An AIDS-Free Generation: Hope from the XIX International AIDS Conference
By Jesse Milan, Jr., J.D.
I missed my father’s family reunion this year to attend a much larger one—the 2012 International AIDS Conference. Family reunions are special because they bring together far flung kinfolk from across the miles, and connect generations to each other. At re-unions we acknowledge the aging and the young, we note the accomplishments of family members in their prime, and we honor newborns as well as the dead. The XIX International AIDS Conference was no different.
This year’s conference, held on July 22-27 in Washington, D.C., was the 19th and largest ever. Nearly 24,000 participants attended from 183 different countries, including almost 2,000 media representatives and 1,000 volunteers. It was the first time it was held in the U.S. in 22 years thanks to President Barack Obama lifting the travel ban prohibiting HIV-positive persons from obtaining visas to visit the U.S. Like all family reunions, the conference attracted both professionals and those who struggle, such as the 850 scholarship recipients who would not have been able to attend without assistance. Sadly, we pined for family members not able to come, namely HIV at-risk persons whose records of being sex workers or drug users made them still ineligible for U.S. visas. How-ever, we who could attend heard important updates from 19 plenary speakers including Secretary of State Hillary Clinton, the National Institutes of Health’s Dr. Anthony Fauci, and Congresswoman Barbara Lee; and we saw Bill Gates, Annie Lennox, Whoopi Goldberg and Sir Elton John.
Though the conference theme of “Turning the Tide Together” focused on collaborative efforts of governments, scientists, organizations and activists to address prevention, treatment, care and research, a more optimistic theme emerged: An AIDS-Free Generation. A future when no new HIV infections occur, and when the 34 million already infected and living with HIV might, due to treatment advances and the increasing availability of medications, never develop or die from AIDS. This future goal was made more meaningful by the display of The AIDS Memorial Quilt. The Quilt was presented on the national mall and panels from it hung in sites around Washington including the Convention Center, the headquarters of the U.S. Department of Health and Human Services (HHS) and the National Cathedral. The more than 40,000 panels of the Quilt offer names and memories of some of the more that 640,000 Americans who have died from AIDS. It showed global attendees that Americans have grieved like them, and that we are all kin in this pandemic.
For communities of color that are disproportionately impacted worldwide by HIV/AIDS, the notion of An AIDS-Free Generation was thrilling. African Americans like me know that people of color look to future generations to live longer and better lives than our forbearers. The stigma of racism and poverty make each graduation, job and birth a chance to renew optimism that the future will be better than the past. So too it is with the notion of An AIDS-Free Generation. This year 47 percent of the attendees were from the U.S., many of whom were African Americans and Latino Americans who might never have the chance to connect with or learn from their brothers and sisters from around the world, or to share with them our common issues of stigma, discrimination, and access to care. Yet the conference allowed us to hear together information about healthy aging with HIV (a topic of growing interest in many places); and learn that by the end of this decade more than half of HIV infected people in the U.S. will be over the age of 50—thanks to growing access to treatments. Strategies were presented for completely eliminating mother-to-child transmission worldwide and preserving the lives of mothers in high-impact countries by putting pregnant women on treatment immediately for life – strategies that could make it possible for women to not only give birth to uninfected children, but live to see them graduate, marry, and have children of their own.
More news at the conference concerned biomedical advances and new funding to make An AIDS-Free Generation possible. Treatment as Prevention was widely discussed. HIV treatment regimes have the primary purpose of reducing viral loads and helping people live longer with HIV; but new evidence shows that giving treatment to HIV-positive persons and offering the HIV drug Truvada to high-risk HIV-negative persons may also significantly reduce new infections. News about funding came from HHS Secretary Kathleen Sebelius who announced in her keynote address that HHS was awarding new funds to eliminate waiting lists in America’s states for the AIDS Drugs Assistance Program. Globally the combined domestic funding for HIV/AIDS by recipient low- and middle-income nations is now exceeding the investments of donor countries. These are huge steps forward.
Yet, we also heard that the global health care workforce crisis leaves 1 billion people in over 50 countries without adequate access to trained health professionals, and we learned that despite the billions of dollars the U.S. spends domestically and globally on the pandemic, only 28 percent of HIV-positive Americans are receiving adequate treatment to attain an undetectable viral load. We heard that the global goal of getting 15 million on antiretroviral therapy by 2015 requires scaling up to add 7 million more people who are not on treatment today. Ownership strategies by affected nations and innovative approaches for health care are needed everywhere. The President’s Emergency Plan for AIDS Relief goals of reaching 6 million people on treatment by the end of 2013 and training 140,000 new HIV health professionals in the coming years are significant parts of the global solution, but we still have much to do to ensure that current generations get the care and treatment they need to survive. And we were reminded that a vaccine and a cure remain distant hopes to be achieved.
Every successful reunion is often months and years in the planning. Having been privileged to serve on two of the Conference’s main planning committees, I have new respect for the political challenges and hard work involved in mounting this event. Over 12,400 abstracts were submitted this year with 3,837 selected for presentation in 194 workshops or as posters, and 84 high-level non-abstract driven symposia sessions were created by the planning committees. The committees, workgroups, abstract reviewers and organizers were an amazing mix of researchers and representatives from international agencies and grassroots groups. We came together, working across agendas and fields of expertise, to achieve the conference’s mission of focusing the world on advances and solutions for HIV/AIDS. And we succeeded.
Closing keynote speaker President Bill Clinton summed it up by saying that goodwill always prevails.
Indeed, advances in treatment and prevention are reducing to all time lows the global numbers of new infections and of annual deaths, and in-country strategies of impacted nations are growing. The XIX International AIDS Conference showed the world there is hope for An AIDS-Free Generation. But, for all those united and reunited at the conference, the future cannot come too soon.
Jesse Milan, Jr., J.D., is vice president and director of Community Health Systems at Altarum Institute. He has been living with HIV for 30 years. For the XIX International AIDS Conference he represented Altarum on the Leadership and Accountability Programme Committee, and the Black AIDS Institute on the Conference Coordinating Committee.