Former US President Bill Clinton and philanthropist Bill Gates address conference
Scientists, practitioners and advocates from around the world today made a united call for global leaders to commit at least $US20 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria at its upcoming replenishment meeting in October. Because the level of replenishment committed at the meeting will determine the Global Fund's grant levels for 2011-2013, the meeting is widely viewed as the critical next step towards universal access to HIV prevention, treatment, care and support.
"The replenishment is the moment at which we will know whether or not world leaders intend to fulfil the promise they made to universal access," said Dr. Brigitte Schmied, AIDS 2010 Local Co-Chair and President of the Austrian AIDS Society. "The rich scientific findings and on-the-ground experiences presented at AIDS 2010 should be all the evidence that leaders of all nations need to fully commit to doing their part."
The Global Fund has a strong record of success that includes supporting 2.5 million people on treatment, treatment for almost 800,000 HIV-positive women to prevent vertical transmission and an estimated 4.9 million lives saved. Support for the Global Fund is vital, but alone is not sufficient to reaching universal access. Increased financial support must extend beyond donor government pledges to the Global Fund to include innovative financing mechanisms, increased support from the private sector and full implementation of the Abuja Declaration in which African nations committed to spend at least 15% of their national budgets on health.
"We are at a pivotal moment in the global response to AIDS and there is both a moral and a public health imperative that we continue in the right direction, especially as HIV treatment guidelines are expanded to reach people earlier in the course of their disease and our understanding that providing antiretroviral treatment also prevents new transmissions continues to grow," said Dr. Julio Montaner, AIDS 2010 Chair, President of the International AIDS Society (IAS) and Director of the B.C. Centre for Excellence in HIV/AIDS in Vancouver, Canada. "Increased financial commitments must be matched with a drive for the most efficient use of available resources."
Efficiency was an important theme in a Sunday town hall meeting on a new paradigm for HIV treatment and prevention sponsored by UNAIDS and the IAS. The meeting featured UNAIDS' launch of Treatment 2.0, a strategy that has as its goals the development of better combination treatment regimens, cheaper and simplified diagnostic tools, and a low-cost, community-led approach to delivery.
Monday's plenary session included three powerful and notable voices:
Keynote Address: President Bill Clinton
Former U.S. President Bill Clinton of the William J. Clinton Foundation delivered a keynote address.
Positive Health, Dignity and Prevention
In her plenary remarks, Vuyiseka Dubula (South Africa) of the Treatment Action Campaign noted that HIV prevention is a universal goal regardless of one's HIV status. Dubula spoke to the framework of Positive Health, Dignity and Prevention, a comprehensive approach to supporting people living with HIV with their prevention and social needs through empowerment and with dignity rather than through fear or coercion. In many cases, the failure of governments to recognize human rights violations that oppress and punish leads to oversimplified prevention interventions that ignore the full spectrum of challenges shaping the prevention needs of HIV-positive people.
Treatment as prevention provides an opportunity to keep access to treatment high on the global agenda. Scientists and activists need to find new ways to ensure that world leaders are accountable for the targets they set by replenishing the Global fund with at least US$20 billion and this will be a step to recognizing the importance of the right to health and human rights. Treatment must remain a goal, whether or not prevention is a goal. Many of the values, principles and components of Positive Health, Dignity and Prevention go hand-in-hand with achieving universal access and contribute to the achievement of the Millenium Development Goals. The leadership of people living with HIV is crucial in responding to policy and legal barriers and in advancing HIV programmes, especially in terms of access to treatment and care, attention to gender inequality, and the needs of young people, including children living with HIV, she argued.
HIV, Drug Policy and Harm Reduction
Anya Sarang (Russia) of the Andrey Rylkov Foundation for Health and Social Justice examined the use of harm reduction in HIV prevention, arguing for programmes and policies rooted in human rights. Noting that policies of the so-called "war on drugs" maximize harm, including risk of HIV infection and drug-user deaths, Sarang called on national governments to promote evidence-based approaches to harm reduction - including scale-up of easy-to-access needle and syringe distribution programmes, opioid substitution therapy, and community organizing - and to resist policies that criminalize drug users.
Drawing on examples from China, Iran, Russia, Thailand, Uzbekistan and other countries, Sarang examined factors that foster HIV risk, transmission and excess deaths among drug users. These include state reluctance to endorse evidence-based harm reduction interventions, the fear and terror generated by policies of the "war on drugs", and the social stigma and discrimination exercised through criminal justice agencies, health systems and coerced drug treatment. Using Australia as an example, she showed the ability of evidence-based harm reduction programmes implemented early in the HIV epidemic to contain or prevent HIV among people who inject drugs. Sarang pointed to the strong evidence in support of effective drug policies as a call to action to challenge governments that do not support them and to advocate for structural change to enable the scale-up of evidence-based HIV prevention for people who inject drugs.
Bill Gates to Address Special Session on HIV Prevention on Monday
Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation, will address a special session entitled, Building on Success: A Roadmap for Prevention at 13:00 in Session Room 1. The session will be webcast by the Kaiser Family Foundation and will be viewable through the conference website.
Pre-Conference Meetings Address Key Issues
Many AIDS 2010 delegates arrived in Vienna as early as last week to begin work. Over 300 young people attended the four-day Youth Pre-Conference to network and gain skills in research, advocacy and communications. The BE HEARD! Pre-Conference organized by the Global Forum on Men Who Have Sex with Men (MSMGF) attracted over 500 participants. At the meeting, public health leaders called for an end to the human rights abuses against MSM that contribute to HIV vulnerability. Other pre-meetings focused on strengthening health systems, eradicating HIV reservoirs and children's issues, including the latest models of family-centred care and services for children affected by HIV and AIDS.
Egypt achieves historic malaria-free certification