The World Health Organization (WHO) played a fundamental role in disaster management throughout the AIDS crisis. As Elizabeth Fee and Manon Perry explore in “Jonathan Mann, HIV/AIDS, and Human Rights,” American doctor Jonathan Mann created the WHO’s Global Programme to combat AIDS in 1986. Since 1984 Mann had been working in Central Africa as a founder of Project SIDA where he and other physicians researched the heterosexual spread of AIDS in African populations: to contextualize this, in 1984 most researchers were still convinced that AIDS could only be transmitted by homosexual and intravenous contact which heavily impacted the socio-political reactions to the crisis.When Mann approached the General Director of WHO Halfden Mahler with his convictions on social dimensions of AIDS (including heterosexual transmission), he appointed Mann to be the director of WHO’s newly-created AIDS program. Fee and Perry argue that Mann changed the way that people viewed HIV/AIDS by approaching it as a social disease that spreads through behavior rather than as a product of identity.
In 1993, the World Health Organization published a book called AIDS: Images of the Epidemic. The timing here is interesting: 1993 was both the height of the AIDS crisis as well as the beginning of its conclusion. On one hand, AIDS-related deaths reached their highest numbers ever in 1993, making this year the climax of the AIDS crisis. On the other hand, this was only two years before highly active antiretroviral therapies (HAART) were released and the disease became categorized as “chronic” rather than “deadly” in the developed world. By 1993 the global community had generated many different strategies for managing the spread of HIV/AIDS, meaning that it was no longer classified as a “disaster.” As such, this book oscillates between these two extremes. On one hand it demonstrates the severity of the crisis through its pictures and discussion of disaster. On the other the mere existence of such a book demonstrates that the crisis was ending: it proves that disaster management was already in effect.
There are three different “centerfold” collages in the book, but I’ll be focusing on two in particular, the first and the last. By centerfold, I don’t mean “the two middle pages of a magazine typically taken up by a single image,” I mean “two consecutive pages filled with a variety of different images,” as shown below.
The first centerfold shows images of orphaned children in Africa. Many stare straight at the camera, some attend to different activities like dancing and eating. Notably, one picture depicts two orphaned African children praying at a grave. These pictures are meant to show the humanizing aspects of the plague, as well as the exotic faces of its destruction. Photographer Louise Grubb purposefully places these African children as the sole subjects of this photograph series even though there were clearly WHO workers around at the time of her visit, including herself. The exclusion of non-African people in these pictures centralizes the African experience of AIDS which was traditionally discounted: even today, the history of the AIDS crisis is mostly told from an American perspective, something that I myself am guilty of perpetuating. By removing that Eurocentric narrative, Grubb challenges the viewer to see beyond their own perceptions of AIDS and recognize what it means to people from other cultures. Her photographs demonstrates the scope of AIDS beyond the Western world. Nowhere else in this book are there so many consecutive images of people from one particular culture: by focusing on African AIDS orphans from one particular area in this centerfold, the authors demonstrate how the virus functions on a societal dimension and how it devastates the community. Meanwhile, Grubb’s focus on these African children emphasizes the helplessness of their situations, both visually and emotionally. In only one image are any of the children smiling: the rest are either emotionless or sad. In part this reduces the subjects of the photographs from individuals into archetypal figures of suffering: the viewer is meant to pity these children which reinforces the power differences between the voyeur and the object of voyeurism. By objectifying these orphans Grubb feeds into a tragedy-charity mode of contribution and activism, which continues a system that empowers people in developed countries rather than helping those from developing nations. Such images can sometimes disaffect viewers, and even by 1993 many Americans were starting to perceive HIV/AIDS as “their problem” rather than “our problem.” Overall, this centerfold is meant to illustrate a world where HIV/AIDS remains a large and ominous threat and where vulnerable people, children in particular, get hurt in the process.
The other centerfold of the book shows images of prevention efforts from across the globe: from the provision of condoms in a Tanzanian bar bathroom to the establishment of an AIDS hotline in Brazil, these images demonstrate steps that have been taken to promote AIDS awareness internationally. The strategies shown here are both culturally sensitive and socially integrated: it is clear that the pictured management efforts accounted for how the community passed information and accounted for how the respective authority structures governed sexuality within that culture. This centerfold tells a completely different story from the first. Rather than trying to investigate a single group of people from a single community, this image series is meant to show the breadth of effort and innovation from all across the world. There are pictures of local peoples integrating AIDS prevention and education into their livelihoods, there are pictures of communities as well as pictures of individuals. There’s even two poster prints from France and Switzerland recommending condom useage and fidelitous relationships respectively. These photographs were not all taken by a single photographer but by several different photographers including Gerard Diez and Armando Waak. The scope of this series really emphasizes the global scale of WHO’s outreach and their successes abroad. Rather than removing the Eurocentric narrative of AIDS, it compiles Western prevention tactics along with other successful efforts as if to blend all the accomplishments together within the global community. While this prevents complete objectification of the impacted peoples, it also erases the power dynamics present in international relations relating to AIDS. For example, governments from United States and France had a continued patent on the HIV virus and all HIV blood tests, meaning that they were paid interest for every use. US pharmaceutical companies continually overcharged for antiretroviral drugs, making them far too expensive for most of the world. To distort such a power difference gives the opportunity for countries to backlash against the system and even injure their own people. I’m thinking of HIV denialism in South Africa during President Mbeki’s term. Overall, these images show a story of hesitant success and optimism, of hope for a future where AIDS is no longer a threat. The people pictured congratulate the viewer for being part of the effort.
I believe that these centerfolds demonstrate the two different perspectives of the AIDS crisis in 1993. The first series presents 1993 as the height of the AIDS crisis: it shows how people are dying and children are suffering, it calls for the viewer’s compassion. This first set of images displays only the beginnings of disaster relief at the height of a catastrophe. Meanwhile, the second series presents 1993 as the conclusion of the AIDS crisis: it shows the efforts to prevent and educate, it shows a global community united in its fight against a pandemic threat. This final set of images really perpetuates the idea that by 1993 people were learning from the disaster and preparing for the future. As such, both perspectives are technically true. The AIDS crisis would officially end some time in 1995-1996, and its end was both sudden in some aspects yet gradual in others: it was global efforts like the ones employed by WHO that helped smooth the transition, and the contemporary world owes much to their disaster-management strategies.