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Dispatches from the XVII International AIDS Conference in Mexico   
More than 22,000 leaders in the global response to AIDS are gathered Aug. 3-8 in Mexico City to share knowledge, best practices and strategies in the effort to fight AIDS at theXVII International AIDS Conference. If you are at the conference, join CEDPA Aug. 6 for a satellite session to discuss Advocacy Strategies to Make the AIDS Response Work for Women (Room SBR7, Centro Banamex). Panelists include U.S. Congresswoman Barbara Lee, CEDPA’s Yolonda Richardson, and women leaders from Nigeria, Egypt and Poland. Read conference highlights posted below by CEDPA staff. And, watch daily Webcasts at Kaisernetwork.org Sunday, Aug. 3, 2008 Monday, Aug. 4, 2008 Tuesday, Aug. 5, 2008 Wednesday, Aug. 6, 2008 Thursday, Aug. 7, 2008
Friday, Aug. 8, 2008
Dignitaries including Mexican President Felipe Calderon Hinojosa, United Nations Secretary General Ban Ki-Moon, and UNAIDS Executive Director Dr. Peter Piot addressed the opening ceremony, emphasizing the need for continued urgency and action to end AIDS. “This conference takes place as we enter a new phase in which we have results,” said Piot of UNAIDS. “For the first time there are fewer people dying of AIDS—but we cannot call it a victory because the end is not in sight.” Today, 33 million people are living with HIV, and despite recent gains in fighting AIDS, rates of new HIV infections are rising in many countries including China, Indonesia, Kenya, Russian, Vietnam, Germany and the United Kingdom. Dr. Piot’s comments were echoed by Dr. Margaret Chan, Director General of the World Health Organization. “The AIDS response expanded the frontiers of public health,” said Dr. Chan. “We have cause for optimism, but we dare not let down our guard. The epidemic is far from over.” Also addressing the crowd was CEDPA alumni, Mony Penn of Cambodia. She explained how she lost her husband to AIDS and found her self penniless and ostracized but, “refused to become a statistic.”
Mony explained how a lack of political commitment can cause harm, citing examples from Cambodia. She called for accountability at all levels and a greater involvement of people living with HIV in all response to AIDS. “It is a sad reality that political commitment in most countries is lacking,” Mony said. Mexican President Felipe Calderon was the last speaker of the evening and as he approached the stage he was met with a chorus of chants demanded AIDS treatment for all Mexicans. Recognizing the large local activist presence, the President acknowledged the accomplishments to date in Mexico regarding HIV and AIDS. These include anti-stigma laws to protect homosexuals and health clinics for treatment and testing around the country. The President did remark that much work was still left to be done, especially regarding vulnerable communities including women and girls. He also promised to lower the cost of anti-retroviral medications for all Mexicans. The International AIDS Conference continues throughout the week with activists, researchers and political leaders participating in conference sessions, satellite events, exhibitions and cultural programs. Aug. 4, 2008—Day two of the conference featured remarks by former U.S. President Bill Clinton on “HIV/AIDS and Health System Reform: Achieving Universal Coverage.”
President Clinton noted that “the 2008 U.N. AIDS report tells us that AIDS related deaths declined last year, that more women are getting ARVs to prevent mother to child transmission, that the number of new infections among children fell, that more children are receiving treatment, and that the long-term funding gap has been substantially reduced by the recent American legislation.” But, he added, “the progress made and the future funding committed should convince us that we can now face the persistent challenges that remain.” These challenges include “much yet to be done to expand prevention, treatment, and care...[including] to integrate the fight against AIDS with the problems of TB, malaria, other infectious diseases, and the lack of maternal and child healthcare.” He continued that “the other challenges include substantial shortages of healthcare workers and an adequate infrastructure in developing nations, and a resurgence of infections in the United States, especially among African Americans.” Clinton noted that prevention efforts must be ramped up in order to turn the tide against the epidemic. He added: “We also know that with prevention, there is no silver bullet. So we are forced to continue to pursue a number of approaches, including campaigns to change sexual behavior, adopt consistent condom use, provide substitution therapy to injection drug users, and increase male circumcision.” Also, Clinton referred to the need to integrate AIDS services with reproductive and other health programs, noting that “We need to make testing and counseling available and to promote it in every single health facility in every community so that people know their status and can get care as soon as they need it.” Aug. 5, 2008—Day three of the conference highlighted strategies and challenges to prevent HIV transmission.Speakers throughout the day noted that unless successful prevention strategies are accelerated, the fight against AIDS will be lost. In 2007, 2.7 million people were newly infected with HIV worldwide, nearly 7,400 each day.
The opening plenary included leaders such as Tachi Yamada, President of the Global Health Program at the Bill and Melinda Gates Foundation, who said that prevention “is not all about development of new solutions. What we have learned is that we have many, many solutions that we know to work. There are, of course, clean needles, condoms, circumcision, prevention of mother to child transmission. We know they work. The big problem, in this case, is not developing new solutions, but really how to deliver them.” During a special afternoon that highlighted a series in the journal The Lancet, speakers reviewed current and future needs for global HIV prevention. Panelists including Jessica Ogden from the International Center for Research on Women and Peter Piot from UNAIDS discussed what is working in current prevention efforts, and what is still needed. Their conclusions? HIV prevention strategies are most effective when focused on the broad set of economic, political and social drivers of the AIDS epidemic rather than solely on preventing transmission based on one individual’s behaviors or risks. One other notable session was a special evening session on Leading the AIDS Response in Asia: Recommendations from the Commission on AIDS in Asia. The Commission on AIDS in Asia released their report, When asked, communities answer!, which assesses the dynamics of the epidemic in Asia and provided recommendations for an effective strategy in the region. The report used a mixed methodology of internet survey, face to face interviews and key informant interviews to gather data on the current situation in Asia. This topic is especially timely for CEDPA as our Advancing Women’s Leadership and Advocacy for AIDS Action program moves to Asia in 2009. CEDPA will hold two training programs in the Asia region to discuss technical and management components of HIV programming and advocacy. The curriculum will reflect current issues and needs of Asian women infected and affected with HIV, including: violence against women and HIV, stigma and prevention related to the commercial sex trade. Panelists during the session discussed results and reported that issues unique to Asia in the fight against HIV and AIDS include: unprotected sex among men who have sex with men, unsafe drug injection, violence against women and most importantly, unprotected commercial sex. The Commission reported that roughly 75 million men in Asia regularly use commercial sex workers, which put their 50 million wives in direct risk of contracting the disease. Prevention programs face the challenges of social stigma, lack of involvement of people living with HIV in decision-making, and current laws that criminalize homosexuality and commercial sex workers, therefore driving these target groups under-ground and making them harder to reach in prevention programs. Advocacy Strategies to Make the AIDS Response Work for WomenAug. 6, 2008—Wednesday, CEDPA held a satellite session that brought together AIDS activists from Egypt, the European Union, Nigeria and the United States who are working to make the AIDS response work for women.
They argued that too often, the importance of putting women at the center of efforts to confront AIDS has not moved beyond rhetoric and that the current response to AIDS does not effectively recognize the realities of women’s lives. Today, about half of all adults living with HIV are women, and women make up the largest percentage of those living with HIV in regions such as sub-Saharan Africa. Speakers at the CEDPA session included alumni Wesam Hassan of Egypt, Anna Zacowicz of Lithuania, and Morolake Odetoyinbo of Nigeria--all graduates of CEDPA training programs. They were joined by Christos Tsentas, legislative director for U.S. Congresswomen Barbara Lee, and Yolonda Richardson, CEDPA’s president. Morolake has fought for the rights of people living with AIDS in Nigeria for over ten years. She related her own story that when she was first diagnosed, she did not think she would see the age of 40. “The only reason I am here today is because at some point I realized I wasn’t going to die,” Morolake said. She explained how once she realized she could live with HIV, this information empowered her to help herself, and help others. This is why HIV education that reaches women is at the top of her list of efforts needed to make the response work. Today, Morolake’s organization, Positive Action for Treatment Access Nigera, advocates for equitable access to prevention, treatment, care and support in Nigeria. Anna Zacowicz, originally from Poland, contracted HIV years ago when she battled drug addiction. At first, the news sent her into a tailspin, but ultimately she figured out that she had something to give back. While still in Poland, she lived and began volunteering at a rehabilitation center for drug users and people living with HIV and AIDS. She also helped start a self-support group that provided legal and psychological services for former drug users and people living with HIV and AIDS. Today, she works in Belgium with the European AIDS Treatment Group to monitor access to antiretroviral medicines in seven countries in the Eastern European region: Azerbaijan, Estonia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. The project is building capacity among local civil society groups to be more effective watchdogs in their own countries to ensure that medicines can reach all who need them. Wesam Hassan focuses her work with youth in Egypt. Though Egypt is a country with only a small number of documented cases of HIV, many cases go undocumented because it is a conservative society and getting tested or talking about HIV is taboo, she said.
Wesam is trying to break through this silence. One of the participants in her youth education programs once told her “I know I am not the only HIV positive person living in Egypt, but it feels like I am.” The most effective advocacy strategy for Wesam’s organization has been media outreach. She related a story about the media’s impact on her own mother, who never really understood why Wesam worked on AIDS issues. Then, her mother began to see stories about people living with HIV on television and realized the importance of her work. “Involving media really helps in delivering your message to people at home,” Wesam said. The final speaker, Christos Tsentas, spoke about the recent reauthorization of the President’s Emergency Plan for AIDS Relief by the U.S. Congress. The bill authorizes $48 billion for global AIDS efforts over the next five years. Christos explained that U.S. Congressional champions such as his boss, Congresswoman Barbara Lee, will work to improve the legislation so it does more to address the needs of women and girls. One area that could be improved, he said, was ensuring that AIDS programs were linked to reproductive health services within communities, so women could access information and testing no matter where they received health interventions. “Family planning programs around the world are looked to by women and utilized by women on a daily basis,” he said. “We need to bring HIV services with those programs.” In February 2008, CEDPA and the International Center for Research on Women (ICRW) conducted dozens of in-depth interviews with alumni from CEDPA’s Advancing Women’s Leadership and Advocacy for AIDS Action training program on women’s participation in HIV programming and policy. These results were shared in Wednesday’s conference session led by Elizabeth Tyler Crone of the Athena Network titled “Women Take the Lead.” Crone explained that the purpose of the survey was to discover if women living with HIV were participating in the full spectrum of approaches related to AIDS, or were only visible regarding women’s issues. With the help of the CEDPA and ICRW interviews, the study found that women overall do not have meaningful participation in the HIV arena, and women are underrepresented in the formal AIDS response. Women living with HIV continue to fill traditional roles in the form of unpaid caregivers and volunteers. Other session panelists agreed with Crone, calling for a scale-up of programs building the capacity of women living with HIV, more leadership training to prepare emerging women leaders, and the strengthening of women’s alliances and networks, especially those for people living with HIV and AIDS. CEDPA is proud to be a leader in capacity building for women living with and working in HIV programming and advocacy through its global training programs, and work in countries including Nigeria. CEDPA Alumni in the Fight Against AIDS Aug. 7, 2008—CEDPA staff connected with dozens of alumni of our training programs who were in Mexico City to share strategies to improve the fight against AIDS in their communities.
Veronica Valencia Garcia is one of CEDPA’s alumni who works in Aquas Calientes, Mexico, a rural community about 300 miles from Mexico City. Her organization, the Center for Capacity Building to Develop the Community (Centro de Capacitación para el Desarrollo Comunitario), use education and advocacy to improve the health and well-being of families, primarily around reproductive health issues, HIV/AIDS and also family violence. She is particularly proud that her organization was able to secure rapid HIV testing for pregnant women in four Mexican states. Recently, the organization has started to work with sex workers to prevent the transmission of HIV and ensure that this marginalized population can access services. Veronica is attending the AIDS conference to learn more about successful outreach strategies, since this is a new area for her. Veronica graduated from CEDPA 1992 Institution Building workshop, which she credits for helping her expand the capacity of her organization to meet new challenges.
CEDPA alumna Christiana Laniyan is working in Nigeria for Family Health International for their Strengthening Nigeria’s Response to HIV/AIDS program. This program works with State Action Committees on AIDS (SACAs) in the six Nigerian states with highest HIV prevalence. She focuses on strengthening these agencies and building their capacity for financial, human resources and program management. When asked what she got out of participation in CEDPA’s Women in Management training, Christiana said, “Women in Management changed my life! It made me catch a vision of myself not only as a manager but as a leader. “ She went on to get an MBA because of her participation in CEDPA’s training, and her staff calls her “the coach” because she uses the facilitation and mentoring skills gained from another of CEDPA’s trainings she attended: an Africa Regional Training of Trainers in Ghana. Christiana wanted to be sure to convey that “I am very proud to be a CEDPA Alumna!” Rally for Healthcare Workers
“Healthcare workers are needed now!” was the rallying cry of more than fifty men and women from around the world who marched through the International AIDS Conference today, singing songs from Africa and raising awareness about the need for more health care workers for people living with HIV and AIDS, especially in sub-Saharan Africa. In the most recent UNAIDS report, community health workers are recognized as critical to ensuring care and support for those living with HIV and AIDS. In addition to care, community health workers support reducing stigma and have shown to increase rates of HIV testing in communities in which they work. Despite the critical need, the reality is that most countries hardest hit by the AIDS pandemic face and enormous shortage of workers. In Zimbabwe, there are 1,800,000 people living with HIV and AIDS and only 770 doctors and 6,931 nurses to provide their care. Preventing HIV by Strengthening Human Rights At the United Nations High Level Meeting on HIV/AIDS in 2006, world leaders reaffirmed that “the full realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV/AIDS pandemic.” Despite this agreement, much work remains between linking HIV/AIDS and human rights, especially with the increasing criminalization of practices of vulnerable groups including intravenous drug users, and sex workers. Presenters at the session on The Role of Human Rights in HIV Related Interventions Amongst Vulnerable Groups challenged themselves and the audience to think about how to center AIDS interventions within a human rights framework to prevent HIV in vulnerable groups.
Are organizing sex workers to protect themselves with condoms empowering or is it ignoring the lack of choices available to the women who are working in this field? This was the example used by Mr. Simranjit Jana as he discussed efforts to work with sex workers in Southeast Asia and noted that while for many women they didn’t choose to become sex workers, criminalizing their behavior only drives them into hiding away from HIV testing and services, not unlike intravenous drug users. Examples of successful rights-based models include programs that combat discrimination and violence. Allowing more room for vulnerable groups to speak for themselves is the key to human rights for all, the presenters argued. Closing SessionAug. 8, 2008—The XVII International AIDS Conference was brought to a close by fervent reminders that, despite the successes over the years and the enthusiasm at the conference, the road ahead is a long one. The most recent UNAIDS report on the global epidemic reports that for every minute that passes, there are five new infections. And, though the numbers of new infections and deaths attributed to AIDS have dropped, there were still at 2.7 million new infections and two million deaths in 2007. “We are glad to learn about our successes, but more than ever, we need to be reminded that, as we speak, thousands of human beings are conducting a preventable disease and thousands are dying from a treatable disease,” explained International AIDS Society President Pedro Cahn on his last day in office. “The high statistics behind each number, behind each graph, there are millions of people waiting for support, treatment, and care. Now it is in our hands, leaders, scientists, and community to keep our commitments on track and to fulfill these commitments we have made,” he said. Co-chair Luis Soto-Ramirez brought to light the fact that we need to bring marginalized group into the focus before we claim success. “Ignoring the needs of children and adolescents, and women…continues to marginalize groups at greatest risks for infection, and will only lead to more new infections and fewer people in treatment. We will pay for such foolishness in the future,” Soto Ramirez said. “It is time to end the stigma, discrimination, and social injustice, and to involve those mostly affected in public health policies.”
Dr. Michel Kazatchkine, Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria summed up the conference. “The need to drastically scale up prevention has dominated this conference,” he said. “We can leave Mexico confident that in the course of fighting AIDS we have created the most dynamic movement for health and justice that the world has ever seen. And we are rightly proud of it.” He also highlighted four challenges that the world still faces, and that will be themes for future conferences: lack of human rights, under representation of AIDS research, weakness in health systems, and sustainability of the global AIDS response. Dr. Julio Montaner, the incoming president of the International AIDS Society, spoke about the renewal of the President’s Emergency Plan for AIDS Relief (PEPFAR). “Last week we heard plans to reinstate PEPFAR funding for HIV and AIDS and tubuclerosis and malaria to the amount of 40 billion…I would like to thank the American people. You should be applauded for this tremendous commitment,” Dr. Montaner said. “However, this responsibility cannot lie solely on the shoulders of the America people. The world must follow their example; ultimately if George W. Bush got it, the rest of the G-8 leaders must get it too. Let me be clear, I call upon Prime Minister Steven Harper from Canada along with the rest of the G8 leaders to match President Bush’s contribution now.” Back to story index. |
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