In September 2016, the United States Conference on AIDS (USCA2016) occurred in Hollywood, Florida. The National Minority AIDS Council (NMAC) organized it. Drug manufacturers, Gilead, Merck, ViiV and others provided financial sponsorship.

While antiretroviral treatment (ART) has saved millions of lives, drug companies charge exorbitant prices for ART. This has not made them popular, despite their coupons and various discounts. The drug companies have priced Hepatitis C treatments even higher. Gilead charges $94,500 for a 12-week treatment for Hepatitis C. A mark-up like that would even embarrass Nieman-Marcus.

These high costs absorb large shares of HIV spending, leaving less for other HIV programs. These same drug companies fund HIV conferences, HIV media, and LGBT media.

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At a lunch session, this tension surfaced. The session was to feature a Todrick Hall performance and speakers, including former MSNBC host, Melissa Harris-Perry. Just before the session began, about twenty people took the stage. They were chanting “Fight Pharma.” They denounced Gilead’s enormous profits as well as its potential influence on the conference. After roughly fifteen minutes, the protest ended. Hall and the scheduled speakers went on. This tension had become visible.

Jeremiah Johnson, HIV Prevention, Research, and Policy Coordinator of the Treatment Action Group spoke at the protest. The next day, he agreed to an interview. Johnson said he had concerns about “the presence that Gilead has at this conference.” He felt that presence could discourage discussion of drug cost.

According to Johnson, an earlier incident illustrated this problem. At a workshop on barriers to hepatitis C treatment, a moderator had prevented Johnson from discussing drug costs. 

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A similar protest had occurred at the Durban International AIDS Conference. The marchers had demanded that medicines should be in the public domain rather than patented. He noted, “Internationally, there's no question that these patents are rigged to create enormous problems for low- and middle-income countries.” Johnson said that the multiple coverage systems in the U.S. obscure the cost of ART.

This tension may have stood out more at this conference than at others. USCA2016 focused on the social determinants of health. Social determinants cause certain diseases to cluster in certain communities.

Some people think of health as an individual possession. Others look at health as a social process or a community resource. People with this view, focus on why certain diseases cluster within certain groups of people. For example, HIV infection tends to cluster in two groups: Black People; and Gay and Bi Men. Among Gay and Bi Men, Black Gay and Bi Men have much higher rates of HIV infection and have less access to treatment. 

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NMAC advocates opening up discussions about race within the HIV communities. It recognizes that people with HIV cannot wait for the resolution of all U.S. race issues. The dynamics of race may be central to reversing the epidemic. Race affects who becomes infected and who has access to treatment. While NMAC advocates “leading with race,” its approach is inclusive of other races, sexual orientations, and gender identities. 

Another lunchtime session focused on the affects that Puerto Rico’s economic crisis has had on its HIV epidemic. USCA2016 had tracks on PrEP, Transwomen, Gay men, Women and HIV, and People living with HIV.

The social determinants of HIV were on full display at USCA2016. When a profiteer of the epidemic funds a conference focusing on social determinants, other tensions go on display.  If no other funders exist, these may have to become creative tensions from which movements grow

To learn more about NMAC, please visit