Policy wonk, human rights advocate, AIDS researcher, feminist. Graduate student in social policy at Oxford University. Rotary Global Grants Scholar.

Aug 7, 2016

Reflections on #AIDS2016

Looking back on my time in Durban, South Africa for the 21st International AIDS Conference.

Scenic palm trees near the Indian Ocean.

The past several weeks have been a time of reflection on the global response to HIV. The last time the International AIDS Conference was in South Africa was in 2000, a time when treatment costs were exorbitant and drugs were only available to a select few in high-income settings. AIDS2000 ignited the movement to address the AIDS epidemic, with people taking to the streets and calling for governments to uphold the right to health.

One of the most amazing attributes of the International AIDS Conference is its unity of a movement. The conference doesn’t just attract world-leading scientists and social science researchers, but is also inclusive of policymakers, community leaders, practitioners, activists and, perhaps most importantly, people living with HIV.

A setting as diverse as this fosters critical conversation, to “call the bullshit” as several of the organizers prompted delegates to do. Our community did this in 2000. We did this again at AIDS2016.

We are at a critical point in the AIDS response. The Millennium Development Goals set forth by the United Nations just expired and we are now in the post-2015 era of Sustainable Development. As we took stock of progress, it became clear that we have made many gains in the global response to HIV. Seventeen million people are now on treatment, an almost unimaginable number compared to 2000 (UNAIDS, 2016). However, 20 million still lack access and access to treatment is only at 50% for children (UNAIDS, 2016; UNICEF, 2016).

So while we celebrate our gains, we need to challenge complacency in the movement for accepting the status quo. We need to hold governments accountable and address the broad structural issues that impact the spread of HIV: Restrictive trading policies, homophobia/transphobia, HIV-related stigma, lack of education, and criminalization. It became clear that this last issue — criminalization — is one of the key topics emanating from the conference. How can we even begin to reach the most vulnerable people for HIV prevention when someone’s identity (i.e., being gay, injecting drugs, selling sex, etc.) can have them imprisoned and subjected to human rights abuses?

The Durban International Convention Centre.

Mid-week, I was on a panel with researchers and leaders from the Center for Disease Control (CDC), the US Agency for International Development (USAID), the Amsterdam Institute for Global Health, and from multiple non-governmental organizations in Kenya. This panel focused on male circumcision practices and, in particular, moving forward in scaling up the intervention. As a part of the panel, I presented my senior thesis, in which I created an interaction model between two HIV risk factors to assess their joint impact on HIV prevalence. All of our papers on diverse topics within the field of male circumcision highlighted challenges and innovations in efforts to promote the uptake of the practice.

At the end of every AIDS conference, delegates leave feeling inspired by high profile speakers, which at AIDS2016 included Bill Gates, Prince Harry, Sir Elton John, and Michel Sidibé (Executive Director, UNAIDS), among others. But more so perhaps, we leave feeling inspired by the solidarity of the movement. Nearly 16,000 delegates from all around the world gather every two years for us to take a look back on progress, set new goals, and recommit ourselves to the movement for human rights. With 16,000 change-makers strategizing and working together, one can’t help but be inspired.

Beyond this, having the conference in South Africa — a country at the epicenter of the AIDS epidemic — certainly facilitated reflections. South Africa is a beautiful country with equally wonderful citizenry. Even as an outsider, I could feel the strong sense of community in Durban.

View of the Indian Ocean from nearby Golden Mile promenade.

Coupled with this strong community is profound inequality. Driving back to King Shaka International Airport, inequality stared me in the face: To the left, slums. To the right, mansions. AIDS feeds off of inequality and, in order for us to end the AIDS epidemic, we have to address not just economic inequality, but sociocultural and political inequalities that impact HIV risk and individual’s abilities to seek HIV testing and treatment.

We are at a juncture in the AIDS response. We can finally say that we can be the generation to end AIDS. We can also be the generation that failed to place human rights and human dignity at the center of global development for social progress. In a time when financial resources for the AIDS response are dwindling and 13 out of the 14 major international donors reduced their contributions in the past year alone, we need to go back to the initial call to action to “call the bullshit” and hold donors accountable to their commitments to ending the epidemic. Without a revitalized movement, AIDS will resurge and the progress made to date will regress.

Let’s have AIDS2016 be as influential as AIDS2000 in galvanizing a movement. Let’s scale up interventions. Let’s innovate new social policies and social protection mechanisms. Let’s ensure sustainable financing. And most importantly, let’s #EndAIDSNow.