At a tipping point: making sure no one is left behind

I met a nurse from Ukraine on a bus to visit the Victorian Aboriginal Health Service (more on that later), she said that only 25 per cent of people who need ARV (anti-retroviral treatment of HIV) are getting them. Later on, during a session about reforming drug policies to end the HIV and AIDS epidemic among people who inject drugs, I learned that since Russia annexed Crimea more than 800 people were kicked out of a methadone program.

It is due to a difference in national policy between Ukraine and Russia – Russia doesn’t support opiate substitution treatment (methadone treatment) and has limited needle exchange.

A doctor who is here from Poland, who specializes in HIV and infectious disease, was telling me that in their society a strong religious thread – mainly Catholic – has prevented people from talking about HIV, from getting tested. The epidemic she sees is predominately among gay men, sadly young gay men.

Of every $100 spent on HIV from donors, only one per cent (or $1) is spent on programming around sex workers. Of those dollars, many are spent on faith-based organizations, which may or may not support sex work. A group of sex workers who interrupted the morning plenary session are trying hard to get this message out.

Indigenous people are over represented in HIV statistics in many countries, and until recently their voices were not heard.

There is not a lot of commonality between those people but until each of those groups are recognized for their individual needs in the HIV/AIDS epidemic, the tide will not turn.

This was the message from Global Funds’ Mark Dybul. He says we are at a tipping point and with specific strategies (which will require all nations to actually pay the money from their commitments) we can move towards the end of AIDS.

Lest this comes across as far to Pollyanna in its simplicity, there are actually small movements underway to change the global approach to HIV to a more specific one.


Floor at the Victorian Aboriginal Health Service.

During that trip to the Victoria Aboriginal Health Services in Melbourne, we learned services are for the Aboriginal community by the Aboriginal community. The perfect example of the tide changing is a package of condoms with a snake on it.

The box was designed by an Aboriginal young man to appeal to his counterparts. Inside are three condoms, one red, one yellow and one black – the colours of the Aboriginal flag. Since the health service started handing these condoms out, the uptake of condom use and conversations about safe sex have increased. Not bad for a simple design change.

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AIDS 2014 underway

In some ways Michael Kirby reminds me of Stephen Lewis; both are articulate, eloquent and fiercely passionate about people who are discriminated against because of HIV.

Lewis is a former Canadian politician, and past special envoy for HIV/AIDS in Africa. Kirby is a former Australian high court judge and on the United Nations Human Rights Council.

When Kirby spoke last night I was left with the same feeling I have when listening to Lewis, completely convinced that despite the hills in front of us, they are surmountable and it is possible to stand up, speak out and make a difference.ah-AIDS-aids conference opening session 1

Kirby spoke as the Jonathan Mann lecturer for the opening session of AIDS 2014 on Sunday night.

He commented on the parallels between the death of AIDS researchers and activists en route to this conference on Malaysia Airlines flight MH 17 and that of Jonathan Mann, whom the lecture is named for, dying in a plane crash en route to an AIDS conference in 1998.

“If only we laugh and sing and drink and struggle shoulder-to-should with them here tonight, but we all know that we cannot do those things. So we think of them and others who have suffered and others who have suffered through irrational unjust, destructive acts.”

He named Dwayne Jones, murdered in Montego Bay Jamaica – condemned for being gay. David Kato, a Uganada activist, killed for opposing the anti-homosexual law.

“The violence does not end and yet brave reformers stand up for the essential idea of equality.

“We think of sex workers, drug users, prisoners, transsexuals, the disabled people living with HIV. For them our conference theme of ‘No One Left Behind’ must often seem a cruel irony.”

But, he didn’t just talk about those people who are still struggling, but rather pointed fingers at those who caused the struggle. He said,

“in many countries leaders have tragically failed to embrace the paradoxes of AIDS. They have talked. They have received the subventions for antiretroviral drugs. But they have failed dismally to defend the human rights and lives of their own citizens it is beyond time for the adoption of initiatives by these leaders that work.

Without such reforms and without changing the global laws on intellectual property, people will die needlessly. It is as simple as that. Someone must tell those who will not act, the practical facts of life in our world. They cannot expect taxpayers in other countries to shell out, indefinitely, huge funds for antiretroviral drugs if they simply refuse to reform their own laws and policies to help their own citizens.”

At this point he stopped and a video played.

He said that Mickey Mouse in Fantasia shows the global state we are in now.

“Too many countries are leaving the tap running full pelt. To sweep up the flood with a solitary broom is not going to work. We must turn off the taps. And that will not happen without an embrace of the kind of laws and policies we have long adopted in Australia.”

Those are decriminalizing HIV, allowing for needle exchanges to continue, respecting people who are LGBTQ and creating programs for those at risk of becoming HIV positive. Kirby gives credit to Tony Abbott, the Australian PM, for standing up against pressures that would change those programs. Kirby also said he believes that Abbott can help further the cause of HIV with many political leaders resistant to change.

“Many of those who have left the taps of infection still open are more likely to listen to him than to others that talk a language that they abhor. Conservatives, you see, can be vital allies in the struggle against AIDS.”

Kirby captured what it meant to be at the 20th International AIDS Conference, taking into account the state of affairs in the world.

“We come to renew our commitment to ourselves, to our lost friends, and to the strategies that work: Rich and poor. Men and women. People living with HIV and those who love and support them. Religious and non-religious. Straight and gay. Liberals and conservatives. We are in this together.

To those who live with HIV, to those who have died of AIDS and to those who have died in the struggle to advance the principles of our Declaration, this Melbourne Conference should give a renewed commitment: To continue down the paradoxical path that has been shown to work. Never to allow the forces of cruelty and ignorance to deflect us. And never to be content whilst anyone is at risk of being left behind.”

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Our sadness, our anger and our solidarity

I’m exhausted and it’s the middle of the night here in Australia.

I’ll have more on the opening session of the 20th International AIDS Conference in the morning (my time), but I just wanted to share a quick moment that I found particularly touching this evening.

“Let our silence represent our sadness, our anger and our solidarity,” Francoise Barré-Sinoussi

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Update on MH17 effect on AIDS 2014

The complete passenger manifest of Malaysia Air Flight MH 17 has been released and is on the Malaysia Airlines website.

Joep Lange

Joep Lange

The International AIDS Society has confirmed the names of another five people set to arrive at the conference. This brings the total to six people confirmed, with another 100 thought to have been on the flight.

  • Pim de Kuijer, lobbyist Aids Fonds/STOP AIDS NOW!
  • Joep Lange, Professor of Medicine, University of Amsterdam and Scientific Director, Amsterdam Institute for Global Health and Development
  • Lucie van Mens, Director of Support at The Female Health Company
  • Martine de Schutter, Program Manager Aids Fonds/STOP AIDS NOW!
  • Glenn Thomas, World Health Organization
  • Jacqueline van Tongeren, Amsterdam Institute for Global Health and Development

Buzzfeed has done an incredible job of searching the internet to track down photos of these people and find comments from their friends and co-workers.

And then there is this article in the Washington Post, Ukrainian officials accuse rebel militias of moving bodies, tampering with evidence.

While the tragedy is going to overshadow the conference, there is hope. Health expert, author and journalist Laurie Garrett had this to say.

“A Tweeter asked me if the loss of Joep, Glenn, and other AIDS researchers and activists possibly on board MH17 would prove a major set-back in the fight against AIDS. No, I said. One of the glories of the AIDS community is that its bench is deep, its talents enormous, and its sorry history of processing grief and moving on is unparalleled. The dead, as has always been the case since this awful virus emerged in the late 1970s, will be mourned. And then energies will be mustered, to get the job done.

Until there is a cure.”

Read her blog here, on the role Joep Lange and others have played in the research on HIV/AIDS treatment.

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AIDS 2014 is off to a tragic start

AIDS2014_bannerAs people from around the world come together for the International AIDS Conference in Melbourne, you would think there would be excitement as people share research, talk about new ideas and see old friends.

This isn’t the case.

Right now all people are talking is Malaysian Airlines MH17 flight that has crashed over Ukraine earlier today.

Apparently as many as 100 people on that flight (of the 295) were on route to Melbourne to attend the 20th International AIDS Conference.

According to the International AIDS Society, among the passengers was former organization president, and long-time researcher Joep Lange, a man considered a giant in the AIDS community.

In a media release earlier this afternoon, the International AIDS Society said, “in recognition of our colleagues’ dedication to the fight against HIV/AIDS, the conference will go ahead as planned and will include opportunities to reflect and remember those we have lost.”

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