A Thai girl highlights the problems of stigma faced by many of those with AIDS. Pictures: Paul Jeffrey, Ecumenical Advocacy Alliance.

23rd July, 2004

DAVID ADAMS

Since it was first diagnosed more than 20 years ago, HIV/AIDS has killed more than 20 million people. Another 38 million are currently estimated to be affected by the disease with as many as two-thirds of them living in sub-Saharan African where up to 20 per cent of the adult population is affected.

The battle against AIDS is far from over.

Almost 20,000 delegates gathered in Bangkok last week for the 15th International AIDS conference to hear of the latest developments and newest threats in the fight against the disease - “described as the most devastating disease humankind has ever faced”.

There they debated the pros and cons of approaches such as the ABC - “Abstinence, Be Faithful, and Condom Use” - advocated by, among others, the United States, lobbied for more money and resources to be put into the fight or took a few minutes to gawk at the line-up of stars who flew in to lend their faces to the event - Nelson Mandela, Richard Gere, Sonia Gandhi and Australian-born Miss Universe Jennifer Hawkins to name a few.

While there was much talk of the success of antiretroviral drugs in treating HIV/AIDS and reports on ongoing research into the development of a vaccine - seen as the only way to completely put an end to the pandemic, those at the conference were also reminded that the battle against AIDS is not just about finding a cure or minimising the risk. It’s also about overcoming the discrimination those who suffer it face.

An elephant entertains delegates outside the AIDS conference in Bangkok last week.

“More than twenty years after the first reported case, stigma and discrimination continue to undermine efforts to prevent HIV and to encourage early care,” Dr Joep Lange, president of the International AIDS Society, said on the last day of the conference.

“Due to fear of rejection and reprisal, many people live with HIV in silence, and what was true in the early years of the pandemic is still true today: silence equals death.”

One of the important messages to come out of this year’s conference was recognition of the important role religious leaders can play in helping to overcome discrimination, a point emphasised by the director of UNAIDS, Dr Peter Piot. He challenged religious leaders “to play an expanded role, not just in the delivery of care, but in leadership to address those social factors which make people vulnerable and fuel the epidemic”.

Dr Piot's comments found support in those of Hilde Frafjord Johnson, Norway’s minister of international development, who challenged religious leaders from all faith traditions to help break the taboos and silence that contribute to stigma and suffering.

“Religious leaders are in a unique position to influence and inspire,” she said. “They can reach into people’s hearts and minds in a way no other group can. They can change norms and values. In many countries, faith-based committees and societies are also the best civil society network in existence. Religious leaders must realize the power they have in the fight against HIV/AIDS, and use it to the fullest.”

With the theme of the conference “Access for all”, many delegates used the opportunity to call for a dramatic ramp-up in access to HIV/AIDS treatment in the developing world with figures showing that only some seven per cent of the five to six million people needing HIV treatment in low and middle-income countries had access to treatment by the end of 2003.

The figures show that if current rates of infection continue, without access to treatment as many as 60 per cent of people now aged 15 living in Africa will not reach their 60th birthday.

The World Health Organisation (WHO) and UNAIDS have previously announced a shared goal of ensuring three million people have access to HIV treatment by 2005.

Conference participants also highlighted the plight of women, with data showing that the proportion of women living with HIV/AIDS has grown from 41 per cent in 1997 to 48 per cent as at the end of last year.

The conference was told that women are often unable to prevent infection because of their inability to negotiate safer sex due to imbalances of power, the lack of female-controlled HIV prevention methods such as microbicides inadequate knowledge of HIV/AIDS, and the lack of access to sexual health and educational services. Poverty can also fuel HIV transmission as women engage in unsafe sex in exchange for money, housing, food or education.

Young people are also at risk with as many as half of the 14,000 people newly affected with AIDS each day aged between 15 and 24 and as many as 2,000 aged under 15.

Several speakers identified a lack of access to health and information services and a failure to promote educational messages in a manner that engages their interest as key obstacles in working with young people.

While speakers at last week’s conference acknowledged that many of the greatest challenges in the fight against AIDS - such as the lack of a coherent approach and failure of political leadership - are those of our own making, United Nations Secretary-General Kofi Annan this week called on national leader around the world to continue the fight against the disease.

“They must speak out and they must put many, many more resources - much, much more - into the fight. This is a fight we have to win.”

Whether last week's talk-fest will result in victories - small or large - remains to be seen.

- with reporting by Paul Jeffrey of the Ecumenical Advocacy Alliance (www.e-alliance.ch).