PRESS CONFERENCE ON FUTURE OF GLOBAL HIV PREVENTION
At a Headquarters press conference this afternoon, a panel of international health experts called on the international community to seize the opportunity presented by the special session to confront the myriad social, sexual and racial intricacies of the AIDS virus in a frank and open manner. In a discussion on the future of global HIV prevention, concerned actors also stressed that while viable strategies to combat the disease were well known, none could be truly successful without increased human and financial resources.
Leading the discussion, Drew Altman, President of the Henry J. Kaiser Family Foundation, a co-sponsor of the press conference along with the Bill and Melinda Gates Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS), drew correspondents’ attention to the important outcome of a Leadership Forum held last Friday here in New York. That conference, attended by more than 130 leading international public health experts and officials, had been convened to examine effective strategies to contain the HIV/AIDS epidemic. The conclusions of that meeting -- including the notion that the high rate of HIV transmission worldwide was testament not to the limitations of HIV prevention, but to the international community’s failure to mount a meaningful prevention effort –- would enrich the ongoing deliberations during the special session.
Mr. Altman said that for him, the various debates and exchanges of views surrounding the AIDS special session, which runs through tomorrow evening, all came down to one thing: money. There were obviously huge challenges even if more resources were provided, particularly in the areas of prevention, treatment and research, but without more resources the international community would not even have the chance to fail in efforts to combat the deadly disease.
He added that he was not alone. Seldom had there been an issue on which there was stronger consensus –- current funding levels were simply woefully inadequate. Other priorities to consider included the idea that HIV prevention initiatives must be based on examples of programmes that worked. Further, the global community must pursue a comprehensive strategy to fight AIDS -– particularly by promoting an integrated approach that included elements of prevention and treatment.
Mr. Altman next introduced a panel of “long-time warriors” in the fight against AIDS, which included Dr. Helene Gayle, Director, National Center for HIV, STD and Tuberculosis Prevention, Centers for Disease Control (CDC); Professor Nkandu Luo, former Minister of Health, Zambia; Professor Michael Merson, Dean, School of Public Health, Yale University, Dr. Daniel Tarantola, Senior Policy Advisor to the Director-General of UNAIDS; Phil Wilson, Founder and Director of African-American AIDS Policy and Training Institute; Ndioro Ndiaye, Deputy Director of the International Organization for Migration (IOM); and Elhadj Sy, Head of the UNAIDS Liaison Office in New York.
Two decades of struggling with and against the measure and magnitude of the various effects of the HIV pandemic, the international community now knew what worked and what did not, Dr. Tarantola said. Young people benefited from well-designed prevention programmes –- particularly when they were involved in their design -- and preventive behaviour could be reinforced or induced when the appropriate methods were applied. Vulnerable populations must receive the support
aimed at decreasing stigma, marginalization and discrimination. Those populations must also be given the means to engage in safer behaviours so they could become the subjects and not merely the objects of international response to the disease. “We know prevention works”, he said, “it is a necessity.
“We also know that we don’t know everything”, he continued. Therefore, enhanced research must support and guide the efforts of international actors. A combination of prevention, care and support initiatives would bring the epidemic under control. Echoing that sentiment, Dr. Gayle added that concerned actors needed to stress the global consensus that prevention and care were bound together. “But since we do know what works in prevention”, she said, “we should not be apologetic about putting in place polices that we know can make a difference”.
Dr. Gayle said the challenge was to take specific successes achieved in a few countries and expand those efforts around the world. The hope would be to boast a wide range of successes at community, regional and national levels within a few years. Ms. Ndiaye agreed, and, using her country Senegal as an example, added that it was time to use unique success stories as models of a global solution to the problem of HIV/AIDS. She also said that going forward, the most important concern for developing countries would be to find ways to update their infrastructures. Without such improvements, poor countries could not sustain their efforts to fight the disease.
Mr. Wilson said that the debate on the merits of prevention as opposed to care was unethical, as well as just plain bad public health. The question was not whether to chose between the two, but how to pursue a comprehensive global strategy to combat HIV/AIDS. The elements of such a strategy included care, treatment and prevention. “Treatment can help prevention”. he said “and perhaps the single greatest underused HIV prevention source is people living with HIV”. In addition, emerging treatment infrastructure could help deliver prevention services, and exiting prevention infrastructure could provide a foundation to expand access to treatment in resource-poor settings.
He also said that stigma must stop. “In the face of derision, fear and sometimes violence, people might not get tested or seek treatment for HIV.” In the face of homophobia, anti-drug hysteria and bias against sex workers, people were less likely to disclose their risk factors. Inevitably, the people most at risk were the most invaluable resources of information and leadership. By sharing their stories and giving a face to a disease that was too often characterized by numbers and statistics, they could inspire hope and promote prevention.
Prevention strategies must also tackle structural problems such as poverty, gender and orphans, he said. The tools were available to fight the disease, but the question was whether the international community could muster the moral and political will to use those tools compassionately and effectively. Ms. Lou said it was important that the international community should see the HIV/AIDS crisis as a crisis with social, developmental and economic aspects. She believed that sadly, the response had so far been limited and segregated, often overshadowed by the stigma attached to those living with the disease. She called on the leaders attending the special session to initiate action on a global level that could lead to concrete results.
Mr. Merson said the main point was that there was a unique opportunity to join together and confront the epidemic in a comprehensive way. At the same time, leaders attending the session should look to the future and ask themselves what
would happen after tomorrow. Would 25 million deaths and the near devastation be enough to rally those leaders to act and not just sign a declaration? What was truly needed was a commitment to a moral and humane approach to treatment and care, as well as ownership of plans and programmes. What was needed above all else was the courage and frankness to talk about human behaviour without prejudice, and to take on controversial issues no matter the risk.
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