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Reflections on AIDS 2014 – Stepping up the Pace and Leaving No one Behind By Georgia Burford (CAFOD)

Reflections on AIDS 2014 – Stepping up the Pace and Leaving No one Behind By Georgia Burford (CAFOD) The International AIDS Conference in Melbourne 20-25 July 2014 is the 20th gathering of the largest regular conference of any health or development issue, bringing together politicians, scientists, epidemiologists, practitioners, policy makers, the private sector and communities of people living with and affected by HIV. There is uniqueness in this fight against HIV in that it is a social movement, pulling people together and putting people at the forefront of the response to sustain our efforts on addressing HIV. It’s a powerful reminder that HIV has not gone away and is still affecting the lives of many today. The theme of this year’s conference was ‘Stepping up the Pace,’ summarised by Bill Clinton when he said ’It says much good work has been done, but it’s not an excuse to slow down. Right now we must redouble our efforts on areas like stigma and discrimination, which after 30 years is still increasing in some regions. We have the tools; we need to step up the pace.’ There has been remarkable progress since the 1980s, when HIV was a condition that had no name, no tools to diagnose, prevent or treat it. Today, there are 15 million people on treatment, yet there are still alarming challenges that must be tackled in order to even contemplate an AIDS free generation. Statistics from 2013 show there were 1.5 million HIV deaths, 2.1 million new infections and 35 million people living with HIV. Of the 35 million people living with HIV, 55% (19 million) don’t know they have the virus. They haven’t been tested and if they don’t find this out, they will die. The conference highlighted many reasons as to why people do not access or drop out of treatment. Reasons can be due to lack of services; however, a large part is due to stigma. Studies and personal testimonies have shown that:

  • Men are less likely to come forward for testing [1] when their wives are being tested during pregnancy because:” pregnancy is about women not men”. Men may be testing but not telling their partners, claiming that “they’re too busy”
  • Women, who may often discover a positive test whilst pregnant, will opt out of treatment and out of disclosing to their partners for fear of loss of trust, abandonment and violence from their partner for bringing HIV into the home[2],[3].
  • For youth, where 2 out of 3 new infections is amongst girls aged 15-19 years old, HIV remains the biggest killer of adolescent girls. This can be attributed to the lack of education around sex and HIV[4],[5], the stigma and barriers to youth friendly sexual health and HIV services[6] and links between poverty and transactional sex[7].
  • For Key populations, including sex workers, men who have sex with men and injecting drug users, many are inhibited from seeking testing and treatment because of legislative, structural and societal barriers – fear of judgement or reprimand[8],[9].

In many cases it may be easier to ignore the positive status than deal with the consequences of seeking support. The need for this is highlighted in a recent report produced by STOPAIDS Entitled “Increasing DFID’s contribution to Addressing HIV among key populations which makes a series of recommendations about ways to advance the rights of communities who are disproportionately affected by AIDS. The report was launched at the conference alongside a recent film focusing on people who use drugs in Moldova. We must tackle stigma and discrimination at every level including state policies. The AIDS 2014 conference organisers released the AIDS 2014 Melbourne Declaration, calling for an end to discrimination against people with HIV and the eradication of criminalising laws and practices. [10] Another key issue highlighted at the conference is the importance of monitoring viral load to ensure PLHIV are able to access necessary medication in order for treatment to be optimally effective. However, currently very few high-burden countries routinely offer viral load testing to people receiving HIV treatment. Since 2012, UNITAID has supported projects working to make viral load testing technologies available in resource-limited settings in Sub-Saharan Africa, but these do not yet address viral load monitoring needs on the large scale required. More efforts are needed to make new viral load testing technologies must be affordable and appropriate for poor resource settings in order to be used effectively. In Melbourne, UNAIDS launched the Diagnostics Access Initiative which calls for improving laboratory capacity to ensure that all people living with HIV can be linked to effective, high-quality HIV treatment services. Lack of access to Treatment is still a huge concern especially that there is a 10 fold price increase from 1st line to 2nd line treatment. In reality, the international community is facing huge challenges to control HIV. Therefore, governments, policy makers, funders, and civil society need to:

  • Have a renewed focus to work on the Key Populations and those most at risk and focus on stigma, discrimination and the legislative barriers
  • Address the dysfunctional health systems that hinder treatment
  • Continue campaigning for effective, affordable and appropriate new medicines and medical technologies (e.g. viral load equipment)
  • Challenge the notion that HIV is over and ensure that decision makers realise that  we are at a critical tipping point, where if we don’t step up the pace now we will miss the opportunity to contain the epidemic
  • Ensure the unfinished business of MDG 6 is taken forward post 2015 into the health goal

In the expressive words from Sir Bob Geldof, ‘We have come so far but there is a preposterous reluctance to fund the last mile. The advocates get tired, the same message goes out to the same people and it becomes less effective.’ I can’t help but think that many of the UK based members of the STOPAIDS network feel the same. It’s not only a challenge on the global stage, but often within many of the organisations we work in. We must not become those tired advocates beating the same drum, but come back from the conference championing the successes of our work over the last 30 years and enter a phase of renewed energy to ensure we step up the pace and most importantly leave no one behind.


 

References

[1] Intrahealth International at AIDS 2014 Conference

[2] Rev Phumzile Mabizela, INERELA+, Pre Interfaith Conference
[3] Jennifer Gatsi Mallet, Namibia women’s health network, ICW, Plenary Session AIDS 2014 Conference
[5] UNESCO poster at AIDS 2014 Conference
[6] YWCA, PNG, Pre Interfaith Conference
[7] Cluver, L, Boyes, M, Orkin, M, Pantelic, M, Molwena, T, Sherr, L. Child-focused state cash transfers & adolescent HIV infection risks: A prospective multi-site study in South Africa. The Lancet Global Health
[8] Rev Phumzile Mabizela, INERELA+, Pre Interfaith Conference
[9] Khuat T. Oanh, MD, Vietnam, Diane Havlir, MD, United States, Daisy Nakato Namakula, Uganda, James Ward, BA, Australia, Wednesday Plenary Session AIDS 2014 Conference
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2 Responses to “Reflections on AIDS 2014 – Stepping up the Pace and Leaving No one Behind By Georgia Burford (CAFOD)”

  1. AMUDA says:

    20th INTERNATIONAL AIDS CONFERENCE took place in 2014, not in 2012. I think there is a mistake on date, on the first line of the article.

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