Elite vs. Grass-Root Conflict Emerges at AIDS 2016

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The 21st International AIDS Conference occurred in Durban, South Africa from July 18 through July 22. It had the theme “Access Equity Rights Now.”

Out of all the conference papers, African scientists wrote about a third and women the majority. More than 15,000 people from 153 countries attended the face-to-face conference. The virtual conference tweeted 144,000 times. While about 34,000 people visited the conference’s website, its Facebook posts reached 726,268 people.

Related: With HIV/AIDS Cases on Rise, PrEP is Now Part of The Prevention

This every-other-year conference not only functions as a major scientific exchange. It also functions as a global “meet-up” for the HIV communities. Scientists, advocates, activists, and people living with AIDS or HIV (PLWAH) network at this event. Its location ensured that large numbers of PLWAH from Africa could attend. 

Conflicting views and priorities emerged at this conference. While elites talk about ending AIDS by 2030, PLWAH lack access to HIV testing, prevention and treatment. Every year about 1 million people die from AIDS, a treatable disease. Globally, about 36.9 million people live with HIV or AIDS. More people, 19 million, are unaware of their HIV positive status, than have access to treatment, 15 million. Millions more at risk of HIV infection in resource-poor countries need access to PrEP, but global funding has begun to shrink.

On July 18, PLWAH, activists, and scientists marched through Durban to dramatize this conflict.

This march demanded the following: Provide full HIV treatment for all PLWAH; Create and maintain fully staffed and functional public healthcare systems; Remove patents from medicines and put medicines in the public domain; End discrimination and criminalization of key groups; and Increase funding for the global AIDS response.

The key groups in demand include gay men, sex workers, transgender women, injection drug users, migrants, and prisoners. Many sessions at the conference linked controlling HIV with decriminalizing these key groups.

The conference frequently reflected concerns similar to those of the march. Sessions described a new conception of human rights emerging from the response to HIV. This conception included a right to health care, rejected criminalization of key groups, and rejected HIV criminalization. While these criminalizing laws reflect cultural norms, they reinforce stigmas. Those stigmas form major barriers to testing and treatment, furthering the epidemic. The HIV epidemic has tragically shortened millions of lives, but the global response to HIV may redefine human rights.

Large numbers of PWLAH live in resource-poor countries, relying on donor funding. While increased access to treatment requires more money, international donors decreased their contributions in 2015. Michael Sidibé of UNAIDS said, “I’m scared because we’re seeing – for the first time in five years- a reduction in donor government funding for HIV.” International donor funding declined from $8.6 billion in 2014 to $7.5 billion in 2015. Out of 14 international donor countries, 13 have reduced funding.

Jennifer Kates, of the Kaiser Family Foundation, attributed this decline to competing demands such as the refugee crisis and fiscal austerity.

This donor funding primarily provides services to the key groups in resource-poor countries, such as gay men in sub-Saharan Africa. Decreased funding could have devastating consequences for these key groups. 

Related: August South Florida AIDS Network Report

When elites talk about ending AIDS by 2030, it can sound very hollow to the key groups in resource-poor countries. The emergence of this conflict may give those groups a vice.

To get a feel for the 2016 AIDS conference as a meet-up for the global HIV communities, please visit Mark S. King’s video blogs from the conference, Bit.ly/2aD5E9J .

To read a summary of the entire conference, please visit, Bit.ly/2aanjAI .

To read the Kaiser Family Foundation’s report on donor funding, please visit, Kaiserf.am/2aAPA7c .

Follow Sean McShee on Twitter @SeanMcShee .


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