2016 Annual International AIDS Society letter By Owen Ryan.
Think back 15 years ago, just after the turn of the millennium. Picture yourself walking down the street, turning to a stranger and asking him or her to name the biggest health problem in the world. The likely answer: AIDS.
If you tried that same experiment today, AIDS probably wouldn’t make their list. That’s a good thing. We’ve made dramatic progress in the fight against HIV. But AIDS still continues to claim many more lives than most people realize.
In 2014 alone, 1.2 million people died of AIDS. Worryingly, HIV-related deaths among adolescents have tripled since 2000 – an alarming increase, and, while new HIV infections are falling globally, they are on the rise in many countries – mostly in the developing world and among key populations, such as men who have sex with men, transgender people, sex workers and people who inject drugs.
Today, many people aren’t benefiting from increased access to comprehensive HIV prevention, care and treatment services: young women and girls are not adequately supported to make their own health decisions; many men who have sex with men are unable to be honest with health care providers for fear of being harassed, arrested or jailed; migrants are excluded from many national health systems; men and boys are not accessing HIV treatment as readily as they should because health services are not adequately promoted as avenues for managing men’s health; sex workers and their clients are discouraged from seeking healthcare by punitive laws; transgender people find both prejudicial and uninformed health care workers a barrier to accessing services; and people who use drugs frequently risk detention if they seek out care.
In this way, the “global HIV epidemic” is a misnomer. There is not just one epidemic. Some people in some places are witnessing historic success – they can access and afford a variety of lifesaving HIV prevention and treatment options and live knowing their rights and freedoms are protected. In many other places, where political commitment to HIV is weak, health systems are deficient and human rights are persistently violated, the picture is bleak.
There has been a great deal of discussion in policy circles about already having the tools we need to end AIDS. We’ve set a deadline, created targets and updated global treatment, care and prevention guidelines to help us reach our goal. At the global level, our discourse is infused with cautious optimism and determination.
BUT IN FAR TOO MANY PLACES IN OUR WORLD, THE END OF AIDS IS STILL AN ILLUSION
Not only are there fewer signs of progress, there is growing skepticism around whether the world will follow through on commitments to bring the epidemic to an end.
The reality is that our global pronouncements are often slow to be taken up in the real world. And in the fight against AIDS, delay is tantamount to defeat. If we are to truly end AIDS, we must ensure that sound science grounded in human rights approaches is more rapidly and thoroughly put to use to achieve concrete results for people – especially those who are marginalized and socially excluded. AIDS will not end until those at the very forefront of the epidemic – those whose voices are all too frequently insufficiently heard in the hallways of political power and influence – have access to the latest scientific and biomedical advancements that we know are so critical. And access to these will not be attained until human rights considerations, and their inextricable links to HIV, are squarely addressed. Unless this is done, AIDS will not be over. We must be sure our efforts succeed in all places and for all people. Only then can we declare victory.
Recognizing the profound challenges ahead has led us to re-examine the role, purpose and position of the International AIDS Society (IAS) in the global response to AIDS. Over the past year, we consulted with hundreds of our members and partners to better understand what they need from us. The result is a new direction for the IAS, embodied by our organizational strategy for 2016-2020. It rests on three pillars:
- Science: Pushing for the full spectrum of scientific achievement – from basic science to implementation research – and using IAS’ convening power to highlight dynamic, innovative work.
- People: Ensuring that those responsible for putting science into practice – researchers, physicians, nurses, laboratory workers, community workers and civil society – have the resources they need to do their jobs.
- Progress: Driving rapid and sustained improvement in health outcomes by using IAS’ scientific authority to move science into policy and policy into tangible impact against the epidemic.
As a membership-driven organization, we have a responsibility to move beyond rhetoric and spotlight evidence-based, human rights-centred solutions to the epidemic everywhere in the world. It is our responsibility to represent our members – including frontline HIV workers – to the normative, regulatory and policy-making bodies that impact their work. To be a collective voice for change and a place where science and community meet. That voice is urgently needed during the next several months leading to the 21st International AIDS Conference (AIDS 2016).
IAS will use its convening power to push change on a national and regional level as the steward of AIDS 2016. Just as the 2000 International AIDS Conference in Durban served as a catalyst for global treatment advocacy and access, the return of the conference to Durban this year will be a defining moment to establish a clear path toward guaranteeing that no one is left behind in the AIDS response.
We must not settle for noble speeches about global targets and political commitment. Instead, when we meet again in Durban, we must speak directly, ask the hard and uncomfortable questions and demand tangible answers – of ourselves and of each other.
The document that follows outlines the issues IAS is prioritizing on the road to Durban. We hope you’ll join us, develop your own list of essential questions and topics and take full advantage of the historic moment before us.
Owen Ryan is an IAS Executive Director.
