 |
 |
 |
 |
 |
Neglect and Fatigue: The U.S. Media’s Construction and Framing of the HIV/AIDS Pandemic in Africa
On July 3, 1981, Lawrence K. Altman reported that “doctors in New York and California have diagnosed among homosexual men 41 cases of a rare and often rapidly fatal form of cancer. Eight of the victims died less than 24 months after the diagnosis was made.” This article, the first published in The New York Times regarding what would soon be known as HIV/AIDS, marked the beginning of a complicated and inconsistent process by which the media in the United States have interpreted and distilled information about AIDS for the American public. Since HIV/AIDS was first covered by the mainstream media, there has been much criticism about the extent and content of the coverage.* As this pandemic ravages large regions of the world, with the focus of its devastation in sub-Saharan Africa, the response of wealthy nations like the United States, which many allege has been inadequate, is tied to the problems that persist in the perceptions and knowledge constructed by the mainstream media.
Examining the media is essential to understanding HIV/AIDS as a political and public policy issue because so few citizens are equipped with the specialized knowledge necessary to sufficiently comprehend the disease and its effects. In fact, a survey conducted in 2003 revealed that roughly three-quarters of the U.S. public receives most of its information about HIV/AIDS from media like “television, newspapers, and radio.” However, despite the public dependence on the media for valuable information, many observers assert that an “AIDS fatigue” has afflicted media organizations and journalists “report great difficulty in persuading their news organizations to run HIV/AIDS stories,” leading to the criticism that “coverage of global HIV is inadequate and coverage
The media’s treatment of AIDS in Africa might not be surprising considering the manner in which it has been approached by state officials and policy-makers. The most tragic of these approaches, perhaps, is neglect. In 2000, James Sherry, then director of program development for the Joint United Nations Program on HIV/AIDS, said, “I can’t think of the coming of any event which was more heralded to less effect…. In terms of real deployment of resources, it hasn’t changed. The bottom line is, the people who are dying from AIDS don’t matter in this world.” Evidence of just how “heralded” the pandemic was appears in “The Global AIDS Disaster,” a report, corroborated at the time by the World Health Organization, begun in 1990 by the Central Intelligence Agency that “projected 45 million infections by 2000 – inexorably fatal, the great majority in Africa.” After being delivered to the White House and Cabinet agencies, the document, according to its principal author Kenneth Brown, was met with “indifference.”
If not “indifference,” then outright contempt and scorn underscored by racism. Brown recalls military officials at the National Intelligence Council saying that the proliferation of AIDS “will be good, because Africa is overpopulated anyway” and that if officers in allied African militaries began to die from the disease, it would not have a major effect on military strength, but could “boost morale, because there’s more room for advancement.” Even though, by this point, the groundbreaking research of Dr. Jonathan Mann pointed to “conditions of poverty, oppression, urban migration and social violence” as major causes, as well as effects, of the spread of HIV/AIDS, these issues were neither discussed within the U.S. government nor by the vast majority of mainstream media outlets. In fact, Mann “was ignored by most media outlets or branded an alarmist by many in the field who clung to the idea that AIDS was just a virus like many others that preceded it, not an emerging social and economic crisis.”
In the last two decades, media coverage of the disease has “declined steadily.” In fact, the number of stories covering HIV/AIDS in 2002 was less than one-fifth of the number in 1987. Spikes in media coverage have only occurred as a result of specific events or incidents related to celebrities. Even in 2000, when “media coverage shifted to the emerging stories of HIV/AIDS in Africa,” there still was not nearly as much attention as there was in the early 1990s, when stories focused on the revelation that former NBA star Magic Johnson was diagnosed with HIV.
One of the more telling aspects of media coverage is its lack of correlation to changes in rates of infection or those populations that are most at risk. For instance, in the years preceding 2002, there was a marked decline in stories “with a consumer education component,” despite the fact that, for the first time since 1993, rates of infection in the United States were on the rise. Further, though the majority of new HIV infections in recent years in the U.S. were diagnosed in people under the age of 25 and though AIDS has been the “leading cause of death among African Americans ages 25 to 44, [who] represent the majority of new HIV infections,” only one percent of media stories focus on teenagers and young adults and only two percent focus on African Americans. The media’s neglect toward to the interconnectedness of HIV/AIDS and race, class, and age in the U.S. is even more glaring in the context of Africa.
By ignoring social and economic factors that contribute to the pandemic in Africa, a perception of futility and hopelessness is created among Americans that reinforces the notion of “AIDS fatigue” in the media. Attention to such factors could result in renewed efforts to alleviate poverty and increase access to affordable drugs. Instead, most media outlets uncritically accept the official agendas and statements of government officials. Despite criticism from organizations all over the world, only a handful of media sources in the U.S. seriously challenged the arguments made by Andrew Natsios, the Bush administration’s former Administrator of the U.S. Agency for International Development (USAID), who, in 2001, told The Boston Globe that the focus should not be on antiretroviral drugs in Africa, as Africans cannot comply with drug regimens because they “don’t know what Western time is. You have to take these drugs a certain number of hours each day, or they don’t work. Many people in Africa have never seen a clock or a watch their entire lives.” Both Natsios’s statements and the lack of skepticism from the mainstream press reflects the priority of serving corporate interests. According to media watchdog Fairness and Accuracy in Reporting (FAIR), “[Natsios’s] attitude was in service to the U.S. government line that developing countries should not be allowed to undermine pharmaceutical companies’ profits through the distribution of generic versions of patented drugs—since their lack of infrastructure and general backwardness would make the distribution of such drugs wasteful or worse.”
As it turned out, evidence demonstrated that Natsios was completely wrong. In a study published in The Journal of the American Medical Associationcomparing adherence to antiretroviral drug regimens in North America and Africa, “North American studies indicated a pooled estimate of 55%...of the populations achieving adequate levels of adherence….African studies…indicated a pooled estimate of 77%.” Yet, outside of medical journals and various health organizations and institutes, no major news sources reported these findings, despite the fact that they debunked a major rationale affecting government policy with regard to HIV/AIDS in Africa. By attributing the spread of the disease to causes like non-compliance with drug regimens, powerful nations like the U.S. are able to blame the victim while shirking responsibility.
Certain stories that have emerged from the pandemic in Africa continue to be downplayed by the U.S. mainstream press, despite the humanitarian disasters they represent. One example is the “tens of millions of children orphaned” as a result of AIDS, a growing problem that “rarely makes it into popular media.” Journalist Carol Devoe, who helped create the film documentary Nkosi: A Voice of Africa’s AIDS Orphans, calls the media situation “disheartening,” adding, “This is such a compelling story that journalists should be falling over each other to [report]. But many calls are not even returned, unless the story is attached to a high-profile donation like one by the Gates Foundation.”
As the deleterious effects of the disease on youth expand beyond Africa, even the involvement of powerful international economic institutions like the World Bank has not been enough to command adequate media attention. According to a World Bank report, “HIV/AIDS has ravaged the lives and prospects of children and youth globally, with half of all new HIV infections occurring in the 15-24 age group. AIDS [as of 2001] has orphaned 10.4 million children under the age of 15. Children orphaned by HIV/AIDS comprise the majority of orphans under the age of 15.” The disturbing trend, pointed out by media critic Danny Schechter, is that “as AIDS claims more victims, it gets less coverage.” Schechter adds, “This is true not only in the West, but in Africa itself, where stigma and discrimination against AIDS sufferers is deeply entrenched, and where silence and denial still drive many governments to cover up their frightening infection levels.”
The media may reinforce this “silence and denial” through their unwillingness to make those who actually suffer and die from AIDS in Africa the focus of their coverage. In the U.S. media frame, the anguish of millions of dying Africans is too often depicted as a prop for the drama of high-profile American political figures and philanthropic celebrities. In 2006, activists “derailed a news conference” to voice their grievance that “the constellation of political and entertainment world stars drawn to the International AIDS Conference [in Toronto, Canada] has drowned out the voices of the people living with AIDS.” The fact that every major U.S. newspaper reported the presence of President Bill Clinton, Bill and Melinda Gates, and Richard Gere at the Conference, but almost entirely ignored the protests of these activists, is evidence supporting the activists’ complaint. However, even the famous names at the Conference attracted little more than brief mentions from the U.S. media and the event was ignored by the CBS and NBC nightly news producers completely: “of the three nightly network newscasts, ABC World News alone aired a report, and it was not likely to assuage activists’ concerns about the impact of using the wealthy and powerful as a lens for the AIDS story.” According to the ABC segment, Clinton and Gates are “saying things no one else has said and doing things that no one else has done.” While such reports fawn over the efforts and goodwill of celebrities, they ignore the fact that the Clinton administration only turned its attention to the pandemic in Africa after declaring it “a national and global security threat [with] the potential to destabilize governments” in 2000. Further, these stories neglect to report that, prior to 2000, the Clinton administration was heavily criticized by AIDS groups for its failure to act on various issues, such as needle exchange programs, for which Clinton was rebuked by the Presidential Advisory Council on HIV/AIDS. Meanwhile, amid the media coverage of celebrity involvement, little is reported on the Bush administration’s “insistence that 33 percent of global HIV-prevention dollars go toward much-criticized abstinence-only programs [or]...its refusal to fund groups unless they pledge to oppose commercial sex work,” even though these issues have received much critical international attention and are considered “central to the story.”
One particularly salient example of the manner in which the mainstream U.S. media has covered issues of HIV/AIDS in Africa occurred in 1999 during then Vice President Al Gore’s presidential campaign. When Gore was announcing his candidacy during a speech in his home state of Tennessee, “heckling broke out” according to CNN on-scene correspondent Jeanne Meserve, who reported, “It was a group called AIDS Drugs for Africa. They were moderately loud. Gore supporters tried to counter them with chants for Al Gore. Eventually, they were escorted out of the area.” Most news stories about the activists either ignored or misrepresented the actual issues being protested, such as the one printed by The Boston Globe, which asserted that the demonstrators were “urging [that] more U.S. dollars be funneled toward the AIDS crisis in Africa.” This was not, in fact, the demand of the demonstrators. The call was actually for “Gore and the administration to stop interfering with South Africa’s and other nations’ attempts to deal with their massive AIDS crises. With nearly 3.2 million HIV-positive people,…South Africa passed the Medicines and Related Substances Act in 1997, invoking their right to obtain essential drugs, including those used in treating AIDS, at accessible cost.” The response of the Clinton administration was not to support the AIDS victims in South Africa, but rather to come to the defense of the drug firms: the State Department assured Congress that “all relevant agencies of the U.S. government . . . have been engaged in an assiduous, concerted campaign to persuade the government of South Africa” to honor drug patents and fight the Medicines Act. Gore, as the chair of the U.S.-South Africa Bi-National Commission in 1998, “made changing the law a ‘central focus’ of his August 1998 meeting with South African deputy president [now president] Thabo Mbeki” and even “threatened trade sanctions if South Africa permits the widespread sale of cheaper, generic drugs that would cut into U.S. companies’ sales” (The Washginton Post, 6/28/99, A12). Yet, with the one notable exception of The Washington Post’s coverage of “health and AIDS activists accus[ing] Gore of favoring drugmakers’ profits over the lives of millions of South Africans infected with the human immunodeficiency virus,”none of this background was given by media reports covering the AIDS activists disruption of Gore’s speech.
Instead, major newspapers covered the event solely in the context of Gore’s presidential campaign (if they covered it at all), not in the context of HIV/AIDS in Africa. Most stories resembled that in Cleveland’s The Plain Dealer, which reported, “Activists protesting U.S. opposition to a South African AIDS drug policy disrupted a campaign speech by…Al Gore yesterday. ‘Gore’s greed kills,’ they chanted as Gore tried to address about 100 voters….Gore said above the din, ‘Let’s hear it for free speech.... I’d like to talk to you about the risky Republican tax scheme.’ Gore offered to meet with the activists later” (8/9/99, A8). Other media sources framed the event as an opportunity for Gore, “who has often been described as ‘wooden,’…to demonstrate his ability to ad lib” (Arkansas-Democrat, 6/18/99, A5). Almost every journalist reporting on the event, including The Boston Globe, noted that Gore told the activists that “he would be happy to talk to them later” (6/19/99, A6). Yet, not one of these journalists actually followed up on this claim by reporting whether or not Gore did in fact meet with the protestors. The message from the media appears to be that Gore’s ability to handle the dissent is the only story that matters; the root of the dissent is not important enough to report as news.
The U.S. mainstream media reacted similarly when AIDS activists interrupted the 13th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in 2003. While the media was willing to focus on the protest of Peter Piot, the director of UNAIDS, that “it’s the right time to rethink ICASA, its format, its value, and whether the huge investments we make in such conferences are justified,” major news sources failed to offer details or explanations about the “more than 30 AIDS activists who drowned out a speech by the top US representative at the ceremony, Leslie Rowe, the new charge d’affaires at the US Embassy in Nairobi” (Boston Globe, 9/27/03, A6). Only activist groups and alternative media organizations took the time to elaborate on the demonstration; according to ACT UP, the activists were “part of the Pan-African AIDS Treatment Access Movement (PATAM) which seeks more government funds to subsidize anti-AIDS drugs.” The ACT UP report adds that PATAM has members in over twenty nations and quotes Nigerian activist Mohammed Farouk, who says, “Nutrition is being discussed here as an alternative. We say it’s not an alternative; it is not the same as antiretrovirals (ARVs). We want the treatment, we want ARVs and we want them to be cheap.” Because of the choices made by the U.S. mainstream media, voices such as Farouk’s rarely get the chance to participate in the debate, even though they are the ones that are most affected.
The number of media sources in the United States has been steadily decreasing for decades and almost all media sources with the ability to reach a substantial number of people are owned by large corporations with the primary end of maximizing profits, not in practicing critical and responsible journalism. According to FAIR, “As news outlets fall into the hands of large conglomerates with holdings in many industries, conflicts of interest inevitably interfere with newsgathering.” It might not be surprising, then, that the U.S. media has largely neglected issues integral to the story of HIV/AIDS in Africa that could adversely affect pharmaceutical corporations. Until media organizations demonstrate a commitment to exposing the reality of Africans afflicted with AIDS and to effectively communicating the perspective of those who are actually affected, it is unlikely that there will be strong pressure within the United States and other countries for swift action that might have a real impact. As the 2008 presidential election approaches, it will be telling to observe how many journalists ask candidates questions related to HIV/AIDS in Africa. Unless such questions are asked, the terms of the debate in the U.S. will remain tragically limited, the result being continued inaction, or even detrimental action, regarding the HIV/AIDS pandemic in Africa
* “Mainstream media,” as used here, is distinguished from what Steven Epstein in Impure Science calls “alternative media institutions, including the lesbian and gay press, movement publications, and grassroots literature about AIDS treatments.” Epstein 22.
Aaron Sussman is the co-founder of Incite Magazine and has contributed to many publications, including Z Magazine, TheNation.com, MediaChannel.org, and more . For archives of his work, visit www.ACrowdedFire.com. Aaron can be contacted at Aaron@InciteMagazine.org.
|
