Buddhism and AIDS

English translation by Helen Loveday

In the very first sermon which began his fourty-five years of ministry, the Buddha declared: “Birth is suffering, ageing is suffering, disease is suffering, death is suffering”. This statement about universal suffering constitutes the first of the Four Truths that make up the Buddha's most fundamental teachings. And this very statement is exemplified by the HIV-spread AIDS pandemic that we are now experiencing.

AIDS presents several well-known characteristics: a cure for the disease still appears a long way off and its prognosis, be it at short or long term, is death. In this respect, the discovery of new therapies, though welcome, simply extends the term of the problem and even then only within the confines of the wealthy nations. In addition, the illness can only be contracted by contact with organic fluids already infected by the virus. Yet, like all other phenomena of existence, it only develops within that complex and natural set of causes and conditions known as karma, literally “action”. In this context, therefore, AIDS can not, any more than any other disease, be considered a form of punishment or chastisement inflicted by some exterior power.

Aetiology distinguishes two categories of patients among AIDS victims. The first includes those who have contracted the disease by being exposed to the virus through their own hazardous behaviour, be it in their sexual relations or through the sharing of hypodermic needles. The second category includes those passive victims who were infected either through blood transfusions or by transplacental or perinatal transmission. These distinctions however have no role to play in one's approach to the disease, for the Buddhist will make no value judgement about these types of behaviour. This attitude was recently demonstrated, for example, by the meeting in San Francisco in 1997 of the Dalai-Lama and representatives of the gay community.

What Buddhist ethics does call upon is for each person to develop his own sense of responsibilities, be it in his private life or in his professional activities. Similarly, it encourages one to develop and support all humanly realistic projects which favour prevention of the epidemic and protection against the virus, for example by generalising access to condoms, disposable syringes, and screening, as well as increasing the control of blood-based products.

AIDS has a dimension to it that makes it in many ways the “illness of all illnesses”. More than any other pathology, it is thus a synthesis of all the existential characteristics of disease. For all that, from the Buddhist point of view it does not represent anything more than just one of the basic facts of the suffering of existence: the AIDS tragedy is, when it comes down to it, simply the tragedy of existence itself, even if the latter is expressed through it in a particularly acute manner. The catastrophe of the past decade thus constitutes from the Buddhist perspective a signal subject of reflection on the impermanence and suffering which are inherent to the universal condition of all living beings.

Given that, Buddhism is a practical spiritual way, essentially concerned about the fate of the human being. More than the pathology itself, it is the people, those who carry the virus and those who are ill, whom the Buddhist will focus his attention upon. He will consider them all in the same spirit of love and compassion, and notably from the viewpoint of the ideal of the bodhisattva.

The Buddha himself, with his community, ministered to the sick to bring them spiritual assistance. He also made it the duty of both the secular and ordained members of the community to help those who are ill or dying. The aim of these visits is to put the patient in the best possible frame of mind to allow him to face illness, death and his next existence with serenity. For if our present situation is a consequence of previous karma, our future equally depends on the karma that we are presently building. Therein lies the great hope that Buddhism offers, the very opposite of fatalism. In this respect, the Buddha is not simply compared to a doctor; through his teachings, he is considered to be the doctor of universal suffering.

Patients who are already practising Buddhists are encouraged to develop their faith, particularly that in the Three Jewels, that is the Buddha, his teachings, and his community. They are also lead to realise in all lucidity that whatever the illness, their condition is inherent in the very nature of existence. Finally, they are encouraged to turn their mind away from attachment to this world and to direct it towards better planes of existence and towards liberation from the very cycle of births and deaths itself. Those who do not follow Buddhism can none the less find real comfort in it while still respecting their original convictions. The teachings of the Buddha on existential suffering, its karmic causes and the possibility of deliverance from this have a universal import and can be appreciated by all, while leaving one free afterwards to follow along the path of Buddhism or not.

Several Buddhist techniques, such as attention to one's breathing, can prove to be beneficial to patients, whether or not they are carried out in a religious context. One should always bear in mind however, that these techniques are to be conducted only under the supervision of a experienced person.

As a continuation of this long tradition of hospital work, contemporary Buddhism has taken up the challenge presented by AIDS. Several projects aimed at supporting and counseling patients have been formed, both in Asian nations, the birthplace of Buddhism, and in the West, which has more recently opened up to this faith. In the latter region, a pioneering role is being played by the USA and other Anglo-Saxon countries.

The clear-minded Buddhist observer is nonetheless conscious that the world-wide problem of AIDS needs a solution on an equivalent scale. Independently of its religious aspect, Buddhism carries with it an ideal of tolerance, humanism and realism which should inspire individual, national and international actions throughout the world. Buddhism is very conscious also of the dramatic repercussions of the North-South split which is apparent in the treatment of AIDS. According to the available data, about 16.000 new HIV infections a day occured in 1997, of which more than 90 % are in developing countries. Buddhism thus wholeheartedly agrees with the Guidelines on HIV/AIDS and Human Rights as adopted by the Second International Consultation on HIV/AIDS and Human Rights (Geneva, 1996). It also agrees more generally with the principles of the Universal Declaration of Human Rights, as they are formulated in article 25, paragraph 1:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including […] medical care and necessary social services, and the right to security in the event of […] sickness […] .

Twenty-five centuries ago, the teachings of the Buddha emphasised the strong connection between social and economic conditions and quality of life. Already then, he was denouncing poverty as one of the causes of immorality and criminality. He was also condemning the arms trade - even when legal - while hinting at a balanced improvement of economic conditions.

As you can see, although Buddhism is directed, in the long run, at freedom from existence and its suffering, it nevertheless squarely faces the problems of humanity with warm compassion. It is my conviction and my hope that Buddhist values will in the years to come contribute significantly and effectively to people's approach to AIDS.