AlertNet Deputy Editor Tim Large is at the 15th International AIDS Conference in Bangkok. Here are tidbits from his notebook on the fourth working day of the world’s biggest AIDS meeting.Thursday, July 15, 2004
Looking frail but feisty, Nelson Mandela takes to the stage to remind us why he set up his “46664” global campaign to raise awareness of AIDS in Africa. He receives cries of adulation and a standing ovation in the packed arena.
“It is always pleasing to see such response, especially as I have recently announced my stepping back from public engagements,” he says. “It is also pleasing, as I am aware that as an old age pensioner, and as I am constantly reminded a former president with no power and even less influence.”
He may be right about the power but he’s wrong about the influence.
African leaders were conspicuously absent at this conference despite the devastation AIDS has caused on the continent. The only head of state to who did turn up, Ugandan President Yoweri Museveni, stoked rage on the first day by saying abstinence -- and not condom use -- was the best way to stem the spread of AIDS.
“Leadership involves personal commitment and concrete actions,” Mandela says. “Leaders must mobilse and inspire people to respond to the crisis. They must lead the response with clear vision and imaginative action.”
Many will take that as a swipe at South African President Thabo Mbeki, who has in the past questioned the link between HIV and AIDS and failed to recognise the seriousness of the pandemic – and this in a country with the highest infection rate in the world.
And Mandela's words are a rebuke to plenty of other world leaders too.
“Our inability to act decisively on this challenge is a direct reflection of our disregard for our common humanity,” Mandela says.
Will his words sway and inspire world leaders? Guess we’ll know at the next AIDS powwow two years from now in Toronto – if it’s not too late.
HOW WAS IT FOR YOU?
It’s official: The 15th International AIDS Conference is the biggest such meeting in history.
According to final figures, 17,001 delegates forked out as much as $1,000 each to take part. Things wind up on Friday afternoon with a closing ceremony featuring Nelson Mandela and Sonia Gandhi, the icing on the cake of a $17-million, week-long extravaganza devoted to the fight against AIDS.
Was it worth it? It kept AIDS in the news for a week and put an awful lot of experts under the same roof. It produced a scuffle or two and reminded the world that condoms can be fun. In theory, it has set the agenda in AIDS research and policy for the next two years.
I take a straw poll of delegates to see how it was for them.
“It’s been very empowering,” says Barinem Vulasi, executive director of the Ogoni Youth Development Project in Nigeria. “It’s challenging. The oral presentations and lectures have opened new doors for me when I get back to Nigeria.
Mandi Taruvinga, director of a group called Good Practice that upholds NGO standards in southern Africa, isn’t sure the content justifies the price.
“I was looking for something more but I didn’t get it. I’m looking for exploration of issues at a very high level.”
Tom Flavin, public relations officer for the U.S. President’s Emergency Plan for AIDS Relief, is more upbeat. “I found the whole experience rewarding, and I think most of the people here will come away with hope.”
HOME-GROWN HEALING
At a panel discussion on the use of traditional medicine for treating AIDS and related illnesses, doctors from Africa and Asia present research on indigenous therapies and call for traditional approaches to be included in the anti-AIDS arsenal.
With so much attention focused on the search for a vaccine and the science of antiretrovirals (ARVs), it’s easy to forget that for swathes of the world traditional healers are still the first port of call for AIDS sufferers.
The U.N. World Health Orgnisation (WHO) estimates up to 85 percent of people in sub-Saharan Africa get their health care from healers, who are influential members of local communities.
“Therefore, for any health programme to be successful in Africa, healers must be involved,” says Erick Gbodossou, a doctor at PROMETRA International, a group devoted to advancing the arts of traditional medicine.
But is it good science? Studies suggest it may be.
Zeng Yi, a scientist at the Foundation for Prevention of STD and AIDS in China, treated 1,000 HIV-positive people with low CD4 cell counts with a cocktail of four traditional Chinese herbs over six months.
He says the effects on body weight and appetite were dramatic. Fatigue decreased, skin rashes disappeared and CD4 cell counts rose.
“We need to overcome the ignorance and misconceptions surrounding these traditions,” says Mary Ann Burris of the Trust for Indigenous Culture and Health in Kenya.
TO THE PEOPLE
In an interview, Ganyam Nyamndi Godlove tells me how the Cameroon government is encouraging people to get voluntary AIDS tests and counseling by setting up grass-roots committees to inform and educate at the village level.
“Because no one tribe or culture will be the same,” he says. “You have a culture where they do mass circumcision of kids using the same instruments. When you come to this type of society, if you don’t know the culture, if you don’t know that this is what is happening, you will not be able to help them in any way.
“You will be saying prevention, prevention, prevention. But how? You must know the means of transmission before you can break it. That is our major principle in attacking at the grass roots.”
He says more and more people are turning up at testing centres set up in every province. Villagers pay 25 percent of costs and the government pays the rest.
Prevalence rates in the general population stand at around 11.5 percent in Cameroon. About 560,000 were infected as of the end of 2003, out of a population of 16 million.
About 9,000 people are currently on ARVs, but the government hopes to triple that number by slicing the cost of drugs by two-thirds in the next few weeks, Godlove says.
“The grass roots approach that we have taken can be applied or copied by any other African country."
STIGMATISING STIGMA
Posters up around the convention centre put it bluntly: “Stigma kills.”
After days of talking with those on the frontlines of the war against HIV/AIDS, my notebook is overflowing with examples of the truth of that statement.
Stigma splits families and breeds discrimination. It makes the vulnerable more vulnerable. It blocks access to vital support and information.
“As women living with HIV, the environment in which we live has a lot to do with how we cope,” says Beatrice Were, HIV/AIDS team leader for ActionAid Uganda.
Were works with women and girls subjected to brutal rape in northern Uganda, where the Lord’s Resistance Army has forced thousands of indigenous Acholi girls into sexual slavery. Many of those who escape face terrible discrimination.
“For us the struggle is a daily struggle to live,” she says.
But stigma thrives the world over, often denying people with AIDS access to life-saving treatment.
“In Thailand, some HIV-positive women who are on ARV programmes get rejected if they are pregnant,” says Monruedee Laphimon, programme coordinator for the Southeast Asian Consortium on Gender, Sexuality and Health.
“They are branded. People say, why did you get into this situation?”
The problem is especially acute in India.
“Doctors are the problem,” says Sunita Abraham of the Christian Medical Association of India. “People get listed (as HIV-positive) and then the discrimination starts.”
Dr. I.S. Gilada, honorary secretary general of the Peoples’ Health Organisation, tells me many Indian doctors charge HIV patients four, five or even 10 times normal rates. He says the government is working on an anti-discrimination law that could help.
“Doctors are scared AIDS could be transmitted,” he says. “But basically it’s because it is related to sex. We have a double-standard society -- below-the-carpet all dust, above the carpet all clean. That’s the main reason.”
With more than 4.6 million people infected in India – and amid signs the disease is spreading beyond high-risk groups into the general population – experts say the country can ill afford not to tackle stigma head-on.
Members of the Eastern Africa Standby Brigade from Uganda queue to board a French tactical aircraft C160 Transall at the French Air Base 188 in Djibouti, December 5, 2009. The EASB ...
