The XVI International AIDS conference was held in Toronto Canada from 13th -18th August 2006. EPN was represented at the conference by the coordinator and a board member.
The coordinator participated in the Ecumenical pre-conference from 10th – 12th as part coordinator for one of the streams and on Monday 14th she was part of a team organized by Bread for the World (BfdW) that ran a skills building workshop on treatment literacy.
Jane Masiga an EPN board member, also participated in the main conference and presented a paper on Challenges of Scale-up and Local Distribution in the session: “Supplying a Lifeline: Delivering Quality, Affordable Medicines and Supplies to People Living with and Affected by HIV/AIDS.”
Click on the links below to view summaries of their experiences.
Coordinator’s experience:
This is a summary of the coordinator's experience on the sessions attended on 10th August.
This was the first day of the Ecumenical pre-IADS conference. There were over 500 people in the main hall (ball room). The theme of the conference is “Keep the promise” and this was well kicked off by a powerful opening worship in which stones were used to state our promises. This continued into the closing ceremony when pots were broken to symbolize broken promises and where we threw stones into the pots, breaking them even further, while remembering broken promised make to those who have died or are suffering form HIV/AIDS. Terry Macarthur and the worship team once again did a fantastic job!
In the morning plenary presentations, key issues highlighted were the aspects of covenant i.e. relationship with God, relationships with one another, reaching out to the poor and vulnerable (i.e. commitment to them) and resolving to keeping any promises we make. Faith communities were called to be the core of who are meant to be i.e. to be the hands, feet, eyes etc of God. Keep the promise means being the very heart of God. The inequality of access to care and treatment was highlighted by a call for collective action and investment in sustained strategic response that is long term. A young Baptist pastor, Adam Taylor, moved the group with his very clear and interesting presentations. He explained that HIV is an exposé of our brokenness and social injustice. HIV presents both a danger and opportunity for humankind to look at things they were not paying attention to before. Using the example of how David defeated Goliath with selection of 5 smooth stones, he said the church also has 5 stones against the AIDS Goliath:
Using the HIV initial he ended by saying in God’s vocabulary this probably stands for Healing the International village and Heaven interdependent Village.
The afternoon plenary session highlighted the challenges of working with faith organizations. These include the still inadequate engagement of religious leaders, their inability to talk in neutral way about sexualities and the continuous stigmatization of positive people. Also church leaders are not themselves getting testes and when they do they are unable to acknowledge their status. Other challenges include their inability to address real issues such as culture and power struggles between religious bodies (religions or denominations). R. Sawyer an openly gay activist gave a story of their struggle with the Catholic Church over the issue of condoms and sex education in schools and the stigma against gays in the Black churches. His main message is that loving care should include providing tools to save lives. There was however a question as to whether as a church, we should change and abandon the Christian values. The reply was that the church has been changing with time since 2000 years ago (it is not the same today as it was then) and that there is no greater Christian value that love for all. Time ran out for more discussion on this.
I attended three workshops
It was pointed out that according to promises made at least 10% of the funding made available to HIV/AIDS should be for work on OVC. For more information contact: hivaids@gmfc.org
Also www.plan-international.org/news/publications
This workshop gave two examples of advocacy work on access: the TAC in South Africa (shown video clip about 20 minutes) and the work in Canada to follow up the problems with the flawed Doha declaration that is proving impossible to use. The problem is that for a company to request a compulsory license (CL), it must deal with it on a case by case, drug by drug and country by country basis! This does not allow economies of scale and therefore two years since Canada put this in their regulations, not a single pill has left Canada on this provision. There is therefore a need for a faster process and the advocacy in Canada is to have the issue of CL as routine where the company having acquired the CL, can go to countries and negotiate for orders. This means changing the process from being one to get order then get CL, to one of getting the CL then get the orders from many countries. It was also pointed out that India is now compliant with WTO and therefore it will also be impossible for the generic manufacturers to export products made under CL unless India includes this provision for export under CL its laws.
Follow up issues
Keep an eye on the Canada process and also see if India will include the provision in its regulations.
An interesting skills building workshop using role plays to see how corporations impact our lives, what power we have to impact on the corporations and how to interact with corporations (used example of a pharmaceutical company).
Although time was to short, it was interesting to see some of the ideas of how to impact on corporations including changing buying habits (yes even for one person), working on collective ownership; boycotts; regulations; campaign on spending of public money e.g. where to put pension funds; use of public alternatives e.g. public mass media. It was noted that faith communities seem to be a corporation-free zone.
The tick used by corporations to stall work of advocacy groups was also highlighted e.g. wasting time, not committing to time frames, making pronouncements that of minor consequences, extracting information without giving any, agree on non-contentious issues but not on practical issues, getting the process controlled by the corporation etc.
In terms of how to interact with corporations, it is important to know what is the strength and level of power the advocacy group has, for example if they have an alterative or if they no power to influence course of event. In the second position, advocacy groups need to look at areas of common interest and capitalize on these (win –win situations). The importance of “arms length” consultative groups (i.e. maintenance of independence) was highlighted.
Follow up issues
Obtained a copy of the booklet: “Benchmarking AIDS; Evaluating Pharmaceutical Company responses to the public health crisis in emerging markets.”
Jane Masiga, a member of EPN's board gave a report of her experience in Toronto:
XVI International AIDS Conference (AIDS 2006) which was organised by the International AIDS Society (IAS) and the AIDS 2006 Toronto Local Hosts was held at the Metro Toronto Conventional Centre in Toronto, Canada between 13th and 18th August 2006. The week marked the 25th anniversary of the first reported case of HIV/AIDS. The conference was expected to be the most important global gathering in the fight against the spread of AIDS, as well as a unique opportunity for science, community, government and leadership from around the world to advance the response to the epidemic. It was a forum where timely and important data on the leading HIV/AIDS issues were presented and allowed for sharing of lessons learned among developing and developed countries. This would assist in bringing and supporting effective treatment and prevention programmes to communities around the world. World-wide, an estimated 38.6 million people are living with HIV/AIDS.
Attendance was higher than expected despite the strict air security. More than 31,000 people attended the conference from more than 170 countries. This reflected the intense interest in this event. Conference logistics proved a challenge to the organisers – included accommodating people who had never used escalators, dietary and customs issues, traffic flow, security and receiving the world’s poorest among the world’s richest man. Just moving people from one side of the conference centre to another was like crossing the town. For this reason, lounges were prepared for HIV/AIDS patients to rest during the day, take naps or take their medication. The residents of Toronto are quite friendly and willing to help foreigners. The organisers made all the necessary arrangements to make the delegates comfortable, with signs showing directions all over the city, and volunteers posted at strategic places to offer help when required.
Melinda and Bill Gates (the richest and one of the most powerful men on the planet) delivered the keynote address at the opening session on Sunday 13th. One of the issues they stressed is the “empowerment of women” as key to an effective response to HIV/AIDS. They said that “the world leaders must put the power (economic, sexual and legal) to prevent HIV in the hands of women” by accelerating the search for microbicides (gels and creams used to block virus) and other new HIV prevention. They promised to invest more charitable dollars into this cause. “No matter where SHE lives, who SHE is, or what SHE does, a woman should never need her partner’s permission to save her own life.” Young women between the ages of 15 to 35 years are three times more likely to be infected with the AIDS virus than men the same age.
My participation to the conference was sponsored by USAID Washington. I presented a paper on “Challenge of Scale-up and Local Distribution” in the session “Supplying a Lifeline: Delivering Quality, Affordable Medicines and Supplies to People Living with and Affected by HIV/AIDS”.
The conference was attended by delegates from all over the world representing all interest groups: scientists, health workers, people living with AIDS, activists, politicians, religious leaders, community leaders, advocates, exhibitors, journalists, etc.
Prime Minister Stephen Harper was blasted and booed at the opening ceremony for his failure to attend the conference. It was claimed that his failure to attend cheapens the office of prime minister and reflects poorly on him as a world leader. Liberia’s President Ellen Johnson-Sirleaf was planning to attend the conference but decided not to after learning that the Prime Minister of the host country was not planning to attend.
According to Bill Clinton, the biggest impediment to increasing HIV/AIDS treatment and prevention programmes is the critical shortage of nurses in the developing world. “You can’t just take these ARVs and drop them in a parachute. You need a health infrastructure.”
The trend in HIV testing is moving from the current standard practice recommended by WHO, called “voluntary counselling and testing” (VCT) to “routine offer of testing with opt-out option” where every one who comes into contact with the health system is offered an HIV test, and the onus is on the patient to decline.
Pharmaceutical industry was a popular target for activists yet some became darlings during the conference. Below are some examples:
Abbott suffered greatly during the conference because they have not made their new break-through Kaletra (which does not require refrigeration and has easier dosing) available and offered at access prices to developing countries. Their display stand was vandalised, and when they escaped the stand was taken over by activists and covered with black polythene paper with posters reading “your stand is as empty as your promises” They sang and danced while selling items of advocacy e.g. T-shirts.
Tibotec (the Belgium Company which manufactures Miconazole MAT which is distributed by MEDS at subsidised prices to AIDS patients) was a darling at the conference because they have a number of new molecules for HIV in the pipeline which they have promised to offer at no profit basis. They were also major sponsors of the conference.
Boehringer supplies MEDS with Nevirapine but in June threatened to take legal action if we went ahead to import generic Nevirapine as we will be contravening the patent laws. We joined hands with MEDS friends (WHO, UNAIDS, EPN) to put pressure on them. After several meetings, they agreed to withdraw their letter of threat, and I received their letter reversing the issue before I left Toronto (copies of both letters are available at my office for those interested).
Trials for HIV vaccines are in advanced stages in Australia, Brazil, Canada, Dominican Republic, Haiti, Jamaica, Peru and Thailand.
In addition to HIV vaccine, a wide range of promising new HIV prevention approaches are being tested in clinical trials, including male circumcision, cervical barriers, pre-exposure prophylaxis with ARVs, herpes suppression and microbicides.
Merck & Co. is developing a drug which belongs to a long-awaited new class of HIV medications known as Integrase Inhibitors, and is now undergoing clinical trials. This class works to block the enzyme the virus uses to integrate its genetic material into the DNA of the host’s cell and make copies of itself. The patients have shown a quick reduction in the number of viruses circulating in their bloodstream. As more and more patients develop drug resistance to standard therapies, this new class is raising hope of a new treatment against the HIV virus.
Christian Health Association of Zambia (operating like MEDS) had an exhibition stand at the conference. They told the world of their contribution in the area of HIV/AIDS with posters, sale of T-shirts and caps, and their staff explaining to those who visited the stand. It was a nice show for a church procurement and distribution organisation from the developing world!
There were activists’ activities at almost every session which included T-shirts with slogans, posters, cartoons, and even shouts which were sometimes entertaining but also destructive. For example the Health Minister of Canada was confronted by supporters of a “safe injection site for intravenous drugs users” who were unhappy that the government was going to withdraw its legal exemption. This site is the only one in North America and attends to more than 600 drug users daily. It is a place where drug addicts get clean needles (to prevent them from sharing), medical help in the event of an overdose, and assistance in entering detoxification programmes should they desire it. There were also fashion shows from “out of this world” and these included ladies wearing dresses where people could inscribe messages.
There were a number of Skills Building sessions organised for delegates. I attended the following:
Monitoring treatment efficacy in the context of resource limited settings
Time to deliver: HIV care and support in the workplace
Responding to the challenges of delivering ARVs in resource limited settings
Pre-qualification of HIV/AIDS Diagnostics and its impact on prevention and provision of care and treatment in resource limited settings
STI: Is it smart to stop HAART?
Solving problems with the procurement of HIV commodities
Four aspects of scale-up
Assessing and monitoring supply chains of ARVs
My outward trip took place two days after the London terrorist threat and we had to wait in long queues and all flights were delayed. Most of my toilet bag contents were confiscated as travellers were not allowed to carry liquids, gels, toothpaste, aerosols, etc. However, the conference was worth attending as it was an eye opener. It was also nice to be in the presence of powerful, rich and great people. I am grateful for USAID for sponsoring my trip and MEDS for giving me time off to attend this great event.
Jane Masiga
22nd August 2006