Show Hide image

The NS Interview: Linda-Gail Bekker

“So many of our people live daily with the effects of HIV”

Your work focuses on HIV and tuberculosis. What does that involve? What's the plan?
Here in Southern Africa, children are getting TB in huge numbers. They don't get the disease immediately, but they become infected. When you superimpose the HIV epidemic on top of that, you speed up the progress of the illness - so the TB infection becomes TB disease in young adulthood because of their immune deficiency. We have to think of TB and HIV together almost as a new disease. That requires us to go back to fundamentals, but also to think outside the box. What will be the new interventions? What else could we be doing?

What drew you to work in the field?
I was born in Zimbabwe, and came to UCT [the University of Cape Town] to do my medicine degree. It was the late 1980s and the HIV epidemic was just breaking for us. I remember a strong sense of frustration, anxiety, impotence - I didn't fully understand what was going on and wanted to know more. I went on to do my PhD in host immunology, which I am still fascinated by. But as time has gone on, I've been drawn to the hands-on side of things. I'm really a closet social worker these days.

Are you engaged in the politics of South Africa?
Well, I think we are activists at heart simply because, again, you can't work in this field and not be politically aware. We work hard to change policy, but through evidence. And that's a slow and often arduous process.

Do you personally feel political? Do you vote?
Oh, yes. I came from Zimbabwe, perhaps politically quite naive, to UCT, which was a very liberal university in those days. I had quite a political awakening as a result of that.

In what way?
I came to university in the 1980s, an incredibly volatile time in SA's history. And the 1990s was the most extraordinarily liberating period. That initial starry-eyed, honeymoon phase is a little bit over. We really need to roll up our sleeves and say: "What are the issues at hand?"

Do you think there's been a lack of political leadership in South Africa?
Yes. Civil society became the leaders: we have had to take on the government on some occasions. On other occasions we've taken on the pharmaceutical companies with the government. SA has huge challenges still - some days you kind of recognise that it's a big job, and how ever are we going to meet all the challenges? But the little triumphs along the way do count. I think we are making progress.

You've just won the Royal Society Pfizer Award for your research into HIV and tuberculosis. What does the prize mean to you?
I'm overwhelmed. I think one of the aspects of working in this part of the world is that you get on with the job, you get lost in the day-to-day work. So when somebody stops and acknowledges you, it's a very pleasant surprise.

It's said you marry science and humanity.
HIV and TB are just so much a part of our lives. A good part of our workforce lives openly with HIV. I have had TB and had to take treatment.
It really is very tangible for us: you're dealing with it not only at work, but in everyday life.

How do you balance your work with the rest of your life?
I married someone in exactly the same field. He's the director of the HIV centre at UCT and I'm deputy director, and we run the foundation together, so a lot of our work comes home. But we have a great work team who can be relied upon. We have two grown-up children and a seven-year-old, Oliver, who started life with an embryonic carcinoma, so the first three years of his life we camped at the Red Cross children's hospital because he needed chemotherapy. Once you've got beyond that, you pretty much feel you could cope with most things!

Is there anything you regret?
I've loved being a mother. I could have quite enjoyed another child. But no, I don't think I have any regrets at all. The only thing is that I would have done more of everything.

Would you ever like to live anywhere else?
I'm inherently an African: I'm fourth-generation. It's hard for me to think of living anywhere other than Africa. Certainly, the work I do seems most relevant here. I lived for some time in New York and I loved it. But what makes me want to stay here for the moment is just the relevance. I'm a hands-on person. I like to engage with the community, with the staff. I think that's where my talent is.

Are we all doomed?
I don't think so, but I can see why you would ask. When you look at TB-HIV figures you wonder what the next terrible virus or pathogen is that's waiting around the corner. But the thing that strikes me daily is the resilience of humanity. Human beings find a way.

Linda-Gail Bekker is deputy director of the Desmond Tutu HIV Centre at the University of Cape Town and chief operating officer of the Desmond Tutu HIV Foundation.

Read a longer version of the interview.

Sophie Elmhirst is features editor of the New Statesman

This article first appeared in the 09 November 2009 issue of the New Statesman, Castro

Show Hide image

The age of loneliness

Profound changes in technology, work and community are transforming our ultrasocial species into a population of loners.

Our dominant ideology is based on a lie. A series of lies, in fact, but I’ll focus on just one. This is the claim that we are, above all else, self-interested – that we seek to enhance our own wealth and power with little regard for the impact on others.

Some economists use a term to describe this presumed state of being – Homo economicus, or self-maximising man. The concept was formulated, by J S Mill and others, as a thought experiment. Soon it became a modelling tool. Then it became an ideal. Then it evolved into a description of who we really are.

It could not be further from the truth. To study human behaviour is to become aware of how weird we are. Many species will go to great lengths to help and protect their close kin. One or two will show occasional altruism towards unrelated members of their kind. But no species possesses a capacity for general altruism that is anywhere close to our own.

With the possible exception of naked mole-rats, we have the most social minds of all mammals. These minds evolved as an essential means of survival. Slow, weak, armed with rounded teeth and flimsy nails in a world of fangs and claws and horns and tusks, we survived through co-operation, reciprocity and mutual defence, all of which developed to a remarkable degree.

A review paper in the journal Frontiers in Psychology observes that Homo economicus  might be a reasonable description of chimpanzees. “Outsiders . . . would not expect to receive offers of food or solicitude; rather, they would be fiercely attacked . . . food is shared only under harassment; even mothers will not voluntarily offer novel foods to their own infants unless the infants beg for them.” But it is an unreasonable description of human beings.

How many of your friends, colleagues and neighbours behave like chimpanzees? A few, perhaps. If so, are they respected or reviled? Some people do appear to act as if they have no interests but their own – Philip Green and Mike Ashley strike me as possible examples – but their behaviour ­attracts general revulsion. The news is filled with spectacular instances of human viciousness: although psychopaths are rare, their deeds fill the papers. Daily acts of kindness are seldom reported, because they are everywhere.

Every day, I see people helping others with luggage, offering to cede their place in a queue, giving money to the homeless, setting aside time for others, volunteering for causes that offer no material reward. Alongside these quotidian instances are extreme and stunning cases. I think of my Dutch mother-in-law, whose family took in a six-year-old Jewish boy – a stranger – and hid him in their house for two years during the German occupation of the Netherlands. Had he been discovered, they would all have been sent to a concentration camp.

Studies suggest that altruistic tendencies are innate: from the age of 14 months, children try to help each other, attempting to hand over objects another child can’t reach. At the age of two, they start to share valued possessions. By the time they are three, they begin to protest against other people’s violation of moral norms.

Perhaps because we are told by the media, think tanks and politicians that competition and self-interest are the defining norms of human life, we disastrously mischaracterise the way in which other people behave. A survey commissioned by the Common Cause Foundation reported that 78 per cent of respondents believe others to be more selfish than they really are.

I do not wish to suggest that this mythology of selfishness is the sole or even principal cause of the epidemic of loneliness now sweeping the world. But it is likely to contribute to the plague by breeding suspicion and a sense of threat. It also appears to provide a doctrine of justification for those afflicted by isolation, a doctrine that sees individualism as a higher state of existence than community. Perhaps it is hardly surprising that Britain, the European nation in which neoliberalism is most advanced, is, according to government figures, the loneliness capital of Europe.

There are several possible reasons for the atomisation now suffered by the supremely social mammal. Work, which used to bring us together, now disperses us: many people have neither fixed workplaces nor regular colleagues and regular hours. Our leisure time has undergone a similar transformation: cinema replaced by television, sport by computer games, time with friends by time on Facebook.

Social media seems to cut both ways: it brings us together and sets us apart. It helps us to stay in touch, but also cultivates a tendency that surely enhances other people’s sense of isolation: a determination to persuade your followers that you’re having a great time. FOMO – fear of missing out – seems, at least in my mind, to be closely ­associated with loneliness.

Children’s lives in particular have been transformed: since the 1970s, their unaccompanied home range (in other words, the area they roam without adult supervision) has declined in Britain by almost 90 per cent. Not only does this remove them from contact with the natural world, but it limits their contact with other children. When kids played out on the street or in the woods, they quickly formed their own tribes, learning the social skills that would see them through life.

An ageing population, family and community breakdown, the decline of institutions such as churches and trade unions, the switch from public transport to private, inequality, an alienating ethic of consumerism, the loss of common purpose: all these are likely to contribute to one of the most dangerous epidemics of our time.

Yes, I do mean dangerous. The stress response triggered by loneliness raises blood pressure and impairs the immune system. Loneliness enhances the risk of depression, paranoia, addiction, cognitive decline, dem­entia, heart disease, stroke, viral infection, accidents and suicide. It is as potent a cause of early death as smoking 15 cigarettes a day, and can be twice as deadly as obesity.

Perhaps because we are in thrall to the ideology that helps to cause the problem, we turn to the market to try to solve it. Over the past few weeks, the discovery of a new American profession, the people-walker (taking human beings for walks), has caused a small sensation in the media. In Japan there is a fully fledged market for friendship: you can hire friends by the hour with whom to chat and eat and watch TV; or, more disturbingly, to pose for pictures that you can post on social media. They are rented as mourners at funerals and guests at weddings. A recent article describes how a fake friend was used to replace a sister with whom the bride had fallen out. What would the bride’s mother make of it? No problem: she had been rented, too. In September we learned that similar customs have been followed in Britain for some time: an early foray into business for the Home Secretary, Amber Rudd, involved offering to lease her posh friends to underpopulated weddings.



My own experience fits the current pattern: the high incidence of loneliness suffered by people between the ages of 18 and 34. I have sometimes been lonely before and after that period, but it was during those years that I was most afflicted. The worst episode struck when I returned to Britain after six years working in West Papua, Brazil and East Africa. In those parts I sometimes felt like a ghost, drifting through societies to which I did not belong. I was often socially isolated, but I seldom felt lonely, perhaps because the issues I was investigating were so absorbing and the work so frightening that I was swept along by adrenalin and a sense of purpose.

When I came home, however, I fell into a mineshaft. My university friends, with their proper jobs, expensive mortgages and settled, prematurely aged lives, had become incomprehensible to me, and the life I had been leading seemed incomprehensible to everyone. Though feeling like a ghost abroad was in some ways liberating – a psychic decluttering that permitted an intense process of discovery – feeling like a ghost at home was terrifying. I existed, people acknowledged me, greeted me cordially, but I just could not connect. Wherever I went, I heard my own voice bouncing back at me.

Eventually I made new friends. But I still feel scarred by that time, and fearful that such desolation may recur, particularly in old age. These days, my loneliest moments come immediately after I’ve given a talk, when I’m surrounded by people congratulating me or asking questions. I often experience a falling sensation: their voices seem to recede above my head. I think it arises from the nature of the contact: because I can’t speak to anyone for more than a few seconds, it feels like social media brought to life.

The word “sullen” evolved from the Old French solain, which means “lonely”. Loneliness is associated with an enhanced perception of social threat, so one of its paradoxical consequences is a tendency to shut yourself off from strangers. When I was lonely, I felt like lashing out at the society from which I perceived myself excluded, as if the problem lay with other people. To read any comment thread is, I feel, to witness this tendency: you find people who are plainly making efforts to connect, but who do so by insulting and abusing, alienating the rest of the thread with their evident misanthropy. Perhaps some people really are rugged individualists. But others – especially online – appear to use that persona as a rationale for involuntary isolation.

Whatever the reasons might be, it is as if a spell had been cast on us, transforming this ultrasocial species into a population of loners. Like a parasite enhancing the conditions for its own survival, loneliness impedes its own cure by breeding shame and shyness. The work of groups such as Age UK, Mind, Positive Ageing and the Campaign to End Loneliness is life-saving.

When I first wrote about this subject, and the article went viral, several publishers urged me to write a book on the theme. Three years sitting at my desk, studying isolation: what’s the second prize? But I found another way of working on the issue, a way that engages me with others, rather than removing me. With the brilliant musician Ewan McLennan, I have written a concept album (I wrote the first draft of the lyrics; he refined them and wrote the music). Our aim is to use it to help break the spell, with performances of both music and the spoken word designed to bring people together –which, we hope, will end with a party at the nearest pub.

By itself, our work can make only a tiny contribution to addressing the epidemic. But I hope that, both by helping people to acknowledge it and by using the power of music to create common sentiment, we can at least begin to identify the barriers that separate us from others, and to remember that we are not the selfish, ruthless beings we are told we are.

“Breaking the Spell of Loneliness” by Ewan McLennan and George Monbiot is out now. For a full list of forthcoming gigs visit:

This article first appeared in the 20 October 2016 issue of the New Statesman, Brothers in blood