Day 5 of attending AIDS 2014 and there’s still so much to see and become aware of. Continue reading
I sorta knew it was going to be special day when walking along South Bank this morning towards the convention centre and seeing the sun reflecting off the top of the Rialto building and it’s ray splitting into shafts of ethereal light through the clearing fog.
“No one left behind” was the name and theme of the first session I attended and although I was late I got there in time to see Daisy Nakato Namakula from Uganda an HIV positive sex worker and activist and an advocate for sex workers rights in Uganda. She is an Executive Director and member of the Women’s Organisation network for human rights advocacy ( WONETHA) founded in 2008 and in Uganda the emphasis is on harm reduction networks which work with female, male and transgender sex workers
With a gentle yet firm voice Daisy started off by making perfectly clear that she chose to be a sex worker and that she did not wish to be treated as a victim although stating that her position did not apply to all sex workers. She told of how she had educated herself, learned English in order to have her voice heard on the world stage so that she could represent herself and other sex workers rather than have outside agencies speak and act on their behalf who she felt could not fully understand what life was like in her industry. Donors gifts of sewing machines to empower women and help prevent HIV is, in her view, not helpful “what use is a sewing machine in the reduction of HIV”? Audience response to this statement received great applause.
What Daisy wanted to see was continued financial foreign aid despite the fact that Uganda has introduced laws such as, The Anti Homosexuality Act AHA, The Anti Pornography APA and The HIV and AIDS bill 2014, which have contributed to many donors pulling out of Uganda.
She made it clear that HIV is a global disease and not one confined by geo political borders. She gave herself as an example of how the disease is mobile…being an HIV positive sex worker here in Melbourne, at a conference, able to carry on her business, if she chose to, and potentially infect others here. A compelling argument that is hard to refute.
The laws, AHA, APA are making things increasingly difficult in Uganda for key populations such as sex workers and the LGBTI community to readily access HIV health care. The criminalisation and increased stigma has led to violence from the people that should be protecting them such as the police and institutions. These laws are marginalising them further and in so doing are contributing to the increasing numbers of those becoming infected with HIV.
So I see a recurring theme here at conference that in many countries continued criminalisation, stigma, intolerance and ignorance are helping the spread of the HIV. That conference is not just about finding a cure or a vaccine, would that it were, it’s so much more than that. There is the continual battle for human rights across the globe, allowing free unfettered access to quality health care and harm reduction programs.
People like Daisy, who very bravely stand up and speak are making a real difference along with the youth, which have been very much in evidence here. The future of an HIV free world lies with these amazing people just as much as those wonderful people methodically working through their science to find a cure.
As I said this was a special day, Bill Clinton, addressed a packed to the rafters hall, in which I managed to secure a good seat. A small video clip saw his daughter Chelsea visiting a liitle boy Basil in Cambodia who had been born with HIV abandoned and on the brink of death who now as a boy was enjoying the childhood he deserved because of the medication he received,
In 2002, the Clinton Health Access Initiative (CHAI) began as the Clinton HIV/AIDS Initiative to address the HIV/AIDS crisis in the developing world and strengthen health systems there. Taking the lead from governments and working with partners, CHAI works to improve markets for lifesaving medicines and diagnostics, lower the costs of treatments, and expand access to life-saving technologies — creating a sustainable model that can be owned and maintained by governments.
His presence at conference was not only an opportunity for him to speak of his organization but also gave a tremendous psychological boost to those attending particularly in light of the MH17 tragedy that has overshadowed the conference this week.
—– By Tony Judson
The importance and quality of work being done in areas of HIV/AIDS research and development, treatment and prevention as demonstrated at this conference cannot and should not be underestimated.
Today my focus turned towards the global access of affordable anti HIV and HEP C treatment and the remarkable steps that have been taken to ensure as many infected people as possible have access to these life saving drugs, particularly in the case of HIV.
Inspired initiatives have come from some of the developing countries like India, Thailand and Brazil who have legislated against drug patents and in doing so have made available to those infected with HIV, life saving drugs.
The way the aforementioned three did this was to first legislate against drug patent laws in their own countries, then set up the manufacturing capability to produce their own generic products dramatically reducing costs. In the case of Thailand for example, costs came down from US$490 to US$31 per patient per month.
These countries are also, at present, able to supply anti HIV drugs to other countries of similar GDP.
Sadly however, some of the big pharmaceutical companies are now attempting to buy out this capability and litigating extensively so that production of affordable drugs will be severely compromised in the future with catastrophic consequences.
One of the major co infection issues in the HIV/AIDS context is Hepatitis C. New and more effective treatments are now available for Hepatitis C but they’re incredibly expensive. A new drug, Sufosbivir, produced by Gillead is $1000 per pill, or $84, 000 for a twelve week course. No that isn’t a typing error! Gillead is considering reducing the cost of Sufosbivir to $2500 for developing countries, which still makes it barely affordable .
Onto this afternoon when I attended ” Reforming drug policies to end HIV and AIDS epidemic among people who inject drugs”
Justice Michael Kirby co-chaired this session. Sir Richard Branson spoke live via Skype supporting the need for the decriminalisation of drug injecting and the scaling up of harm reduction services within those communities in all countries.
Professor Kate Dolan, who, with others, was instrumental in introducing the first needle exchange programme here in Australia in 1986 have the data to show that such an initiative has, beyond doubt, reduced HIV and Hep C infection.
New Zealand was the first country in the world to introduce the clean needle exchange program and the latest data shows that only 1% of its IV injecting population is HIV positive. Australia being a little behind New Zealand was the second to introduce such a program and has 5% of its drug injecting population infected with HIV.
Countries who have high incidences of IV drug injectors that do not have access to clean needles are having a very different experience, the USA for example has 16% of its IV drug using population now HIV positive, a sobering thought.
Needle exchange programs along with decriminalization are powerful initiatives that will help in bringing down community viral load of both HIV and HEP C and it will require strong leadership at a political level in all countries to institute them with undeniable bio socio and economic benefits, particularly in light of increasing costs in treating both infections, cost not being the only imperative.
So, I’ll finish with this:
“In addition to criminalizing HIV transmission, many countries impose criminal sanctions for same- sex sex, commercial sex and rug injection. Such laws constitute major barriers to reaching key populations with HIV services. Those behaviours should be decriminalized, and people addicted to drugs should receive health services for the treatment of their addiction”.
UN Secretary-General Ban Ki-Moon
—- By Tony Judson
Ladies and Gentlemen
Before I say anything further, I want to add my thoughts to all of those who died in the Malaysian airline tragedy over the Ukraine, and particularly pay tribute to those people who were on their way to Melbourne.
Their efforts in meeting the challenges of AIDS and HIV will not go wasted.
Their work, their intellect, their commitment and devotion to helping others; so many qualities perished with the death of those people. They will and must be remembered.
Ladies and gentlemen, it is a privilege to be here tonight to help launch the ENUF Voices Exhibition.
It is an accident that I am here in many respects.
Given I am viewed as a crusty old Tory with embedded old-fashioned values, thanks to middle-class conservative parents from the cosseted stockbroker belt of Surrey in England, some say to me how did you get involved with ENUF and the efforts to remove HIV stigma?
Well, ENUF’s real target was my wife, one of Australia’s most loved people – Natasha Stott Despoja. Natasha is now Australia’s Ambassador for Women and Girls and Chair of the National Foundation to end violence against women and their children.
18 months or so ago Natasha was asked to be an Ambassador for ENUF. She accepted and in the discussion was told that the campaign needed heterosexual men, preferably from senior levels in business, to help challenge HIV stigma and take a role in pushing to end the isolation that many with HIV feel.
So here I am; playing a very small but passionate part in working with other Ambassadors and the superb team at LivingPositive Victoria to remove the fear of disclosure for those living with HIV.
What I have learned and from the many conversations I have had, I have become passionate about playing a part to change attitudes.
HIV stigma is the single most important barrier to public action because people are so concerned about the disgrace or humiliation of talking about it or taking available precautions.
It remains an undeniable fact of life that many people think those with HIV should be excluded from so many aspects of modern life.
Thankfully that number of people is reducing – thanks to the leads set by individuals such as you and me, to companies to governments.
The lead from the ENUF pledge so people do not sit by and take action when others gossip about, reject and/or promote negative stereotypes about people living with HIV.
The lead from 40 of the world’s leading CEOs who signed a pledge in 2012 opposing HIV restrictions, calling them discriminatory and bad for business.
Even the lead from governments – and while we are quick to criticise, we should also be open to welcome positive steps. Indeed our Government has recently determined that people living with HIV do not face an automatic exclusion, or unequal treatment when applying for entry, stay or residence visas.
HIV is obviously regarded as something that is most prevalent among gay men, but it is wrong to see the challenges of HIV, which is once again increasing in numbers, through such a generalised prism.
Most people deal with HIV and lead normal, healthy lives.
But some do not.
Many men and increasing numbers of women are infected by men who often knowingly have contracted HIV from a previous sexual encounter.
That makes me incredibly angry and can be justifiably regarded as cowardly and weak behaviour.
But anger does not deal with the challenge of changing the behaviour of these men.
Making these men understand they must talk about HIV, seek treatment and protect others when they have sex is the goal we must focus upon.
Changing attitudes should not be the domain of sectoral or sexual interests alone.
It is not for the “Gay Community” to lead the charge alone.
Indeed, I often feel we must stop dividing “community” as it is better when we work as one.
Those of us who are not traditional allies in the HIV debate must step up.
What my conservative father always taught me was to try to show respect to others.
He could have his streak of mirth, sometimes misguided but never malicious, but he would always be respectful to others not like him even if he viewed himself as “normal”.
So perhaps it is no surprise that I am part of the campaign.
Respect must be our bond – straight, gay, male, female, HIV or not.
Just as we have removed the stigma of so many problems in society – depression being a prime example – so we can remove the stigma of HIV.
But to do so we must all talk about it, understand it and deal with it.
Back to my opening remarks – it is a privilege to be part, a very small part of the ENUF campaign and I wish ENUF voices, Outrage HIV Justice Film Festival and Beyond Blame every success and urge people to listen and learn over the forthcoming World AIDS conference.
Arriving today at AIDS 2014 was a very different experience. A real vibe had entered the space, nothing subdued about it.
Straight to Melbourne Room 2 for “Criminalisation of Key Populations: How to respond to HIV?
This presentation started off with a speech from the US Ambassador to Australia John Berry and with conviction in his delivery he stated that we are ” on the brink of an AIDS free generation” qualified only by the need for continued determination to make that happen.
He went on to say that criminalisation of HIV and it’s inevitable companion stigma hamper the logistics in delivering quality public health policy. Simply put, criminalisation compounds the HIV/AIDS epidemic rather than diminishing it, then concluding with the observation that services are useless if people fear accessing them.
Three successive speakers, including Nick Rhoades, a US citizen from Iowa, who in 2008 was charged, prosecuted and imprisoned for ” criminal transmission of HIV” . He was aware of his HIV status was on medication had a non detectable viral load and wore a condom. On discovering Nick’s HIV status the person he had sex with went the police. Nick spent a year in prison but continues to be affected by his experience in a very personal way.
We heard that the re-criminalisation of homosexuality in India has contributed to blackmail, extortion and violence against LGBTI communities. Despondency, fear of arrest, violence and stigma is a daily reality for people living there.
In Nepal, there is arbitrary use of the law to make arrests for “unnatural sex” ( as yet undefined) even to point where police officers will apprehend those who they anticipate will be engaging in said unnatural acts, telepathy alive and well in them thar mountains in seems!
To Uganda where recently introduced Anti Homosexuality laws have been enacted which will inevitably contribute to an upsurge in HIV infection rates. This draconian law will of course make it nigh on impossible for the vulnerable to access adequate health care because of the fear of arrest and imprisonment let alone the stigma that will have been legislated vicariously.
The legislators on the panel included Justice Michael Kirby who told his audience to “get real” by implementing change rather than continuing to just talk about it. He pointed out that the democratic process must work in the interest of ALL citizens and furthermore laws not enacted ( in Australia ) should be repealed saying “it’s not a good look” to have them still on the statute books.
So it seems to me that countries like Australia must do all it can, in the way it legislates, to help reduce stigma and marginalisation of minority communities who are vulnerable to HIV/AIDS.
Australia must continue to set an example by responsible and informed public health policy decision making. It must repeal unused and redundant laws completely. Decriminalising HIV will contribute greatly to community viral load reduction and hopefully by 2030 it will have contributed to the irradiation of HIV altogether.
Interestingly as I write this I can hear, in the background, the Melbourne Gay and Lesbian Chorus singing “ain,t no mountain high enough” !