Now More Than Ever, AIDS 2010

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More than 20,000 people descended on Vienna in Austria this month for the 18th International AIDS conference. Researchers, policy makers, health professionals and advocates came together, from as far as Uganda to United States, Peru to Papa New Guinea, they came to strategize and debate the latest developments on the prevention and treatment of the most significant disease to impact mankind in modern times.

Having attended my first AIDS conference in Mexico City in 2008, and now due to give a poster presentation at AIDS 2010, I initially took a sophomoric ‘been there, done that’ approach to the proceedings. However, I quickly discover that I still had much to learn and gain from the dynamic projects and people in attendance.

Under the theme Rights Here, Right now, the conference stressed in no uncertain terms, that any effective response to the AIDS epidemic must include the promotion of human rights at all levels. Working in the community sector, a rights-based approach to HIV prevention has always been a method in which I strongly believe, and I am appreciative of the international exposure it was now getting in this important setting.

Many new developments resonated with me, the first, being a rather old idea now viewed from a difference perspective. Called Treatment as Prevention, it is one of five pillars in a strategic platform known as Treatment 2.0. Essentially, Treatment as Prevention is calling for universal access of HIV treatment for all people who need it, which is nothing new. Previously, however, it had been argued from an ethical and human rights standpoint, whereas today mathematical modelling from researchers has shown that universal access to HIV treatment has a public health benefit, too, it lowers the global viral load, which in turn, should lower the number of new HIV infections globally by up to a third.

G8 leaders fund aids now Now More Than Ever, AIDS 2010

G8 Leaders Fund AIDS Now! Broken Promises Kill

Treatment as Prevention could therefore make a massive difference in regions heavily impacted by AIDS like southern Africa, for example, where the epidemic is generalised. Given its high promise to improve dramatically the lives of people infected and affected by HIV, global AIDS agencies have signed up to Treatment 2.0 as the way forward.

The second development to catch my attention was the successful results of the CAPRISA research trial in South Africa. This trial studied the effectiveness of a gel designed to reduce the risk of HIV infection during sex, and known as a microbicide. The study included close to 900 women with highly optimistic results. Risk of HIV infection was reduced by 39% overall, and by 54% for those women who used the gel consistently. That’s good news!

I was particularly happy to hear the results of this trial, as I had been involved in microbicide advocacy for a few years; and this success was a clear breakthrough from a research and a social perspective. From a research standpoint, this was one of the first success stories of a biomedical intervention in the HIV field. The integration of biomedical and social interventions is the future of HIV prevention, in my opinion, and this promising result will spur greater confidence in microbicide research for both vaginal and anal sex and bring us one-step closer to having microbicides in the public domain as an effective HIV prevention option.

From a social point of view, microbicides as an alternative HIV prevention tool will contribute to the empowerment of women, by introducing a product that can be a female controlled alternative to the condom, and thereby provide a viable prevention option to lower the risk of HIV infection for those who are not able to negotiate condom use.

UNIAIDS: Outlook Report 2010

Recognition of the importance of protecting and promoting human rights for vulnerable populations was, for me, perhaps the most important theme raised in the conference. With respects to HIV, some of the most vulnerable groups include men who have sex with men (MSM), injecting drug users (IDU), sex workers, and transgender people. These groups are disproportionately impacted by HIV, and yet, more often than not, their access to treatment and prevention services is hindered and when they do receive these services, they are often of poor quality. This is the result of being socially maligned and excluded, stigmatised and discriminated against by individuals and institutions, and is further compounded by the fact that they are often criminalised by governments around the world. The human rights of vulnerable populations must be protected and promoted so that they too are supported and empowered to make well-informed choices regarding their health and lives.

I currently coordinate a peer education programme in the United Kingdom on sexual health and social well-being for young black African, Caribbean and British MSM, and so the issue of human rights is one close to my heart. I understand the damaging effect that stigma, discrimination and a lack of human rights can have on the sexual health of black MSM. Whether it’s institutionalised stigma from groups within their communities, or the structural discrimination from certain governments in Africa and the Caribbean where homosexuality is criminalised, for example, having supportive and affirming environments in the lives of these men makes all the difference in their sexual health and social well-being.

Protecting the human rights of vulnerable populations not only makes ethical sense, but in terms of HIV prevention, it also makes practical sense. Huge amounts of research have consistently shown the significant effect that needle exchange programmes have on driving down HIV transmission rates amongst injecting drug users. Yet, many governments continue to refuse to fund needle exchange programmes, whilst criminalising illicit drug use amongst IDUs. Police forces continue to harass and abuse this already vulnerable group, driving their drug use further-and-further underground, preventing them from accessing potentially life-saving drug treatment programmes, whilst causing the HIV rates of many Eastern European and Central Asian countries to sky-rocket over the past 10 years.

I was not the only one among the delegates to applaud as conference officials at AIDS 2010 introduced a resolution entitled The Vienna Declaration. It called for health policies on illicit drug use to be based on scientific evidence, not ideology, and I could not agree more. But when Dr. Chris Beyrer, the esteemed professor from the Centre for Public Health and Human Rights at Johns Hopkins University in USA, took to the stage to give his fascinating presentation, my mind was fixed. Using mathematical modelling, Dr. Beyrer showed that scaling up prevention services to 100% for MSM, and 60% for IDU, in low and middle-income countries would reduce the rates of new HIV infections within these populations, and in the general population, too. This study could be used to boost the human rights argument for providing health services to all vulnerable groups regardless of whether some governments criminalise homosexuality, or injecting drug use.

broken promises kill 300x200 Now More Than Ever, AIDS 2010

Demonstrators at the 18th International AIDS Conference in Vienna (July 2010).

The energy and passion of participants raising the profile of issues of concern to them, through demonstrations, marches and protest, was never very far away from my consciousness. The largest such demonstration, The Human Rights and HIV/AIDS March and Rally, brought together thousands of delegates and protesters in Vienna’s city centre to demand that human rights be an integral part of the AIDS response “Now More Than Ever.” Internationally renowned singer and UNAIDS goodwill ambassador, Annie Lennox, delivered a riveting speech calling world leaders to task, demanding that they stand by their commitments to global AIDS funding and human rights, before giving thousands of spectators a free, live musical performance.

Both inside and outside the main conference hall, protesters from a hodgepodge of groups led the Fund Global AIDS demonstration, intent on ensuring that world leaders kept their promises about AIDS funding and support for universal access to HIV treatment, since many countries had already rescinded on agreements made previously, citing current global economic difficulties as a factor in their inability to offer the level of financial support they had promised. The powerful rallying cry “Broken Promises Kill, No Retreat, Fund AIDS” was a constant echo throughout the six-day conference.

As Prime Minister Cameron and his coalition government settle into their new roles, I implore them to keep the UK’s commitment to domestic and global AIDS funding. I would particularly like to see more money for research into new prevention technologies, vaginal and rectal microbicides, as well as vaccines. I would also encourage more support for prevention work, treatment for vulnerable populations, and the protection and promotion of their human rights. Each time we fail to protect the weak and vulnerable in our society, we lose a part of our own humanity.