International AIDS Conferences are known for their dramatic protests. Tommy Thompson was booed off the stage in Barcelona. Randall Tobias, then head of PEPFAR, silently fumed at the podium for 45 minutes in Barcelona before protesters quieted enough for him to speak. The Prime Minister of Thailand was embarrassed at the Bangkok opening ceremony. AIDS activists, following the tradition of ACT UP! are known for their vocal presence -- and for pushing for real dialogue and action.
CGD Policy Blogs
I attended a packed satellite session on Sunday on South Asia sponsored by the World Bank at the International AIDS Conference in Toronto, in anticipation of a new report released Monday.
Today's Washington Post highlights several AIDS prevention programs in Africa which are using the ABC approach without much success. Programs in both Botswana and Kenya failed to change participants' behavior while another program in Nigeria increased condom use but not fidelity or abstinence rates. The lack of results would make you think that funders would be hesitant to expand ABC programs, wouldn't it? Unfortunately, the opposite may be true.
It's both energizing and exhausting to be at this largest ever AIDS Conference in Toronto. With 25,000+ delegates and an impressive line-up of global, national and community leaders attending this conference, the message is very clear: it isn't just time to deliver, but rather it is Time to Deliver NOW! With 25 years behind us, billions of dollars spent, millions of deaths and millions more being infected there is no time and money to waste.
That was the question at the International AIDS Conference session on "HIV Testing the Era of Treatment Scale Up." As ARVs become more widely available, more people need to take HIV tests to get started in treatment programs. But should Voluntary Counseling and Testing (VCT) be replaced by "Routine Offer" or "Routine Testing" programs? Routine Offer refers to testing programs where all clinic visitors, or those meeting certain risk guidelines, are offered a test.
HIV/AIDS is not gender neutral; the disease disproportionately affects women. Biologically, the virus is more easily passed from man to woman, but even more problematic is the fact that women are often marginalized and discriminated against in ways that deprive them of their agency in choosing when, how and with whom to have sex. Recent studies in India, for example, showed that one of the most at-risk groups for new HIV infection were married women in monogamous relationships with unfaithful husbands.
The Economist is spot-on in identifying transparency in reporting of infectious diseases as a powerful weapon in the global health fight. While Indonesia's government seems to be making moves in the right direction by providing official access to data on avian influenza, the magazine reports, insurgent efforts at transparency are in development, with the Google Foundation head taking charge:
The difficulties of "scaling up" are felt not only in developing countries, which have to figure out how to effectively use large new inflows of aid. On the spending side, a doubling of expenditures by the world's largest foundation is not easily accommodated, either.
As we prepare for next week's International AIDS conference in Toronto, it is a natural time to reflect on progress made and lessons learned in the fight against AIDS. To that end, there is an interesting article at Worldpress.org that asks an experienced development specialist and a veteran AIDS reporter to share their thoughts on lessons learned from the fight against AIDS in Africa.
From the GAVI press release:
This week, Australia becomes the 17th public donor (including the European Commission) contributing to GAVI's life saving mission of preventing the spread of deadly diseases in the world's poorest countries. As it launches a new overseas aid health policy, the Australian Government is committing to a US$20 million contribution to the GAVI Alliance over the next 4 years.