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Last Updated: Tuesday, 25 November, 2003, 18:45 GMT
Aids: Ask Emma Thompson
Emma Thompson, British actor and Aids activist with child in Mozambique

Emma Thompson answered your questions in a LIVE interactive forum.

  • Transcript

    Actress Emma Thompson has become increasingly outspoken on HIV and Aids in recent years.

    As part of a special BBC season on Aids, she will be answering your questions about it.

    The Oscar-winning British film star has accused Western governments of "psychotic detachment" over their "failure" to commit funds to the fight against the epidemic.

    As an international ambassador for the British Charity ActionAid, she has taken time out this year to visit people living with HIV in Uganda and Mozambique, both countries hit hard by HIV and Aids.

    Do governments listen to film stars? How does Emma Thompson think the world should tackle the Aids crisis? Have her visits to Africa changed her perspective?



    Transcript


    Susanna Reid:

    Hello and welcome to this BBC Interactive Forum, I'm Susanna Reid.

    As part of a special BBC season on Aids, Emma Thompson, international ambassador for the British Charity, ActionAid, is joining us to answer some of your many questions about HIV/Aids.

    Emma Thompson began her Aids campaigning in 2001 when she announced she was putting her acting career on hold to help the charity ActionAid, which works to help Aids sufferers in Africa.

    The Oscar-winning British film star has taken time out this year to visit people living with HIV in Uganda and Mozambique, both countries hit hard by HIV and Aids. Emma, thanks very much indeed for joining us. Let's plunge straight in with our first question.

    Jesse Crowder, Los Angeles, USA asks: Of all the fights in the world, what takes you to the Aids fight?


    Emma Thompson:

    I think it's the most important and most pressing one - I think it's a global emergency and I think in a way we all have to address it and engage with it because I think it's the biggest threat to the human race that we have ever faced.


    Susanna Reid:

    As a celebrity, there must be many demands on you from many different charities. So what was the imperative that made you feel that this was the one you really had to go for when every single charity must have compelling reasons for you to represent it?


    Emma Thompson:

    I've a problem with the word charity because I think that NGOs, as I prefer calling them, really do take the work of moral and social responsibilities that ought to be taken on by governments. I think if you took charities and NGOs out of the mix, certainly in developing countries, you would find that there would be huge trouble immediately.

    I therefore joined ActionAid because I liked their politics. I like the fact that they joined up the dots between poverty and most of the ills that beset us and they weren't afraid to challenge government. It's not, as it were, a charity - a nice thing to do that you do and then you go back to your nice life and forget all about it. It's engaging with this struggle to bridge what is actually an avoidable and unacceptable gap between very, very rich people and very, very poor people which really can't go on.


    Susanna Reid:

    So was it the political campaigning element as well which you were attracted by?


    Emma Thompson:

    Yes absolutely and the fact that they encourage people in developing countries to work upon their rights. It's what's known in the developing world as the rights-based approach, i.e. you're not the cavalry, you're not someone driving up in a nice big shiny van because that doesn't work, it doesn't last and it creates resentment as it would if it were to happen to us.

    I think the point about ActionAid is what it's asking people to do is engage with poor people in developing countries and understand what their lives are like and understand how the way we live our lives impacts on theirs. Because I think there really is a general feeling that we live this way and there's no connection and there are many, many connections and often very unacceptable connections.


    Susanna Reid:

    Many people get involved with charity work because they're personally affected by something. Bakht Muhammed, Islamabad, Pakistan wants you to tell us how HIV and Aids has affected you? Either on a personal level or of course, as a result of your work with ActionAid.


    Emma Thompson:

    I have had lots of friends who've been affected by Aids and a very good friend of mine, Oscar Moore, died of Aids and I was with him in his last year quite a bit. And of course he was a man living in a very rich culture with a wealthy family who was able to afford health care. He died nonetheless as it killed an awful lot of people.

    I have a friend who's lived with HIV for 20 years and it hasn't really interfered too much with his life. Now of course I've got a lot of friends in Africa who've been affected by it in ways so dreadful that I can't imagine what it must have been like for them.

    My friend, Lorraine Keleba, who works for UN Aids and who's Ugandan, has four children of her own - none of whom are affected, thank God - her husband died of Aids and 14 foster children. She brings up 14 extra children in Africa, all of whose parents have died because of Aids and some under the most appalling circumstances.

    When I was in Uganda, she took me to the family graveyard which is behind her mother's house and she said this grave is my niece's and she died of karposis sarcoma. She was abused by an uncle and the pain in which she died, the doctors couldn't give her anything for it. And in the end we, the whole family, had to be sedated in order to be able to sleep through the screaming. She was 14 years old.

    So stories like that do make you stop in tracks and think first of all about the difference between people that you know who are treated and live with HIV/Aids. A lot of people in my world - in the acting world - have either lost friends to Aids or live with HIV because its origin in our culture, in New York for instance, was in the gay community. When the same kind of detachment from it, as is shown by western governments I think now, although that is beginning to change, was shown by the American government at the time if you remember. It was appalling the way in which people died in their hundreds - just ignored by the American government.


    Susanna Reid:

    Opal Hope, New York, USA asks: Since the population of those most ravaged by Aids has shifted now to a largely disenfranchised group, what steps need to be taken to re-engage the public with this issue?

    In the western world it is perceived as a largely managed problem now. But as you were saying there are countries where it is just extremely common to have lost multiple family members. So how do we get the public to re-engage with an issue which has shifted to perhaps sub-Saharan Africa?


    Emma Thompson:

    Although our rates are rising again - we've really taken our eye off the ball.


    Susanna Reid:

    So how do we get our eye back on the ball?


    Emma Thompson:

    First of all we need to campaign here for a new campaign. I wrote to Tony Blair about that recently and he said, yes I do see that. And now that we've had some figures about the rising incidences of infection in this country, I think people will begin to realise that the disease is not gone and you can still catch it.


    Susanna Reid:

    How is being infected now in this country?


    Emma Thompson:

    I haven't seen the figures yet because these were released by UN yesterday. But I imagine that it will be amongst teenagers, amongst people using unprotected sex or drug users etc. But I'm not absolutely certain who the key groups are so I can't answer that question.

    As for the point the questioner makes, it's a very good point. It seems to me ironic somehow that the first group to suffer in our culture was disenfranchised - it was the gay community. They were ignored, they were somehow considered, as it were, beyond the pale of normal society and now it's shifted to the poor and not only the poor but the often, not white. And it is very difficult to avoid the assumption that there is a sort of endemically racist response to the fact that this number of people - 24 plus million, it is in Africa infected with Aids - a continent that is slowly dying in front of our eyes, that we haven't taken the kind of steps necessary - the UN would say $10 billion a year - to combat this - is psychotic actually.

    If you consider the fact that in America when the Sars outbreak happened, you had a big full-page spread in the New York Times saying - we, the pharmaceuticals, pledge to provide the necessary amounts of this drug for all Americans who contract Sars. There were 200 cases of Sars. Well, yes that's fine and yes you should look after people in your own country.

    But at the same time, we have leaders who talk a great deal about globalisation and internationalisation and we live in countries that not only have made their wealth in Africa but still continue to make a great deal of money out of Africa and yet we're not responding to this plague.

    I think we're creating a situation that's incredibly dangerous. There's a lot of chat at the moment about the war on terror and whilst there are many causes for acts of terrorism, what kind of society are you creating if you allow civil society in Africa to die and create millions upon millions of orphans? Where are they going to go? What kind of cults, what kind of militias, what's going to happen? The accession of violence in those countries, the possibility of that, to me is very terrifying.


    Susanna Reid:

    Josh MacDonald from Yorkshire has just e-mailed while we've been talking and asks: Why do you think so many African people today refuse to admit the reality and seriousness of Aids and indeed go as far as to try and deny the link between HIV and Aids? I've never understood this.

    Is this a problem on the ground or is this a problem amongst community leaders, religious leaders or governments?


    Emma Thompson:

    Well it's a mixture. I'm sure Josh, you're referring specifically to Thabo Mbeki in South Africa who denied the link between Aids and HIV for a long time and South Africa is so badly affected. But he has actually changed his position now. But you're right to point it out.


    Susanna Reid:

    But not without influencing a massive number of people.


    Emma Thompson:

    No, precisely so. There are huge, huge problems. First of all, religious leaders - what you're up against in Africa in the cultures I've visited certainly and I don't want to generalise because Africa is a continent made up of upwards of 90 countries and they all have different cultures. But certainly in Uganda, Mozambique and South Africa, people don't really talk about sex and certainly religious leaders - some of them - up to now have been very unwilling to accept, for instance, the promotion of condom use.

    There's been this religious notion of the ABC code: which is abstain, be faithful or if you really, really must, use a condom. Now anybody who's ever been to Africa knows it's a very sexy place - it's much sexier than Great Britain, I can certainly say that.

    I can remember being 300 kilometres up country in Zambesia, nowhere near any big city in a place where the electricity was switched off at 10 o'clock at night. But the local disco owner had his own generator. So I went down with the Aids officer from ActionAid and we danced and just spent some time with the young people there. And I looked at them and I thought - look at these kids - they're so beautiful. They're not drinking, there's no drugs, they don't have the money for that kind of thing. But they live in this incredibly beautiful place, they are very beautiful and Aids is sometimes just a bogeyman - it's not real. In the same way as it's often not real to our teenagers - they just don't think that it's going to happen to them. And that's why on every level of society in our country and in Africa we have to start waking up and we have to start talking about it and saying this disease is here and it kills.


    Susanna Reid:

    You mention religious leaders of course and the reluctance to talk about sex in these societies. Tom Quinn, London asks: Do you think that Catholic attitudes to contraception in particular the advice not to use condoms, aggravates the spread of Aids and therefore should change?

    What responsibility do you think that the Catholic Church has?


    Emma Thompson:

    Huge responsibility. The Catholic Church - it's so difficult because I don't want say anything offensive but it makes me very angry that religious leaders from this faith have tried to respond negatively to sexual education and to the promotion of condom use. The fact is that young people are going to have sex whether you like it or not. If you wish to use the fear of hell fire to prevent them from doing so, instead of actual honest discourse giving them the opportunity not only to have jurisdiction over their own bodies but also to make their own decisions, then I don't have a great deal of time for it, I'm afraid. I find it very obstructive and I find it very oppressive towards women and women of course are always on the front line. And in this particular battle - the Aids battle - they're very much affected.


    Susanna Reid:

    Michelle Rogers, Dublin, Ireland asks: Do you think that lack of equality for women plays an important part in the spread of aids in the developing world?


    Emma Thompson:

    Yes, absolutely. As I said before, many, many women don't have jurisdiction over their own bodies and particularly in areas of conflict. You'll have a young girl - I met one when I was in a camp for displaced persons - and all the people I met there now are dead because there was a huge battle there - very dreadful. She was 12, she'd been raped and she was HIV positive. She had a child who was also HIV positive. She had no way of making any money because she'd been removed from her home and she had no way of buying food except by selling her body.

    If I was a woman in that situation and I had children and I didn't know whether I was going to be able to feed at the end of the day, then I would sell my body. I would do anything to keep them alive. So I dislike it - going back to the religious thing - when that is judged. If you don't want women to do whatever they need to do then you must provide them with food, you must provide them with shelter and their basic human rights.


    Susanna Reid:

    Sylvia from Buenos Aires, Argentina asks a very direct and personal question to you but again it is relevant. How will you teach your own daughter about the HIV problem in the world? How would you get the message across to your own daughter, who I know is still young, about how to protect herself?


    Emma Thompson:

    I think I'd start talking about it as soon as she started talking about it. I used to talk to mothers a lot and say when are you going to tell your children and their answers varied a lot. But because of this reluctance to talk about sex, which is one of the reasons why I think the more talk that you have and the more connection you have, especially with the developed world, the more these things will come up, people will be able to discuss them. And it's absolutely true that male sexual behaviour and female responses to male demands change a lot when they start communicating - and the levels of the communication that I've seen on the ground in very, very poor areas are so high and I think why don't we have that here? That what we need here, we need the stepping stones programmes. We need men and women to sit down and talk to each other about sex honestly and openly. That would help us fight Aids so immediately. But our lack of communication is hugely problematic.

    My daughter is four - children discover their sexuality very much younger than I think we like to give them credit for. But I think I'll explain about sex very early and she slowly move towards it and then she'll probably come to Africa with me and I will tell her about it how Aids is transmitted, what the disease is. That's another thing we have rather a lot of difficulty talking about is actual disease and illness and understanding that.


    Susanna Reid:

    That will be a very shocking trip for your daughter to take.


    Emma Thompson:

    No, I don't think so. It's not as if people in Africa are lying bleeding by the side of the road.


    Susanna Reid:

    But you were just mentioning that place which you'd visited.


    Emma Thompson:

    Oh yes, but I wouldn't take her there - you couldn't do that. That is different because, apart from anything else, it is in a zone that is not safe to take children. And I wouldn't take her until she was old enough to have jabs. I would take her to places where there were other children to talk to.

    But even though there are shocking levels of fatality, there's also a shockingly vibrant, fantastic attitude to life and a culture that is not beset with the kind of problems that we have to be honest. We belabour, I think, under a very heavy crust of consumerism really. The thing I worry about more is protecting her from that, to be honest. She doesn't much watch the television - she watches television on Saturday mornings and I watch the adverts and I think how is it allowed that children should be allowed to watch advertising materials - things specifically designed to persuade them to want something that they have not got. We mustn't forget the diseases that our collective psyche suffers from here that are not present in developing countries.


    Susanna Reid:

    Let's talk about some of the questions that those who don't know so much about HIV/Aids might ask and they are the kind of questions that children might ask about infection. Rick, Bombay India asks: Please answer two of my questions which have destroyed my mental peace. They are as follows: 1) After a possible exposure to HIV when I should go for a test? 2) Is it possible that a person can get the HIV virus through lip to lip kissing or exchange of saliva?

    Now after years of Aids education, people are still asking the same questions and these must be very common questions. To put Rick's mind at rest, I wonder if you might be able to give the advice that perhaps is commonly given out.


    Emma Thompson:

    And advice that a lot of people in India will need because again it's a similar culture with regard to the discussion of a sexual nature. And no, you can't get Aids in that way - you'd have to exchange about 18 pints of saliva, which I think is very unlikely. No, you can't get it from kissing or touching or sitting on the lavatory seat. The only way you can get Aids is through the sexual excretions - through the conjoining of your body sexually, through either orifice.


    Susanna Reid:

    When should he go for a test if he thinks he's been exposed to HIV, whether through lip to lip, kissing etc?


    Emma Thompson:

    He should for a test immediately in order to set his mind at rest and when he goes for a test he'd be able to get proper advice from people who deal with persons in his situation all the time. And if he is worried about it, go because he'll find a lot of very good advice and I hope, no judgement because people will be very pleased that he's taken that responsibility. It's a very, very important thing to do and as I'm always suggesting to world leaders here, I think all our leaders should be off in countries where HIV is very highly prevalent, taking tests in public with the presidents of those countries in order to encourage this openness and this willingness perhaps to disclose.


    Susanna Reid:

    I know that your experience has mostly been with countries in Africa where you've been working with ActionAid. But I wonder if you know about the situation in India? Also we've had a question from G R Kishan Rao, Hyderabad, India who asks: May I request your advice on what steps you think Indian people should be taking for containing Aids?

    I wonder if you know how India is dealing with the problem? How health education services are working for instance. You say Rik should go to his doctor and ask for advice, I wonder how understanding people are in certain other countries about going for advice and answering factually correctly questions like Rik's?


    Emma Thompson:

    That, I imagine, is as varied as it is in Africa. There will be some places where if, for instance, an NGO like ActionAid has any kind of influence or there are community-based organisations on the ground then that's the place to go because that's where you'll get the best advice. I know because quite recently I read a big article that ActionAid had produced - it was a comparative article about education on Aids in India and in Africa. Whilst there were of course big differences because there are big cultural differences, there was still a great deal of reluctance on the part of adults to discuss sex with anyone younger than 18 years of age really. The fact is you have to start talking about it very, very young.

    In the case of India, because I have never visited there and because it was a long time ago that I read that article, I can't be more specific about. But the fact is you have to find an adult who you trust and ask them questions. If they're not proffering the information, you are going to have to ask questions.


    Susanna Reid:

    I hate to say it but it does sound a very western, liberal view.


    Emma Thompson:

    Yes, unfortunately because I am a western liberal and I'm not Indian or African. In order to fight Aids, it's the only way. No matter whether it's western or liberal, communication is our only ally and people on the ground in Africa who are not western and not liberal who've undertaken precisely what I've just described - methods of communication that we think of as modern and who in fact communicate much, much better with each other than most western liberals do - it works - it works for them. They reduce their levels of infection by an enormous amount and unfortunately I don't think that there's any other way unless you go for religious codification. Unless you say, well, we have to go through the route of abstinence and of forbidding people. Unfortunately I don't think that's going to work.


    Susanna Reid:

    Devin Dunseith, Mbabane/Swaziland asks: I would like to know what effect you are having on the communities you visit and the governments you encourage. As a resident of Swaziland (which has 40% of the population infected with HIV) I have a great interest.

    What direct impact are you seeing from your work?


    Emma Thompson:

    Well I don't think that I do see a direct impact. I think that my work is my attempt, I suppose, is to try and become a piece of connective tissue. I'm trying to communicate with people here and in America - in rich countries - about what I see on the ground in badly affected areas. I suppose I do see a direct impact in the sense that I write a piece about each place I go to and when people have read it I think they understand much, much better about what it's like to live with HIV in a place where there are no health facilities and they understand perhaps a little bit better about what it is to be poor.

    There's an awful lot of misunderstanding here about what being poor actually means. I don't think people understand that being poor means you have to work from dawn until dusk just to survive through the day. I think there's some notion that poor people lie about all day not doing anything. It is remarkable how many misconceptions there are here about life in the developing world and I think that that knowledge gap has done a lot to contribute to the imbalance quite frankly.


    Susanna Reid:

    The new figures out put the number of new infections at 5 million for the last 12 months - that's the highest rate in a 12-month period that we've seen. Vanessa, Lisbon asks: Don't you feel impotent trying to fight something so huge?


    Emma Thompson:

    Yes, I know what she means and I think the statistics of Aids are so terrifying, so overwhelming that it makes you think that I can't act. But actually you can. You can write letters, you can activate yourself and other people. You can be aware, you can educate yourself about it and you can talk about it. And all of those things are extremely positive, even within your group - of your family and your friends. Merely raising the issue is a hugely important social and political act and people mustn't think that just because they're not shifting the world slightly to the left every time they pick up a pen. The way, I think, anything has ever really changed on this planet is through large groups of very ordinary people saying something finally.


    Susanna Reid:

    Nikolaos Kantzelis, Athens Greece asks: What is the biggest challenge according to your opinion in combating Aids? Is it educating people who are ignorant about the disease?

    This is something which you've been pressing during this discussion or forcing western governments to increasing funding for antiretroviral drugs, or Aids education?


    Emma Thompson:

    Well it's both. The trouble is it's very difficult to pin-point the most important thing because Aids affects everyone in different levels of society, differently and you have to respond to it differently. For instance, on the ground, there isn't a great deal of money needed because there is no infrastructure - so small amounts of money go very far.

    One of the activists I spoke to said what we need is a troop of bicycles, we need volunteers who have been trained - we need them to have tee-shirts and caps and we need them to be able to go out into the bush and talk to people. Now that doesn't require a great deal of money but it requires training and it requires commitment and of course it requires people to be trained, which costs money.

    Now, antiretrovirals on the other hand are another matter - they're generally speaking expensive. You want pharmaceuticals to remove their patents so that these drugs can be available to everybody cheaply. That should have been done a long time ago. Antiretrovirals and primary healthcare, which do cost money, need to be put into place because of course most people who suffer with HIV, live with HIV, die of opportunistic infections. They don't in the end die of full-blown Aids because they don't have time to because TB or malaria or something else gets in there first and there's no primary healthcare to deal with those infections.


    Susanna Reid:

    David Ray, Seattle, Washington, USA asks: The symptoms used to diagnose Aids in Africa can often be explained by malaria, tuberculosis and malnutrition, conditions that have existed in Africa before the discovery of HIV. In light of this, would money given to Africa be better spent on food and sanitation than on Aids drugs?


    Emma Thompson:

    It's a huge argument but I believe and so does the UN that the global fund which is, as you know, the huge and central fund for Aids, malaria and TB, is very, very important. Some people say, don't funnel money directly into those things because precisely that it distorts the budgets in other areas of a developing country. It's absolutely true that food and sanitation are of prime importance because apart from anything else if you are on antiretrovirals you need the proper sustenance for your body to be able to support the drugs and of course those things have to happen together.

    The point about this emergency is that food and sanitation on their own aren't going to keep everyone alive and nor are ARVs on their own. But you are looking at a continent where civil society - all the carers, the parents, the teachers, the nurses and the doctors are dying in their millions. Which is why, as it were, you cannot split that hair and say its got to go to food and sanitation first because that's going to help better - no, you need to put it everywhere and quickly as possible. You need to cancel the world debt - without conditionality. There are so many things we have to do and they're so enormous. So therefore I don't have any truck with - wouldn't it be better if┐because you need the drugs and you need them yesterday.


    Susanna Reid:

    How often though do you come across people who you've met who say, I totally understand what you say about HIV and Aids, I work as a prostitute perhaps but the fact of the matter is, I live in a country with very low life expectancy, something is going to kill me, if it's Aids, then it's Aids.


    Emma Thompson:

    That's one of the big problems. I was talking to a colleague in Mozambique and she said the difficulty is - and this is where I like ActionAid so much because they talk a lot about poverty and about the fact that you must never ever forget that Aids is connected to poverty with hoops of steel - because the fact is that a lot of people will have that attitude. They'll say, I'm very poor, something is going to kill me and you're telling me that if I get this it could take 10 years to kill me - it could kill me very, very quickly - but I don't know. The roulette of being poor is what's so appalling.

    What you have to do is say to people, make it worth their while to have the test, disclose their status by offering them drugs. So therefore you say, if you're careful not only will you avoid this disease but if you've already got it, we'll be able to treat you and you will somehow have much more control over your life. I think that's one of the problems she was trying to articulate. I haven't articulated it very well at all, I'm sorry. But it is a problem and she's absolutely right - she's described something that leaders of Aids support organisations find it very difficult to deal with.


    Susanna Reid:

    Angela Rigg, Glasgow, Scotland: Is there any way of getting financial support to the families of Aids victims?

    For people who were touched by those stories, what would you advise?


    Emma Thompson:

    Well immediately join an NGO that's involved in Aids support. For instance I give money to ActionAid and I work for them because I have seen the community-based organisations, i.e. organisations organised and run by people from that country. I've seen the effects of those organisations at work. They support families not only through counselling but also, when they can, through gifts of food and medical supplies. They are not always able to do that because of course there's an enormous demand. But that's the first thing I would do certainly.


    Susanna Reid:

    June Morikawa, Reykjavik, Iceland: I would like to hear your perspective on the best case scenario and worst case scenario on HIV/Aids by year of 2010?

    If we did everything that you suggest, where could we be in seven years time?


    Emma Thompson:

    I think you need to talk to a policy maker about this because I think that's to do with statistics and I wouldn't like to bandy them about. What I do know is that, as you know, George Bush has pledged $15 billion - well, that's a very generous thing to do although I have one argument with it because it is connected to conditionality and I don't think aid works when it's connected to conditionality. This is a whole other argument, it's very complicated and we can't go into now.

    But the UN has said that in order to combat this disease in Africa effectively, we need $10 billion a year and we need that stretching into the future. If we had it now - because we don't even have our levels of GDP up yet - we have brought ours up to 0.32% but it has to be 0. 7% - now I'm a British taxpayer and I would be very happy to pay the extra and it makes me angry that we haven't come up to the level of other countries.

    The Commission on Poverty says that if we bring our GDP levels up to the levels that they should be at - all of us, all countries - then we can eradicate poverty by the year 2015. Now it's a statistic and I don't quite what it means or how it is implemented. But it shows you how actually relatively little when you consider that $150 billion has to date been spent on the war in Iraq and we found that money easily enough. It's a relatively small amount of money and 0.7% of our GDP is a relatively small amount of what we have. And if we want to live in the world as responsible citizens of the world then I don't really see that we have any choice but to do these things.


    Susanna Reid:

    Emma Thompson, there we must leave it I'm afraid. Thank you to all of you who sent in questions and of course to Emma Thompson for taking considerable time to answer them. From me, Susanna Reid, and the rest of the interactive team, goodbye.




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