Moving from the margins
Bangkok ‘ Once a rallying cry of activists, now the theme of the 15th International AIDS conference, ‘Access for All’ is firmly on the world agenda.
It is perhaps no coincidence that an activist slogan became the theme of the bi-annual meeting which this year drew more than 19 000 delegates to the five-day event that ended on Friday.
Early on in the week head of HIV/AIDS at the World Health Organisation (WHO), Dr Jim Yong Kim acknowledged that many recent developments in finding ways to provide ‘access for all’ were as a result of pressure from AIDS activists.
He invited further engagement calling on activists to ‘hold our feet to the hottest fire, adding ‘if you don’t continue to push us, we will falter’.
In recent years the WHO itself has transformed from an organization that confined itself to providing advice on frameworks and protocols for public health policy to an agency participating in the delivery of treatment for people living with AIDS.
In its ‘3X5’ campaign, the WHO has set a target of 3 000 people on antiretroviral therapy by the end of 2005 as part of an initiative to expand and scale up treatment.
Chief among the challenges facing the broadening of treatment, prevention and support to people worldwide living with HIV/AIDS is the question of resources.
The Gobal Fund to Fight HIV/AIDS, TB and Malaria has approved 227 grants in 124 countries and disbursed $232 million. But estimates by UNAIDS say that $12 billion are needed by 2005 and by 2007 this amount will rise to $20 billion.
Countries most in need of resources are those with high HIV prevalence rates ‘ South Africa, Nigeria and Ethiopia ‘ and countries with lower percentages of infection but with very large populations such as India, China and Russia.
For South Africans the furore created by statements from the health minister and disputes about resistance to the antiretroviral drug nevirapine created a diversion which disappointed many.
How the health department will draw on and interpret the work presented by scientists on this topic remains to be seen.
‘We wanted to come and discuss the difficult issues of how to implement antiretroviral therapy and procure a secure supply of drugs,’ said Treatment Action Campaign chairperson Zackie Achmat.
‘There is profound disappointment at how our government handled this conference,’ he added.
Despite his retirement from public life, former President Nelson Mandela attended no less than three different sessions of this year’s the international AIDS conference.
Speaking at the closing ceremony ‘ his third such appearance since he spoke at the closing of the International AIDS conference in Durban 2000 ‘ Mandela said despite his retirement he could not rest until he was certain that the global response was sufficient to turn the tide of the epidemic.
Mandela called on donors, both governments and the private sector, to ‘substantially increase’ their funding for the fight against AIDS and stressed the need to include a human rights based approach to the pandemic.
‘As former prisoner number 46664 there is a special place in my heart for all those who are denied access to their basic human rights. We urge countries to make the policy changes that are necessary to protect the human rights of those who suffer from unfair discrimination,’ he said.
Referring to his 86th birthday which he celebrates today (July 18) he said he could ask for no better birthday present than that ‘there is renewed commitment from leaders in every sector of society to take real and urgent action against AIDS’.
The importance of vision and leadership in the struggle against HIV/AIDS had been integrated into the conference programme throughout the week under the patronage of former Mozambican first lady Graca Machel.
Urging the world to greater action and renewed urgency, UNAIDS executive director Peter Piot said the impact of AIDS would be long term.
‘Let us have no illusion that in a few years the world will return to what was before AIDS,’ he said.
Piot said AIDS had ‘rewritten the rules’. In response he said exceptional actions were needed be they on the rules of finance, development, trade, activist strategies, public service delivery and fiscal ceilings.
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