biological history is irrefutably laid out in Dr. Jacques Pepin’s The Origin of AIDS and has been corroborated by many peer reviewed medical journals.

One Step Forward, Many Deadly Steps Backward

New anti-retroviral drugs which might have saved my client, Jack, have today been made available globally thanks to the struggle and agitation of groups like ACT-UP (AIDS Coalition to Unleash Power), Doctors Without Borders and activists whose names will never appear in the public record.

As a result, AIDS-related Deaths have been reduced by 69% since the peak in 2004. In 2023, around 630,000 people died from AIDS-related illnesses worldwide, compared to 2.1 million people in 2004 and 1.3 million in 2010. (Source: CDC/HIV.gov) The current, criminal and intentional withholding of life-saving HIV medications and treatment by the United States to millions of those now living or yet unborn, is a new genocide waiting to happen.

On April 8 of this year, the British Medical Journal, Lancet released a scientific estimate of the number  of preventable deaths in Sub-Saharan Africa that will result from Trump’s cancellation of what had been 15 years and billions of dollars of U.S. financial aid used to purchase generic ARV’s HIV drugs and clinical treatment programs in South Africa, Botswana, the Democratic Republic of the Congo and elsewhere:

“A new Health Policy analysis ‘Protecting Africa’s children from extreme risk: a runway of sustainability for PEPFAR programmes” published in the British Medical journal, The Lancet, estimates that 1 million children could become infected with HIV, nearly half a million could die from AIDS by 2030, and 2.8 million children could experience orphanhood in the region without consistent, stable funding for US President’s Emergency Plan for AIDS Relief (PEPFAR).  (The Lancet, April 8, 2025.) To miss even a few days of HIV anti-retroviral drugs can render HIV resistant to an infected person requiring a new and different drug regimen necessary. This is already happening.

Both U.S. capitalist political parties are culpable in this horror story. In 1999, then Vice President Al Gore campaigned to prohibit South Africa from accessing new inexpensive generic HIV drugs: Gore’s fledgling presidential campaign was dogged by the allegation that he sided with US Pharmaceutical conglomerates to deny South Africa access to affordable AIDS medicine.

A group of protesters from Act Up, a pressure group for AIDS sufferers, followed the vice-president around the country. They interrupted a campaign speech at a New Hampshire fundraising picnic, chanting: ”Gore’s greed kills” The controversy centered on an act which the South African parliament passed in 1997, allowing local companies to produce cheap generic forms of the expensive drug-cocktails used to keep AIDS under control. (The Guardian)

Public pressure forced Gore and the Clinton Administration to drop the threat of economic sanctions against South Africa proving once more that both capitalist parties function as the “executive of the bourgeoisie” as Karl Marx famously wrote.

A socialist economy that eliminates capitalist profits and instead returns to workers and the masses the unpaid value of their uncompensated labor power could begin the revolution of constructing life-saving socialism.

The author was  Former Director of HIV Prevention, So. NH HIV/AIDS Task Force, 1995-2000.