It's been a week since the closing ceremony of the nineteenth International AIDS Conference (2012). For the first time since 1990 when it was held in San Francisco California, the meeting was held in the US. At that time, American policy makers and many constituents, allowed fear to override science by banning people with HIV from coming to the United States.
In looking back, was that a smart policy? On the positive side, it limited the type of virus that can be introduced to the general or high risk population. On the other side, it made the US appear less than sterling in how we were viewed globally (read isolationist). By limiting who can come into the US, it closed our society to other influences that may have spurred innovation and creativity. This policy may have hindered the development or advances in medical, psychosocial, environmental and structural front of the epidemic. It has been twenty two years, since an international meeting of the scope had been held in the most industrialized country in the world.
The global pandemic. The very thought that 34 million people are known to have HIV/AIDS is mind blowing. It seemed as though we added over one million people every year to the registry, since the virus was discovered in 1983.
At the conference, it was clear that Sub Saharan Africa, East, West and South Africa were hard hit. Throughout the conference you were reminded of how different each nation was affected. Conversely, many nations were held up as examples of what the potential is for the uptake or scale up of certain technologies (testing, universal access to treatment, circumcision) which can save, or extended lives in the region.
Domestically, the focus was on were the epidemic has been in the past few years, namely among young African American men who have sex with other men, Black women, and MSM mostly among Caucasians. Many of the sessions addressing these populations spoke of advancement in using “test and treat,” “treatment as prevention,” or speculation on how affected communities are not embracing current technologies. The clarion call was to do more and better in targeted outreach and taking away the stigma associated with the disease.
There was politics (Regional i.e. the world looking to Arab nations to decriminalize same sex acts, condom distribution, sodomy laws, etc...). There was showmanship in glitterati style among keynote speakers. There was heavy lifting on the scientific and medical communities. There was "showcasing" of how BRICS (Brazil, Russia, India, China and South Africa) can and have done more (either in financial support or encouraging widespread adoption of civil and human rights for populations most affected by the virus). Bill Gates, Elton John, Bill and Hillary Clinton, Anthony Fauci, Phil Wilson was among the headliners.
Most notably was how often, if not at every keynote, plenary session, plus the opening and closing ceremony there was mention of the US role in the global fight against HIV/AIDS. Naming President’s Emergency Plan for AIDS Relief (PEPFAR) making life saving medication be accessible in the developing world to fight the pandemic. The often cited lifting of the travel ban by President Obama , and the billions of dollars given by both government and privately (specifically Bill and Melinda Gates Foundation) that has profoundly affected the lives of millions of people. As Americans it highlighted what we have done positively in the world, in balance to the destruction we have reeked.
There were lots to sort through, in addition to what felt like the swim upstream to the other side of the convention center when sessions ended. There were thousands of people in close proximity to one another.
Today a week later, I still feel fatigue from being overstimulated by the science, the number of people, the heat, the hope and promise of how we as a people are making advances in slowing the rate of death, decreasing mother to child transmission, and the armory of medication that has been part of the tool kit in the struggle to decrease human suffering.
I also have circling in my head how stigma and discrimination persist. Now we are devising tools for explaining what these abstract notions are, so that we may develop a strategy for decreasing stigma and eliminating discrimination which has contributed immensely in preventing people from testing or receiving treatment.
I felt an affirmation in being among the legions of people who work and experience minor triumphs in fighting the epidemic. I looked at the 21,000 delegates as a small sample of the numbers of people globally who are in this struggle for uplifting the lives of many.
I had renewed my commitment to the fight some 5 years or so ago, after taking an extended hiatus from direct involvement (read care) in the HIV/AIDS arena. Now, I am clear as to what I can contribute too. Much of my focus in the past seven years has been in prevention and education. I look at the intersection of ethnicity, language, culture, risk behavior in the area of prevention and testing, in hopes of advancing how to approach different communities with the right tools. I want to be the front line of the battle and no longer in the thick of the epidemic, where I cared, mourned and struggled on, as close friends and allies became the casualties of the fight. In their memories, I am sustained by their courage, silent support of being part of the solution, and our close friendship.
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