AIDS Experts in D.C. Evaluate Effectiveness of 2010 Vienna AIDS Conference

A month after July’s 2010 International AIDS Conference, a panel of seven experts and government officials working on the HIV/AIDS pandemic met in Washington, D.C. to discuss the event’s findings.

They concluded that there have been marked improvements in HIV/AIDS research since the last international conference in 2008. One of the biggest signs of hope for the pandemic slowing is the recent development of a product that improves prevention for women. The Centre for the AIDS Programme of Research in South Africa (CAPRISA) recently released a study on a microbicide gel that reduces a woman’s chance of contracting HIV and genital herpes.

Lauded at the 2010 conference, which was held in Vienna, Austria this year, the microbicide gel research is what Phil Wilson, president of the Black AIDS Institute, calls “an African solution.”

“The topical gel came out of an African nation,” Wilson says. “The study was conceived and executed in Africa and presented at the conference by Africans.”

The release of the study by CAPRISA was the “standing ovation” of the conference, says Deborah von Zinkernagel, principal deputy global AIDS coordinator in the Office of the U.S. Global AIDS Coordinator.

“They invested $1 billion and took ownership of the problem,” von Zinkernagel says of the growing buy-in of African countries. “[At the Vienna conference] there were 55 presentations on male circumcision and its role in preventing HIV/AIDS in countries where it is not traditional.”

One improvement coming out of the United States at the 2010 conference was the presence of more scientists. In 2004, President George W. Bush restricted the number of government scientists sent to the conference to 20 each for the Centers for Disease Control (CDC) and National Institutes of Health (NIH). Just two years prior, there had been 236 scientists represented from both agencies. While the numbers haven’t returned to 2002 levels, the CDC sent 50 scientists this year.

“There was declining participation of basic science and we feel like that participation is critical,” says Chris Beyrer, a professor at Johns Hopkins Bloomberg School of Public Health. “Science has ended the divide in thinking about treatment and prevention as two separate strategies.”

2010 has also been the year of the lift on the travel ban for people with HIV/AIDS entering the United States. Since 1987, HIV positive people have been unable to enter the country.. The end of the ban, announced this January by President Barack Obama, prompted the conference location to be set to Washington, D.C. for 2012, making it the first one of its kind to be held on U.S. soil in more than 20 years.

“The lift of the ban on traveling for people who are HIV positive is huge,” Beyrer says. “There is some concern and trepidation about whether people will get there, especially vulnerable populations. They have complex personal lives, but their participation is critical: sex workers.” The rates of HIV in sex workers is higher than the general adult population, according to AVERT, an international AIDS charity.

Two days before the Vienna conference, the White House released its National HIV/AIDS Strategy, which was meant to demonstrate the United States’ level of commitment in the both the domestic and international AIDS crises.

Jeffrey Crowley, director of the Office of National AIDS Policy and senior advisor on disability policy at the White House, attended the panel, and explains the goals of the report are threefold: to reduce incidence of HIV/AIDS, increase access to care, and reduce HIV-related disparities.

“We went there wanting to have a discussion with the global community,” Crowley says. “We want to make the strategy meaningful; all parts of the government are responsible for having a specific role in implementing the plan.”

A change in strategy was welcome to Wilson. “For the past 30 years we've been doing the same thing over and over and expecting something different. I know that black people are not the only people with HIV/AIDS, but I'm not going to apologize about only looking at black people; the report looks at this population. Within those concentrated populations where the AIDS epidemic is, it is generalized, and this [National HIV/AIDS Strategy] report focuses on those critical populations.”

The strategy means that government agencies will be responsible for implementing specialized parts of the plan, meaning more money would be allocated for programs, which is critical because of the overall leveling of international aid.

From 2008 to 2009, the commitment from international assistance remained the same at $8.7 billion, the first plateau after rising by $1 billion every year since 2002. Disbursements — monetary funds allocated to country organizations to fund programs — decreased, for the first time since 2002 in 2009 from $7.7 to $7.6 billion.  

While the participation of African states in global AIDS prevention strategies has increased, there was little representation from Eastern Europe, a region with a growing rate of HIV/AIDS. Some suggested that means the United States should demand stronger leadership from Eastern European nations..

“We need new leadership to navigate the difficult period ahead,” says Lisa Carty, deputy director and senior adviser at the CSIS Global Health Policy Center. “When the countries are in denial of the problem, how do we merge that reality with what they believe is going on? We [the United States] are always a huge presence and that imbalance needs to be corrected.”

Wilson made a critical point that if the UnitedStates is to give counsel to other countries, it must address its own epidemic first. This makes the 2012 conference particularly significant.

“The issue of 2012 conference coming to Washington, D.C. is very important,” Wilson says. “In some ways, black America is a developing country — that's why it needs to come here. The intersection of advocacy and research is finally coming together.”

The panelists noted that blacks are disproportionately burdened by HIV/AIDS in the U.S. While they represent approximately 12 percent of the U.S. population, they account for 46 percent of people living with HIV in the United States, as well as 45 percent of new infections each year.

And according to Wilson, if all the black people in America lived in an independent nation, that nation would be comparable to a developing country. Three percent of all D.C. residents live with HIV/AIDS, but 4.7 percent of black D.C. residents are infected. This is comparable to rates in Uganda, which stands at a 5.4 percent prevalence rate.

Von Zinkernagel concluded the panel’s discussion of the conference by saying that while African countries have taken ownership of the problem on the continent, a lack of leadership in other parts of the world still signals a major gap. Hopefully bringing the conference to the U.S. during the run-up to the 2012 presidential election will increase the focus on a global issue that needs local solutions.

Lisa Gillespie is a former staff writer for Campus Progress as well as the Managing Editor & New Media Director at Street Sense. She graduated from the University of North Carolina–Asheville.

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