August 25, 2006

This Week in Washington
1. Rebecca Haag Responds to Washington Post Article Criticizing Senator Clinton

Special Report from the International AIDS Conference
1. Highlights on The International AIDS Conference XVI from Board Members in Attendance

This Week in Washington
1. Rebecca Haag Responds to Washington Post Article Criticizing Senator Clinton
On August 23, 2006 the Washington Post printed a front page article titled, “Sen. Clinton Delays AIDS Law's Renewal, Citing Cut in N.Y. Funds.” AIDS Action was deeply concerned by this untimely, inaccurate, and one-sided story. Rebecca Haag, Executive Director of AIDS Action, responded with the attached letter to the editor of the Washington Post on August 23, 2006.

To read the Washington Post article please visit:
http://www.washingtonpost.com/wp-dyn/content/article/2006/08/22/AR2006082201161.html

The Washington Post requested a shortened version of the editorial for publication. Rebecca’s letter to the editor reads as follows:

Dear Editor:

Your Aug. 23 front-page story titled “Sen. Clinton Delays AIDS Law’s Renewal, Citing Cut in N.Y. Fund” was misleading and divisive. Sen. Clinton has consistently championed additional funding for HIV and AIDS programs around the country. She is a leader in Congress on prevention and early detection and treatment for HIV. As a member of the Senate Health, Education, Labor and Pensions committee, the Senator has been a strong supporter of the bi-partisan/bi-cameral reauthorization process of the Ryan White CARE Act of 2006. Her vote was an indication that the bill still needed work, and her position has been substantiated by many other voices in the House of Representatives.

The House Energy and Commerce Committee continues to revise the legislation recognizing that the Senate version had unintended consequences of dismantling critical HIV care systems not only in New York, but in Texas, Florida, Illinois, New Jersey and other states. Many of those who would have been hurt by this approach are African-Americans.

Although the Southern states are certainly seeing an increase in new HIV infections and there is a growing need for care and treatment, 70% of the people living with AIDS in the United States reside in metropolitan areas funded by Title I of the Ryan White CARE Act.

It is time to change the debate. Let's stop pitting north and south, black and white, homosexual and heterosexual. What is needed is more funding overall for the CARE Act, so that HIV treatment can be provided to all Americans who are HIV positive regardless of their place of residence, race or sexual preference.

Sincerely,

Rebecca Haag

Executive Director

AIDS Action Council
.

Special Report from the International AIDS Conference
1. Highlights on The International AIDS Conference XVI from Board Members in Attendance
The International AIDS Conference (IAC) “Time to Deliver” was held in Toronto from August 13-18th 2006. Several AIDS Action Board members attended the conference. Rebecca Haag, Executive Director of AIDS Action, Dr. Linda Frank, Principal Investigator and Executive Director of the Pennsylvania/MidAtlantic AETC, Ronald Johnson, Associate Executive Director of Gay Men’s Health Crisis, and Tina Podlodowski, Executive Director of Lifelong AIDS Alliance shared their thoughts on the conference. They shed light on themes that emerged and relevant information exchanged, and gave tips for members considering attending the International AIDS Conference XVII in 2008, being held in Mexico City.

The 2006 International AIDS Conference was the first that Rebecca Haag attended. She found the conference to be inspirational and hopeful. She was very impressed by the plenary speakers, especially Bill Clinton, Bill Gates, and Peter Piot. Of the speakers, Rebecca said, “The set a tone that HIV/AIDS is the challenge for our generation, but that even though it is a daunting challenge, we should be able to mobilize our resources and overcome it.”

Rebecca saw prevention as the driving theme of this year’s conference. On the topic of prevention she said, “As important as care and treatment are, we need to focus on prevention. We have to stem the tide of new infections because our resources for treatment will run out. At this conference there was a focus beyond behavioral prevention. The potential of concrete medical interventions such as microbicides, pre-exposure treatment, and male circumcision was clearly a focus.” Rebecca also noticed an emphasis on women, how they are being impacted by this epidemic, and the prevention tools they need to protect themselves, instead of being dependent on their partner’s use of a condom. She expressed that the focus on prevention at this conference connected prevention with care and treatment, making them equally important.

The conference left Rebecca inspired, with a sense of a global community between the many people throughout the world working on HIV/AIDS. However, she thought that the conference was so large it was difficult to find a main purpose. She suggested that there be better organization around helping attendees find the sessions that are pertinent to them and their work. The conference could have been more accommodating by providing more intimate knowledge sharing interactions.

There is a take away piece from her experience in Toronto that Rebecca wanted to share with the members. She said, “This conference helped me change the way I look at the epidemic domestically. I realized the huge barriers other countries face, making me more strident in the domestic work that I do. In the United States we have more access to resources than other countries. Here it is all about political will. We need to shift from morality based techniques to scientific evidence based prevention. If we can get beyond that hurdle, we could see huge changes in the epidemic domestically.”

Of The 2006 conference, Dr. Linda Frank said, “There was not much new scientific clinical information delivered at IAC . This information is disseminated at other conferences, such as the Conference on Retroviruses and Opportunistic Infections (CROI). However, the IAC is important in order to make the world aware of the scope and severity of the epidemic now and in the foreseeable future. The role of this conference is the put HIV/AIDS front and center in the media.”

Dr. Frank also thought the major themes of this year’s conference were clearly women and tools that women can use to protect themselves from HIV. She felt that there was also and underlying theme on the issue of substance abuse. She attended several sessions where the role of injection drugs use serving as the driving force of the epidemic was highlighted. For example, in the former Soviet Union, drug trafficking from Afghanistan into the Russian Federation, has contributed to the rapid growth of the epidemic.

She explained that it is important to note that the conference offers many opportunities for learning through skill building sessions and the poster sessions. “I find the poster sessions very informative. The issues of HIV within the MSM community may not have been focused on significantly in plenary sessions. However, the poster sessions offered a wealth of information and work being done within the MSM community worldwide.”

Dr. Frank commented further on the focus on the conference. She said, “This is the 10th IAC I have attended. Different things take the spotlight. This year was the time for women to take the spotlight. The spread of HIV in women, especially minority women, is a huge problem around the world. The press coverage and focus has been different at each conference I have attended. Durban brought attention to Africa, Bangkok brought attention to Southeast Asia, but Toronto brought attention to women all over the world.
The Bill Gates quote and in my view the quote of the entire conference was: “No woman should have to ask her partner for permission to save her own life.”

Dr. Frank thought that the conference was well organized, with high security due to the big name speakers, Bill Clinton and Bill Gates. Speakers like them helped to give the IAC media visibility.

Dr. Frank gave her advice for members considering going to the next International AIDS Conference in Mexico City in 2008. “This conference is focused on advocacy, so it is great for those of us that do advocacy and policy work. It’s great for networking, and being part of a global community. When so many of us focus our work on the U.S., it’s important to talk to people around the world, as disheartening as it may be. It makes me realize how great the Ryan White CARE Act (RWCA) and the Centers for Disease Control and Prevention (CDC) are, despite their bumps, because they are better than what others have anywhere. Some countries have nothing, absolutely nothing.”

If you are planning on going to Mexico City, Dr. Frank also advised deciding what you are going to focus on and which sessions you are going to attend before you go. You need goals and objectives before you get there, or the conference can be entirely overwhelming. This year Dr. Frank focused on Russia, Eastern Europe, and MSM messages to bring back to the Pittsburgh community.

She also noted that there were several papers at the conference from Community Based Organizations from around the world. She suggests submitting abstracts to the conference, even just for a poster if you are planning to attend. She thinks it is a great opportunity to think about and evaluate the work you are doing and share that with other organizations from all over the world.

Ronald Johnson has attended several International AIDS Conferences. Overall, Ronald was very impressed with the conference. He expressed that this was the largest IAC of the several he had attended. He said, “I continue to be amazed by the diversity of those who attend the conference and those engaged in the fight against AIDS across the world. I found this conference to be very inspirational, educational, and reinvigorating particularly the sheer number and diversity of those engaged in ending this epidemic.”

He was also extremely impressed in the number and strong presence of young people at the conference both participating and presenting, and that there was a devoted track of youth focused activities.

Ronald highlighted two main themes that resonated throughout the conference. First was an emphasis on Human Rights. He thought this conference confirmed that Human Rights issues are integral in this epidemic. HIV is not just a medical disease or a public health problem. It came through that HIV is a Human Rights issue. Ronald said, “This was especially significant for me, to not have to apologize or hang my head for incorporating talk about the human rights and social justice issues that drive this epidemic both globally and in the US.”

The second major theme Ronald noticed was the importance of prevention technologies that women can control. He found the conference to be very informative on microbicides. The necessity of empowering of women as part of our strategy to combat this epidemic was made clear. He noted, it was much of the focus of the opening speech by Bill and Melinda Gates.

Ronald commented on the issue of gay men as a focus of this conference. He said, “I was impressed by this IAC in particular. There was a stronger focus on MSM issues than at previous conferences, which I found very heartening. I thought there was a disturbing de-emphasis on this issue in Barcelona and Durban, and I think this conference started to reverse that.”

Ronald highly recommends that our members consider going to the International AIDS Conference in the future. He said, “You can really learn from it. It is very re-invigorating for those of us in this profession. It is a chance to grasp the global realities of this epidemic. For instance I learned that 90% of the worldwide population projected to have HIV has never been tested. To realize the low number of people all over the world that have access to treatment like we do in Western countries gives you the ability to put our epidemic in the global perspective and to take pieces of what other countries are doing better. It’s truly a learning experience.”

If you do go to Mexico City in 2008, Ronald offers some advice. He suggests you pick at topic to focus on. It is impossible to take everything in. This year Ronald concentrated on sessions on HIV testing.

On a final note Ronald said, “These International conferences are integral to our domestic work. It gives a sense of what global advocacy means for domestic agencies. It is important to realize that in our advocacy efforts with Congress we deal with policy issues that impact the global epidemic. We need to be involved in the PEPFAR reauthorization, an example of the tremendous impact our government has on global policy and programs. As domestic advocates we have a responsibility to advocate on this issue. We cannot make an impermeable divide between domestic and global advocacy efforts. It is appropriate for AIDS Action and like organizations to focus on and influence US policies that impact global HIV/AIDS, especially when those policies impede progress against the global epidemic. That is our job to change, because it is our President, and our Congress.

“Lastly, we must lift the travel and immigration bans in place in the US (which bar people living with HIV from entering the U.S.). Because of the travel ban we could never hold a conference of this magnitude and importance in the United States. We should not rest while that law is on the books.”

Tina Podlodowski began her discussion of the conference with interesting thoughts on the opening session, “Priorities in Ending the Epidemic,” by Bill Gates and Bill Clinton. She believed this was the marquee presentation of the conference. She said, “We often point out that one of the major reasons we all do the work we do is because AIDS is the greatest moral, health care, economic and civil rights challenge on the planet. It was nice to have that restated and reconfirmed by the richest guy on the planet (and head of a $62 billion foundation) and, arguably, one of the greatest masters of politics and government on the planet. Two smart guys, those Bills.”
She also strongly agreed with their points on prevention as a take home message of the conference. She said, “We can spend all the money we (and the Bills) have on care for the 50 million people around the world living with HIV/AIDS, but for every one person we can successfully treat to prolong life (STILL no cure), 10 more are infected. We have got to move prevention efforts to a different level with different tools to slow the epidemic. These include microbicides, oral prevention therapies, widespread condom distribution and education, coupled with the political, cultural and personal power for men, women and youth to use these tools.”
Tina also made the point that each delegate at the International AIDS Conference represents approximately 1,500 people living with HIV/AIDS in the world. Of that statistic she says, “That’s an incredible responsibility for each of us – to know that we are here to learn from each other, to connect across cultures, to encounter the almost overwhelming variety of human experience, to understand that we here are by a small fraction of the pandemic that unites us.”

She thought that there were both discouraging and encouraging aspects to the sessions. She commented that though there were a large number of delegates from the United States, much of the conversation focused on the pandemic in the rest of the world. References to the U.S. were focused on either the effects of U.S. policy on prevention and treatment in the developing world or on the work of the two Bills (Clinton and Gates) overseas. Tina said, “There doesn’t seem to be a widespread recognition that we still have an ongoing epidemic or that access to prevention and treatment isn’t universal in the U.S. I don’t want to downplay the importance of talking about the pandemic in the rest of the world, but we shouldn’t have that conversation without also acknowledging that despite tremendous strides in the U.S., we still have epidemics fueled by social policy, inequalities, poverty, and racism that affect marginalized populations.”

Tina felt a clear shift in themes of the conference away from gay men. She remarked “The word “gay” had been startlingly absent from the conversation. We heard an occasional “homosexual” or “MSM,” but despite the facts that there is an MSM Guide to IAC and that there are gay men everywhere you turn here, there are a few sessions devoted to prevention with MSM. It was very clear that AIDS has been de-gayed in the rhetoric of the global pandemic. In one particular session on prevention with MSM, I was struck by how providers around the world – from Australia to the Netherlands to Thailand – were asking questions about the work that parallel many of the conversations we have in our Prevention Education staff meetings: how do we address HIV prevention in the bigger context of men’s lives; how do we compete with sex; how do we most effectively access and interact with folks on the internet where they are meeting their sex partners; how do we stay current with what men are really doing to protect themselves (especially when it is different from what “we” think they should be doing); how do we make sure that our prevention interventions are effective with various sub-populations of gay men.”

It is the hope of AIDS Action that our members that could not attend the International AIDS Conference find these first hand accounts to be helpful and informative insights. We encourage you to consider these thoughts in addition to media coverage of the conference you may have been following.

The AIDS Action Weekly Update
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