Out Front: Elton John on Fighting the AIDS Epidemic

Fourteen years ago, Elton John created the Elton John AIDS Foundation in the United States and Britain. During a recent visit to New York, Sir Elton talked to The Chronicle about his charitable work. Excerpts of the conversation follow:

What are your thoughts as the Elton John AIDS Foundation enters its 15th year?

Well, there are mixed emotions. When we first started the foundation, it was primarily set up by people who made a conscious decision that we would concentrate on direct aid and not research. So it was a matter of getting food to people, medicine, buddy systems.

The emphasis has obviously changed. It’s become a worldwide epidemic now. It wasn’t at that time. The task is even worse than it was when we first started.

I am incredibly proud of what the foundation has achieved inasmuch as we wanted to keep it small and we still are a very small fish in a big pond. But without keeping it small, I wouldn’t be able to keep an eye on what was going on, we wouldn’t be able to sit down as a group of people and say, where do we want the money to go to, what kind of focus do we want, what do we want to direct our attention to?

I am dismayed because we do run up against brick walls in forms of governments and in forms of regimes and in forms of religious doctrine, which hampers what we do, hampers the ability to help people quicker. And that is frustrating.

And it looks like I’ll be doing this forever and ever. Until the day I die I’m trying to go out there and raise money for people with AIDS. Because even if there is a vaccine found, there are going be millions and millions and millions of people who that won’t help and who will still need help from organizations like ourselves.

How would you describe your charity’s relationship with other organizations?

We try to stay away from governments, because we don’t trust them. We go investigate everything that we do and every project that we fund overseas or in America.

Thank God we are partners with the National AIDS Fund, which has been the biggest help in America.

It’s OK raising money, but knowing where to give it, and to give it to the right people, and to get the quickest results — we had no knowledge of that, we were babies.

We are not billions and billions like the Gates Foundation. All we can do on our scale is do what we do as well as they do, but on a much smaller level.

In addition to being a donor, you’ve been a fund raiser for the charity. Can you talk about that role?

At one point I felt: Well, I’m going to be the whore who goes and raises the money for a while, and then it’s going to be much easier.

But it isn’t much easier. There are various other things that people want to give their money to and equally as worthy. We’ve had 9/11, we’ve had tsunamis, we’ve had Katrina.

We’ve raised more money each year because I’m lucky enough to have the celebrity to go along with what I do to be able to go out and raise the money.

So I’m still kind of like the front man. I’m the Frank Sinatra of the whole thing who goes out in front, the Tommy Dorsey Orchestra behind me, and sings for my supper. And the Tommy Dorsey Orchestra, after I’ve done it, goes out and does the great work.

With the profession and the standing that I have after 37 years of success, I’m able to twist some arms and to pull in some favors. I’m a “Sir” Elton John, which goes down very well in a lot of countries. It cuts no ice with me, I have to say that.

We get a lot of donations, the 1s, the 10s, the 20s, the 5s, the whatever. But to be serious about raising a lot of money, which we want to do, we’ve had to chase the people who have the money and are willing to give you the money because they trust you.

Why did you decide to start your own charitable organization?

A part of my setting up this foundation was because I did things for other people’s foundations. I did something for Dionne Warwick in Washington. I put on a concert to benefit the Elizabeth Taylor foundation at Madison Square Garden. And I suddenly thought: These people are putting their toes in the water. I’ve had the experience of being chairman of a soccer club. It’s about time I did something like this.

And so many of my friends had, obviously, died or were sick. I really didn’t do that much during the 80s, to be honest with you. I had a drug-addiction problem during the 80s, from time to time. I wasn’t active enough with AIDS in the 80s. And I felt very guilty about that.

You make a point of keeping your organization’s overhead expenses low, and you have rejected the idea of building an endowment. Why?

It is nice to be known as an organization people can give their money to and know that it’s going to get out there. And that we’re not wasting it. I find in charity that there is so much money wasted, and it drives me crazy. It’s a sin. And I don’t want to waste a drop of the money that we raise. There are too many people out there who need that money. We don’t need to be spending on unnecessary things.

I just think if we’ve got it there, get it out there. And it gives us more incentive to get more in, so we can get more out. In my career, I’ve never had a problem with being worried about being able to pay the bills, because I just go out there and work. We are a fund-raising organization; there is no point in sitting on [the money]. People need it now. Their lives are dependent on what we give them.

How would you describe the AIDS epidemic currently?

We are facing the problem within Great Britain and with affluent countries of young people getting AIDS and HIV again because they think, Oh, even if we get sick there will be medicine for me. They don’t really realize the consequences of all that, and that’s a big headache for us.

But at the moment, we are also trying to attend, obviously, to the terrible catastrophe overseas, and the hardship people have just from the stigma, from the pure hatred of having AIDS. To have AIDS is one thing, and bad enough, but to have to have the hatred and stigma that goes with it, and to be shunned and thrown out into the street.

In Africa, it’s not the government doing anything. The government in [South] Africa under [President Thabo] Mbeki should be ashamed of itself. But the actual word of mouth is being passed along by the people that are taking these drugs and thought they were going to die and now are back in the work force. We sat in a hospital in Soweto and heard these people talk ourselves. And they were spreading the word themselves. And so you have to get these drugs out there to these people so they can spread the word. That is the only way the message is getting out in South Africa. It’s not coming via the government. The government still thinks that AIDS is a disease of poverty — or that’s the hard line that Thabo Mbeki takes. Which is an absolute disgrace.

But what can I do about it? I can’t do anything about it. So we get more money to get the antiretrovirals to more people so that they can spread the word to their workmates that, Listen, if you take this medicine, you can get back to your life, you can have kind of a normal life again. So it’s necessary to get that stuff out there. Because we are fighting a battle against the government. Not in every country: not in Uganda, which has been fantastic, the first country really to get a grip on AIDS in Africa. And I’m sure we’re going to be facing problems like that in Russia. And, to a certain extent, India.

So, as usual, the people’s revolution started with the people, and it started with people talking with people and it spread. That’s the way we do it in our AIDS organization. We give the medicine through the organization and let them spread the word that, Listen, we are not dying because AIDS is a disease of poverty. We’re dying because we are not getting the medicines.

How can the Elton John AIDS Foundation encourage people to spread the word about treatments?

There are wonderful organizations that are set up, that we fund, that are treating people and seeing them and are making them better. The proof is there.

We had a school for traditional healers in Durban, and they all came in their costumes and everything. And it was invaluable because they now know the symptoms of HIV and AIDS. They can send people to local clinics. They now know what HIV is. So they can spot the symptoms and send the person to someone straightaway, to the local clinic. So that has helped.

Because for most people in South Africa, in rural places, the traditional healer is the only place to go.

You start at the bottom. It’s the infrastructure that’s the hardest thing to put into place in these places. It’s how you put the infrastructure into place for people to actually learn to get well.

You’ve said that policies related to sex education, needle-exchange programs, and condom distribution “must be based on evidence of what works, not ideology.” Can you elaborate?

You have to tell the truth, not pussyfoot around. What is happening in certain situations with government and church is immoral. And I think it’s — I have to choose my words very carefully here — it’s genocide. It’s genocide. No question about it. It’s a form of genocide.

And in this day and age, that’s an outrage.

We live in the 21st century, and this is allowed to happen under the name of God? And under the name of governments? Especially a black government in South Africa you would think would know better. It’s unbelievable, it’s genocide, it’s murder, it’s disgraceful.

You are saying that many people just don’t realize how simple it can be to stop the spread of HIV/AIDS?

Yeah! And it’s always the poor that suffer. It’s not the rich. And those are the people that should be helped the most. They are the ones that are suffering through these decisions. And that makes it even harder, because they live in the worst conditions anyway.

And if you are badly treated — and they haven’t been told the truth — they have been lied to. They’ve been cheated. It’s morally reprehensible.

Why are you devoting so much effort to getting your message out?

I’m at the age now where I have to speak up. I’m [nearly] 60 now, I have to say these things. It’s not going to hurt my career. And if it does, I don’t care. I just can’t bear the injustice of it all. And it’s not a political statement from me. Well, I see it, because I am a gay man, so it is a political statement.

There’s a photo of you holding a baby with AIDS at a hospital in South Africa. Can you talk about that?

I remember that hospital, it was up north of Durban. And the baby was so beautiful. And I said, is she going to make it? And they said no. And she died two days later.

It’s the reality of seeing those things that brings you back to earth. And that’s why I need the foundation in my life. Just to show me from time to time that I live the most incredibly gifted and most fantastic life.

Even though I work very hard, I don’t live in the real world. These people live in the real world. And they have a hell of a hard time.

And they don’t get a fair crack at the wheel. And not just from me or anybody, but they don’t get a fair crack at the wheel from the people that should be giving them a fair crack at the wheel. And if I can do anything to alter that scenario, as long as I live, then I will try to do that. And those are the moments that the foundation just kicks it home to me.