The Coming AIDS Reformation

Toronto - After a quarter-century of fighting the disease, the 24,000 AIDS activists, public health experts, and civic leaders who are gathered here have good reason to feel proud of their accomplishments--and even more reason to feel dread about the future. After 28 million deaths from AIDS, significant breakthroughs in treatment have been discovered, but some 43 million people worldwide carry the virus, and an additional four million were infected just last year.

So AIDS activists know they need reinforcement in their good fight against the disease, but they are going to get even more than that: They are going to get a Reformation. And it's going to be spearheaded by Protestants--just like the original Reformation, come to think about it.

For the moment at least, "compassion fatigue," as well as more competition for mind-market share, has hurt the anti-AIDS forces. The Los Angeles Times noted this trend a few months ago, running a June 14 article headlined, "Goodbye AIDS. Celebs Move on to New Causes/ Hollywood, once galvanized behind fighting AIDS, has its attention divided." The piece, by Tina Daunt, noted that celebrities have embraced other causes, ranging from breast cancer to global warming.

So this conclave, formally known as the XVI International AIDS Conference, has been a little thin on "star power." OK, there's Bill Clinton and Bill Gates, but the glamour contingent consists of Richard Gere and Alicia Keys--that's it.

Another part of the problem is that AIDS is not only "old news," it is also, for some at least, not such bad news. Two decades ago, an AIDS diagnosis was an automatic death sentence; it seemed possible that the virus would annihilate whole communities, especially gay male communities. The poignancy of gay men leaving the closet in the 70s, achieving complete sexual freedom in the 80s, and then entering the intensive care unit--and the morgue--in that same decade sent shock waves through the culture. One result was an explosion of AIDS-themed art and literature, as the creative classes in the US and the West struggled to make sense of what was happening to them and theirs. But now, thanks to advances in antiretroviral drugs, it's fair to say that most AIDS victims in affluent industrialized countries can live a reasonably good life in spite of being HIV+. In the West, it's now a chronic disease, not a killer.

So the cliché of this conference is that the paradigmatic AIDS victim is no longer a gay man--as few as five percent of all AIDS sufferers worldwide now are gay men--but instead a black or brown woman; some 60 percent of total AIDS victims around the world are female. As those demographic realities make themselves felt at the base, or substrate, it only makes sense that the cultural and intellectual superstructure will change, too. So as women replace gay men as the principal victims, AIDS loses some of its dramatic intensity; as the hub of the sickness shifts from New York City and San Francisco to Nairobi and Calcutta, the opportunity for world-media-savvy spectacles diminishes--and as Third Worlders do the dying instead of First Worlders, AIDS loses some of its political potency in the First World. So the Prime Minister of Canada, Stephen Harper, a conservative, chose not to attend this conference in his own country, and few think he will pay much of a political price for his non-attendance. In terms of AIDS awareness, for many in the West, from Hollywood to Ottawa, the compassion-caravan has, well, moved on.

So that's the situation here in Toronto, and it should be sobering--it is sobering--to the activists here, most of whom seem to be earnest women, taking lots of notes. Maybe that's why the zesty, in-your-face-y cultural efflorescence of past conferences is gone; just two years ago, in Bangkok, activists erected a giant condom prominently by the entrance to the hall. There's nothing like that here.

But there's a new kind of efflorescence here, one that speaks, I think, to the basic conservatism of Third World populations. And that efflorescence is religious, which is to say, for the most part, restrained and tradition-minded. Clerics of all kinds have always been active in the AIDS fight, but they are becoming increasingly prominent.

For example, Rick Warren has been here for almost a week. Warren, pastor of the Saddleback Church in Lake Forest, California, author of The Purpose-Driven Life--and a near-regular on "Larry King Live"--must be rated as one of the most important figures in American Christianity today. So when he attended an interfaith "pre-conference" on AIDS here last week, that was news. And when he met with Bill Gates and many AIDS activists, including a founder of ACT-UP, that was newsworthy, too. Along with others in the evangelical movement, such as Franklin Graham, son of Billy, Warren has thrown himself into AIDS issues in a determined manner. But these Christians will address the issue in their own way--a different way. The Reformation has begun.

In an interview at the Metro Toronto Convention Centre, I asked Warren why he had taken up the cause of AIDS. He gave me three reasons.

First, he said, after the success of his book--selling 25 million copies in hard cover, translated into 56 languages--he was looking for a worthy challenge. He felt "blessed," he told me, and wanted to give back as many blessings as he could.

Second, "This is the greatest health concern on the planet." It's the No. 1 cause of death for people under 60, Warren continued, creating 14 million orphans today, with many millions more to come. And the "explosion" in AIDS that lies ahead in China, India, and Russia, he added, could dwarf what's happening now in Africa.

Third, "The church has to be there . . . It's the Jesus thing to do." And what about the stigma of AIDS? His answer: "It's not a sin to be sick." Warren described AIDS as the leprosy of the 21st century, noting, "Jesus hung out a lot with lepers."

So far, at least, the minister is saying nothing that "traditional" AIDS activists, many of them thoroughly secular, can object to.

But here comes the change in emphasis that Warren & Co. are bringing to the AIDS discussion. I asked Warren about condoms. He replied that he's not against condoms--that is, being distributed by others. If others want to distribute them, so be it. But he doesn't do so, nor do the 7,000 Christian activists that Saddleback has already dispatched on missions around the globe.

But the condom, of course, has been one of the key symbols of the AIDS movement. It has achieved talismanic importance because it suggested that people could continue to have sex--it just had to be "safe sex." Now it's true that Warren, a father of three, married to the same woman for three decades, can't be considered an enemy of sex, but he says, nicely--but also flatly and unapologetically--"sex is for marriage." That's what the Bible tells him, and that's the spiritual rock upon which he stands. He can do no other.

Some will disagree with Warren, of course, because words such as "marriage" and "abstinence outside of marriage" have, for the most part, been eliminated from the AIDS activists' value-free discourse. So when Bill Gates mentioned "abstinence" here on Monday, he was booed by some in the audience. And when Bill Clinton declared that abstinence didn't work over the long run, he was cheered.

But it's hard to see Warren ever changing his mind on condoms. And more to the point, it's hard to see his followers ever changing their minds, either. If many people, even after 25 years of being exposed to proselytizing for "safe sex" and "safer sex" through condoms, are still opposed to condoms, there's not much chance of a "breakthrough" any time soon. And that goes double, or triple, for "clean needles"--I didn't even bother to ask Warren what he thought about needle- exchange programs.

If anything, the forces of sexual conservatism have grown stronger in recent years, as AIDS has shifted, as noted, from gay men to women. And it's even possible that science and social science will catch up: Here's a headline from Tuesday's edition of the Canadian newspaper, The National Post: "Teaching abstinence reduces teen sex." The articled detailed a study of black 6th and 7th graders in inner city Philadelphia, and found that--gasp!--abstinence works. No doubt a thousand PhDs will seek to bury the study under their own data, but here's a prediction: Most people will agree with the conclusion that the best way to stop AIDS is to be either abstinent or mutually monogamous, and no amount of social science will change their minds.

"Sex is for marriage," Warren asserts, citing spiritual traditions that reach far outside of Christianity. And to make that come true, he adds, "We have to change boys and men." That is, male urges must be given the soulcraft that leads to faithful marriage--a profound moral exhortation, dwarfing mere prophylactics.

Warren does not come across as angry or even judgmental. In the tradition of many American evangelicals--indeed of many Americans--he is cheerful, optimistic, and solutions-oriented. "I don't want to slow AIDS, I want to stop AIDS," he declares. And to do that, he is eager to mobilize human and financial resources from governments, including conservative governments, as well as from corporations and grassroots Christians. But he wants to add spiritual resources, too, to the effort. "You can't ask Christians to put their values on a shelf," he suggests.

To be sure, when Christians mobilize, the world changes. From William Wilberforce's abolition of slavery to Jimmy Carter's promotion of human rights, religion has been an engine of social reform, worldwide. Yes, Karl Marx said that religion is the "opiate of the masses," but in that same passage, from Critique of Hegel's Philosophy of Right, Marx conceded that religion is "the heart of a heartless world."

And around the world, Warren estimates that he has helped train 400,000 pastors in 162 countries. He just came back from South Korea, where he spoke to 30,000 ministers; South Korea, he added, is the country producing the second-largest number of missionaries, after the US.

In Warren's vision, these Christian missionaries will be the new recruits to the anti-AIDS Army. Counting 2.3 billion Christians worldwide, Warren sees churches distributing medicine, as well as the message. Indeed, new breakthroughs in medicine--a new "three in one" AIDS drug, for example, that vastly simplifies the once-lethal problems of timing and delivering dosage--have made it easier for non-Rx-ers to deliver life-saving care, even in the remote countryside. "We can get to places others can't," the clergyman pledges.

Warren is happy to join alliances and enlist allies everywhere: "I don't care why people do good, so long as they do good." So while he keeps returning, as a theme, to the transformative power of faith, he doesn't limit his vision to the Christian faith. He counts more than a billion Muslims, nearly a billion Hindus, and some 600 million Buddhists as fellow soldiers. He even includes atheists, although noting that just four percent of the world's population considers itself to be completely outside of faith. Warren's point is clear: If it comes to making real change in people, one must start with terms and concepts that people can understand, and empathize with. And even the most ardent secularist must concede, by now, that religion can't be an enemy; it has to be a friend, a central part of any successfully transforming equation.

Indeed, if history is any guide, religious feeling is destined to grow stronger in the coming century, as people seek to process the AIDS tragedy through the prism of morality and spirituality, as well as medicine and science. An epidemic such as AIDS may cause some to lose their faith, but it will likely cause others to embrace their faith all the more tightly.

But Warren, a man of faith, is no enemy of science. So I asked him about medical research and, specifically, about the drug companies. There's been much less drug-company bashing at this conference than at past sessions, thanks in part to the simple reality that progress is being made, thanks also to the overwhelming influence of "The Two Bills," both of whom, of course, are comfortable with CEOs and in tune with bottom-line realities.

Warren, too, puts the drug makers in his "big tent." His new idea is to extend patents of such non-essential "cash cow" drugs as Rogaine or Viagra--on the condition that the drug companies channel any extra profits over to AIDS research, as well as to research on other diseases that disproportionately affect the poor, such as malaria and TB. "In their quest for profits, they are doing good," Warren asserted--using the "invisible hand" argument, first articulated more than two centuries ago. I told Warren that not everyone subscribes to that causative theory. "They are just naïve," he answered. "It takes billions of dollars to make these drugs. The money has to come from somewhere."

Interestingly, Warren himself offers a different and more inspiring model of motivation; he has given away, or given back, 90 percent of the money he has ever earned. In Toronto, he was wearing a nondescript tan suit that showed distinct signs of polyesterdom.

In the course of the last quarter-century, the accomplishment of AIDS activists has been to change the politico-cultural mindscape. But AIDS itself has changed much more; it has changed the demographic and historical landscape, especially in the Third World. And even deeper changes will be seen in the coming century, as billions of people react to AIDS by seeking moral and behavioral equilibrium in their own minds and lives. That is, AIDS isn't going to make people more radical, it's going to make them more conservative.

That's the Reformation that's coming, and Rick Warren seems destined to be a big part of it.