Vienna was my second International AIDS Conference. My first one was Mexico. And as other conference delegates, I had such a high expectation on this conference. I was looking forward to see a great improvement or significant progress on the HIV prevention, care, treatment and support. I believe every conference is unique and has its own characteristics, but one thing that strikes me right from the beginning was the delegate´s badge hanger. It has the branding from Bristol-Myers Squibb. Instead of having something like „XVIII International AIDS Conference 2010 – Vienna“ it has Bristol-Myers Squibb written along the line. I was not sure whether there was not enough time to order the more appropriate one or was it because the company contributed a great deal of money for the conference to happen. Nevertheless, Squibb is not a favourite brand especially because of the scandal in 2003. The company was facing serious allegations such as engaged in a series of anti competitive acts over the past decade to obstruct the entry of low price generic competition for three of Bristol´s widely-used pharmaceutical products which include Didanosine, the second line for paediatric ARV. They also paid a would-be generic rival over US$70 million not to bring any competing products to market as well as avoided competition by abusing federal regulations in order to block generic entry. Bristol produced patented ARV such as Sustiva (efavirenz), Didanosine (paediatric ARV), Zerit (stavudin) and Reyataz (atazanavir) and making the price of these products rising high by blocking the generic products from entering the market. I immediately had the feeling that it would cause a bit of resentment from concerned activists. As a result, I spent the next day looking for badge hanger from any other institutions at the exhibition area and found out that many other activists were doing the same thing.
As a member of Community Programme Committee for this conference, I knew for a fact that there were a lot of gaps in terms of programs for the sessions. It was, of course, positive and negative. The Youth Group for instance, had more visibility in this conference compared to the previous one, so did the Sex Workers Group. The committee had difficulties in placing balance topics due to the focus of the region. The reason why the conference was held in Austria was because this country is considerably the closest one to Russia, Eastern Europe and Central Asia, since it is impossible to hold the conference in any of those areas. This had a great impact in programming because the committee members from Russia, Eastern Europe and Central Asia insisted to have more focus on drug users and sex workers, and almost disregarding other groups such as migrants, MSM and young people. I personally fight for more visibility for migrants because I know for sure that there are a lot of migrant sex workers in Asia who are from Eastern Europe and Central Asia. But then again, migrant´s identity was overshadowed by sex workers´ in this regard. The multiple identity of PLHIV (HIV-positive people who are working overseas, doing sex work, using drugs and a lot of them are young) was often only viewed through one particular identity that was pre-dominantly shown by the person. Thus, I only managed to get one Non-abstract Driven Session on Migration in this conference. Luckily, there were several other satelite sessions on migration held by IOM, ILO and UNDP. Furthermore, I found the statement made by the community speakers at the opening ceremony was a little bit misleading. During the speech, the community speakers mentioned that government must declare HIV as national threat, considering the rapid increase of the epidemic in the region. I did not necessarily agree with this statement, because if the government misinterpret the context, it would be a gateway to reiterate the implementation of HIV-related restrictions and criminalisation of HIV transmission. To be honest, the statement horrified me and other delegates who came from migrants´group. We just hope that no government will misinterpret it.
The location of conference in Europe was also one great obstacle for delegates to attend. I have gone around having chat with various people from Asia and Africa, all of them were telling the same story. Having the conference in Europe is expensive in terms of air ticket, accommodation and daily allowance. Many of the delegates and speakers also failed to obtain the Schengen Visa. I, myself, had a bitter experience when the first time I applied for Schengen Visa to attend the first committee meeting. The Austrian Embassy only gave me 4 days visa. So, I know exactly what these delegates had gone through. It seemed to them the government of Austria was not being supportive or rather having high prejudice towards certain regions.
However, more positive feedback was given for the Global Village. It was said that the Global Village this year was merrier than ever. More things were happening and there were more networking zones which enabled community members to have a lot of sharing and discussions. In fact, a lot more interesting things and discussions happened in the Global Village. All rallies were generated and coordinated at the Global Village. Interesting issues that become the topic of the rallies were the FTA and funding regression. The activists were concerned because some of the funding agencies and governments were giving the hints of backing off from providing resources for HIV programs due to global financial crisis. Other hot issue was the FTA issue in India. The country is currently negotiating an FTA with European Union which putting pressure India to accede to TRIPS-plus provision which are beyond India´s present international obligations under the TRIPS Agreement, will make the ARV unaffordable and adversely affect the right to health of PLHIV. India is the largest supplier of low cost, high quality generic ARV to many developing countries. Over 90% of PLHIV in low and middle income countries depend on India´s generic ARV.
Among many issues that was discussed, one primary topic was the Test and Treat ot TNT. Many activists were hesitant in accepting this methodology. In theory and concept, TNT is good because this methodology will slow down the speed of the epidemic. While the initial investment might be enormous, in the long run it is considered as low investment. Though we all know that treatment provision is a form of prevention, it needs strong support system. The downfall of this methodology is on how to ensure the human rights protection for the patients. In some developing countries, the current situation of treatment provision has already been problematic and unsustainable. The fear of the upcoming huge wave of people going for treatment as the result of TNT is unbearable. If the current situation is unsustainable, how do we ensure treatment is available for everyone post TNT? Another issue is the quality of counseling given in TNT because this will have a great impact on the newly-diagnosed people. Surely, the last thing we want is to have a large number PLHIV suffered from psychological problems. In order to implement TNT, government needs to be ready with sustainable and accessible treatment combined with social support mechanisms such as job security, housing and education. Thus, many activists doubted that TNT is going to be effectively implemented.
There was a lot of suggestions to bring the conference back to Africa or Asia, where the epidemic is still considerably high. But, as we all know, the next one will be in Washington DC, USA. As far as I know, USA had expressed its interest to host the next IAC and this momentum was used to push for the abolisihing of the HIV-related Restriction in that country. It is good because now USA does not impose the restriction anymore, but what we have to remember is that even though now PLHIV do not have the restrictions to enter the country anymore, people who have criminal records, drug users and sex workers are still imposed by the restrictions. This issues had been expressed by Dennis Glodevsky from ITPC Russia and reiterated by Rachel Ong, the Chair of GNP+ in her speech at the closing ceremony. A lot of people were worried regarding the venue for the next IAC and hope that the Obama Administration will do something about the restrictions.
Quite a lot of people also have different impression on the conference. While they acknowledged the importance of having the conference as an arena to share, building capacity and discuss the issues, it came across like a waste of resources. For some people, it is best to put the resources on programs and prevention in the locality and have the conference once every four years instead of biannually. Many people, including myself, expected concrete results and follow ups after the conference. I personally feel that every conference needs to have accountability mechanisms so it would not turn into some avenue to spend money. While I agree that people need to meet, share, network and discuss – I think what most important is how the delegates could bring what they got in the conference to their community and implement it. Or how to turn the conference from a talkfest to real activities with clear objectives and feasible results.
It is year 2010 already and the International AIDS Conference had already been held for 18 times. This year, we are meant to conclude the Universal Access. To quote Rachel, the distance that we had to go through from Global Village to the PLHIV Lounge is a good analogy for reaching Universal Access 2010. It is too far and we have a long way to go. Hopefully this conference will somehow speed up the process of reaching the goal of Universal Access 2010 and Millenium Development´s Goals 2015. Despite of some disappointments that I felt for this conference, I still have hope that in the future IAC will be able to bring in significant results for global AIDS response.
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