Aids Conference: Time to take stock
Today, an estimated 20,000 scientists, activists and government officials convene in Toronto, Canada for the 16th International Aids Conference, committed to sharing knowledge and strategies on how to combat HIV and expand access to prevention, care and treatment. And the conference’s theme, Time to deliver couldn’t have been more appropriate. There is no gainsaying that twenty-five years after the discovery of Aids, the magnitude of this epidemic demands increased accountability from all stakeholders to fulfill their commitments, be they financial, programmatic or political.
Like the previous conferences which have been dominated by much talk and less action, nothing much can be expected from the Toronto conference. But it is time the world shunned rhetoric and stepped up measures aimed at stemming the tide of the pandemic. Already, over 400 sessions, meetings and workshops where delegates will explore the latest developments in HIV science, policy and practice, and look at the progress made to scale-up treatment, care and prevention have been lined up. One can only hope that given the enormous challenges—ranging from accelerating research to end the epidemic to expanding and sustaining human resources to scale up prevention and treatment—all the stakeholders are going to be serious this time round.
Lessons learnt from the “3 by 5” initiative should come in handy. Launched by the joint United Nations Programme on HIV/Aids (UNAIDS) and the World Health Organisation (WHO) in 2003, the “3 by 5” initiative was a global target to provide 3 million people living with HIV/Aids in low and middle income countries with life prolonging antiretroviral treatment by the end of 2005. It was a step towards the goal of making universal access to HIV prevention and treatment to all who need them as a human right. Whereas the “3 by 5” target has not been met on time, the ongoing effort to expand access to antiretroviral therapy has brought about positive change and has paved the way for far greater advances towards the ultimate goal of universal access to HIV treatment and care. In two years, the number of people receiving antiretroviral therapy in low-and middle-income countries has more than tripled, and access to antiretroviral therapy in the world’s hardest-hit region, sub-Saharan Africa, has increased by more than 800 per cent.
But a lot more needs to be done. Kenya, for instance, may not keep its promise of putting 140,000 people on antiretrovirals by the end of the year. Despite a fall in the national prevalence rate from 14 percent in the 1990s to 6 per cent currently, available Aids statistics are still chilling. The country has 2.3 million orphans, 60 per cent of them being HIV-positive. Unfortunately, the HIV/Aids Prevention and Care Bill, which is supposed to address this and other issues, continues to gather dust in parliamentary shelves, three years after its tabling. The situation is even grimmer in Zimbabwe, where only 25,000 of the 350,000 people in immediate need of antiretroviral drugs have access to treatment, with than 3,000 people dying every week. It does not help matters that abusive policies and practices by the Zimbabwean government are fuelling the HIV/AIDS epidemic, increasing vulnerability to infection, and obstructing access to treatment.
Still, poverty and stigma, the two major obstacles to overcoming the epidemic, remain largely unchallenged. At the 15th International Aids conference held in Bangkok Thailand, in 2004, a lot was said but in the end no action was taken to end stigma and discrimination. In the words of Joe Amon, director of the HIV/AIDS program at Human Rights Watch, “Twenty-five years into the epidemic, people living with HIV or AIDS are still feared and stigmatized. We can’t defeat AIDS unless we end outrageous abuses against activists, outreach workers, people living with AIDS and those most vulnerable to infection.”
Amon’s sentiments bring to mind the atrocities perpetrated on Aids activists, people living with HIV/Aids and outreach workers since the 2004 Bangkok conference. In June 2005, Octavio Acuña Rubio, an AIDS and human rights activist, was stabbed to death in the condom shop he ran in Queretaro, Mexico. In July the same year, police attacked peaceful protestors demonstrating about AIDS in South Africa’s Eastern Cape province, firing upon them with rubber bullets and tear gas. In the same month in Uganda, police raided the home of AIDS activist Victor Juliet Mukasa . In April 2006, Isaiah Gakuyo, 15, was killed with a pitchfork by his uncle and guardian for being HIV-positive. Bystanders in Wandumbi village in central Kenya refused to help for fear of becoming infected. In June 2006, Vivian Kavuma was murdered by her lover in Uganda after disclosing that she was infected with HIV. The list could be endless. Yet it is these human rights abuses that are undermining efforts to fight the HIV pandemic and threatening to reverse the gains made.
The news on vaccines is also fairly grim. Whereas scientists all over the world are working round the clock to come up with a preventive vaccine, the world is still several years away from one. Under the circumstances, the development of an HIV vaccine represents one of the most difficult challenges that modern science is confronting. The same case applies to microbicides. Unfortunately, in sub-Saharan Africa efforts to come up with a cure have always been mired in controversy.
Whereas awareness levels have gone up, behaviour change is still lacking, calling for better strategies to fight the pandemic. As Amon puts it, “We must provide information on HIV transmission, protect women from sexual violence, ensure access to condoms, clean needles and methadone, and expand access to anti-retroviral drugs. Defeating AIDS is still more a question of political will than one of knowledge or know-how.”
Indeed, political will is needed if the war against HIV/Aids is to be won. And there is no better place to put this into practice than Toronto. The time to act is now. Too much talk and very little action will not save the world from the pandemic.