Partner in the anti-AIDS battle
By Shashi Tharoor
"The Hindu", Online edition of India's National Newspaper
December 05, 2004

The AIDS pandemic is one where the media has an important role, and may even save more lives, than doctors.

DECEMBER 1, World AIDS Day, is just behind us. The bad news has been widely aired: the number of people living with HIV globally has reached its highest level, nearly 40 million, with at least five million of those living in India. As the tally of people becoming infected increases, so does the number of those needing antiretroviral treatment, as well as care for related "opportunistic" infections. The number of women living with HIV has also risen across the world over the past two years, now making up nearly half of the adults living with HIV worldwide. Women are three times more vulnerable to HIV infection than men (male-to-female HIV transmission during sex is about twice as likely to occur as female-to-male transmission). For many women in developing countries, the "ABC" approach to prevention (the initials represent `A'bstinence, `B'eing faithful and having fewer sexual partners, and using a `C'ondom) is insufficient. Millions of young people are becoming sexually active each day with no access to prevention services. In India, the real numbers may be more dramatic than the official ones; in any case, HIV-carrying men are infecting their wives, who in turn pass the disease on to their children. Things are bad, and could get worse.

The media's reach

When people don't believe bad news, or don't want to believe it can affect them, the tendency is to shoot the messenger. It is not hard to understand why, even in ancient times, when this literally happened, bad news was seldom welcome. But in this column today, I am not just the bearer of bad news. There is hope — and the media is not just the messenger, but the message. The AIDS pandemic is one where the media has at least as important a role, and may even save more lives, than doctors.

What do I mean? The media has been an important partner in the fight against AIDS over the past two decades. When HIV/AIDS was a newly emerging disease in the early 1980s and 1990s, the world media was responsible for drawing attention to the epidemic. In the West, it has played a vital role in educating the public and pressuring governments and communities to act. But it can do more in the developing world, especially in India.

We know that many of the millions of young people who become sexually active each day either do not have the information they need about HIV/AIDS or do not feel empowered to act on that information. And we know something about who we should be empowering: the number of women living with HIV has increased in every region. That's not all. We know that injecting drug use is again on the rise in many regions and that it contributes to an increasingly large share of new HIV infections, especially in countries where the disease is just reaching epidemic levels. We must also be cautious about speaking of "an AIDS epidemic". Rather than a single epidemic, different regions and even countries are experiencing diverse epidemics, some still in the early stages. So we know that if we are to confront the disease, we have to tailor our AIDS message to local realities and dynamics. Despite all this knowledge, we are yet to reverse the contagion. So the big question is how, in this information-saturated age, we can do better.

The point of `denial'

The main challenge is to break down the barrier of denial: sadly, for most people, AIDS still is the disease that affects "other people". Denial of the epidemic has led to inaction. Global statistics can frighten us, but they are clearly not potent enough to protect a young person afraid to ask her partner to use a condom on a hot date, or protect a wife who will be beaten if she refuses sex or insists on using a condom, or even a lorry driver, who is more concerned about the traffic police than a disease that he might acquire at the next truck-stop. Many governments and communities, too, do not yet feel sufficient pressure to act and when they do act, the priorities are not always right.

What can TV do?

AIDS campaigns have long focused on prevention. Prevention should still be the main thrust of any campaign but the solution lies not only in providing condoms or clean needles. Stigma and discrimination are huge barriers to preventing further infection, as well as to providing adequate care, support and treatment. It is frightening that more than 90 per cent of those infected don't even know they have HIV/AIDS, and even those who do are sometimes too fearful to seek treatment. And compounding this are taboos about sex and drug use, morality and cultural beliefs and practices. Media silence on HIV/AIDS only fuels complacency. The answer lies in serious and sustained public education efforts. And there's no better medium for this than television, which roughly 40 per cent of the world's population spends nearly a quarter of their waking hours watching.

What can TV do? The old debate about the social responsibility of the media focused on whether violence on television promoted violence in society. (It was this suggestion that prompted American talk show host Dick Cavett to ask whether comedy on television caused comedy in the streets.) But it's time to move beyond that tired debate to seize on the very real influence that television has on how people behave. On the scourge of HIV/AIDS, television programming can create an enabling environment, where individuals are encouraged to explore ways of keeping themselves safe from this disease and changing their behaviour as necessary.

The United Nations has challenged the world's top TV broadcasters to designate the fight against HIV/AIDS a corporate priority. And why not? The tragic confluence of AIDS, famine and drought in parts of Africa threatens more human lives than the crisis in Iraq ever did. This would mean a commitment at the highest level, which would translate into a powerful influence on programming in all spheres. Such a commitment was made in January, at a meeting chaired by U.N. Secretary-General Kofi Annan, by several media leaders — including the head of Doordarshan — who recognised that the global HIV/AIDS epidemic is a major international crisis that threatens not only the health and security of all nations, but their economic well-being as well. They committed to expanding public knowledge and understanding about the epidemic.

Programming

They told us there were a variety of ways this could be done. Airtime can be dedicated to public service messages. Special educational or awareness-raising programmes could be broadcast; the BBC and others have combined programmes in a highly creative way, featuring documentaries, concerts, arts programmes, competitions and children's shows. And of course, news coverage of the epidemic can be beefed up to ensure AIDS stays on the political agenda, both nationally and globally. By keeping the epidemic in the headlines, world leaders would be encouraged to accept the gravity of the crisis and commit greater efforts — and more resources — to the fight.

But, perhaps more important, HIV/AIDS can be injected into mainstream programming. After all, more than 40 per cent of the top-rated shows around the world are mini-series, sitcoms, soap operas, movies and telenovelas. If, for example, a well-known character in a popular television series confronts HIV or AIDS, as in "Jasoos Vijay", the popular detective show in India, or the BBC's hit "East Enders", this can have a dramatic effect on viewers or listeners who may not choose to watch a more edifying, but less entertaining, programme about the epidemic. In several regions, television dramas have been used to bring AIDS awareness to wider audiences than traditional health promotion could ever hope to reach — from the series "Ordinary People" in China to "Heart and Soul", a soap opera developed with U.N. support in sub-Saharan Africa.

The idea is simple: to ensure that ordinary people can watch their favourite shows and be educated about AIDS, and about how to modify their own behaviour to protect themselves from it. As I said: the media can save lives.