Reflections from the 19th International AIDS Conference, Washington 2012

This year the International AIDS Conference took place in Washington DC. Photo by Glyn Lowe Photoworks/Creative Commons

Following President Obama’s decision to lift the US travel ban on people with HIV, Western attitudes towards AIDS are improving. DiA writer Katie Simkins reports from this year’s International AIDS Conference in Washington, DC.

In July this year, scientists, doctors, campaigners, policy-makers and politicians met in Washington, DC for the Nineteenth International AIDS Conference. The world’s most influential power was to host the conference for the first time in 22 years, following President Obama’s decision in 2010 to lift the ban on HIV-positive individuals entering the country. Increasingly, politicians from around the world are expected to address the epidemic. This development has not come overnight: the fight against a disease as complex as AIDS has been waging uncertainly and with significant setbacks for over 30 years.

In 1987, the last time the International AIDS Conference came to Washington,
President Ronald Reagan and Vice President George H. W. Bush were booed during their presentations. They attracted fierce criticism for breaking their six-year silence on AIDS by declaring plans for mandatory HIV testing. Silence was symptomatic of the early political reaction to AIDS. South African President Nelson Mandela admitted that he was advised to avoid the issue of AIDS in his campaign of 1994 because of a conservative electorate: “I wanted to win and I didn’t talk about AIDS.”

In 1987, the USA declared that all HIV-positive individuals would be refused entry into its borders. Without HIV-positive individuals, the conference could not go on, and the long hiatus began.

When Obama lifted the travel ban, he finally acknowledged the USA’s longstanding contradictory stance: “We lead the world when it comes to helping stem the AIDS pandemic – yet we are one of only a dozen countries that still bar people with HIV from entering our own country”.

However, sex workers and drug users – significant groups in HIV policy-making – are still restricted from entering the USA, prompting protesters to express their outrage by chanting “No sex workers? No drug users? No International AIDS Conference”. So while Obama’s decision was frequently applauded during the week, and while its impact must not be understated, an HIV-positive drug user who spoke to the conference from video insisted that Obama’s gesture was not a momentous achievement but rather “a huge mistake that has finally been fixed”.

Africa and the West have shared uneasy relations during the AIDS epidemic. The early confusion and fear that this mystery killer brought led Western scientists to suggest that it had an “African origin”, based not on adequate research but on assumptions of African sexual promiscuity. In reaction, some African politicians refused entry to Western researchers.

For years, research, policy and funding came from the West and were imposed on African countries, often with little appreciation of different cultural and social realities. The economic crisis, however, has crippled Western funding and shifted the emphasis to country ownership, placing pressure on developing countries to take the burden of funding their fight against AIDS.

The economic context and increased cultural sensitivity are responsible for changing the relationship between Africa and the West from one consisting of donor and recipient to one increasingly described as a partnership. In 2012, it was reported that despite containing approximately 15% of the world’s population, African countries were afflicted with 68% of the world total of HIV infections. With this in mind, it is time that more sessions in future conferences address this imbalance.

Attracting 24,000 delegates, the 2012 International AIDS Conference was the largest so far. Delegates who had attended several previous conferences informed me that the positive tone of this conference contrasted sharply with the exasperation and gloomy tone of the past. Increasingly, HIV-positive individuals are able to lead relatively normal and long lives, implied by the sessions that addressed the issues of ageing with HIV.

“We just have to keep pushing the rocks up the hill” – Bill Clinton

In spite of this however, one must bear in mind that AIDS has been a social and political issue as well as a scientific one since its emergence in 1981. Although the number of AIDS-related deaths and the rate of mother-to-child transmissions are falling, this complex disease is vulnerable to external factors such as community involvement, political will and international aid. The positive tone of the Nineteenth International AIDS Conference was preceded by decades of struggle, and more will follow before the ambitious aims of “Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths by 2015” are met. As Bill Clinton phrased it in his closing remarks, “We just have to keep pushing the rocks up the hill”.


The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.


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