STEPPING UP THE PACE… THE MALAYSIAN WAY!Malaysian AIDS Council (MAC) and Malaysian AIDS Foundation (MAF) delegates reflect on the 20th International AIDS Conference, Melbourne (AIDS 2014)
After a decidedly somber start following the shocking deaths of international colleagues on board the downed Malaysia Airlines flight MH17, the twentieth installment of the premier gathering for people working in the HIV & AIDS sector ended on a resoundingly positive note with a global call for a unified action on HIV and human rights and an increase in the funding of HIV research and response.
Our delegates echoed the sentiments expressed by notable speakers at the conference – President Bill Clinton, Sir Bob Geldof, Nobel laureate and International AIDS Society (IAS) president Professor Françoise Barré-Sinoussi, UNAIDS executive director Michel Sidibé to name a few – and took home key lessons learnt below for our collective inspiration as we step up our own paces to usher in the next phase of the HIV response.
From day one, the conference was abuzz with speeches and presentations warning of the inevitable setback in the progress made thus far in the HIV response, if basic human rights to health are not fully protected. “Stigma and prejudice are surprisingly on the rise,” noted President Bill Clinton, to which he also attributed the leading cause of HIV treatment dropouts. For the AIDS response to realize its full potential, “Laws and policies must be made part of the solution, not the problem!” emphasized Michael Kirby, former Australian High Court Judge who observed continued persecution of sexual minorities and other key populations most affected by HIV.
At home, stigma and discrimination remain the greatest barrier for people living with HIV to attain education, employment and access heath care services, examples of which are described in the recently released HIV & Human Rights Mitigation Report 2013. While MAC continues to work closely with the relevant authorities and policy makers to address this situation, we must recognize the need to put human rights, in the words of Management Sciences for Health president & CEO Dr. Jonathan Quick, “at the fore of universal health coverage.”
At the opening session of AIDS 2014, local co-chair Professor Sharon Lewin remarked that the inclusion of key communities had been fundamental in effective AIDS response in her home country Australia and elsewhere. In fact, putting the key in key affected populations was one of the overarching themes that dominated the proceedings of the five-day conference under the ‘No One Left Behind’ campaign banner.
WHO released the “Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations” in the lead up to AIDS 2014, recognizing that failure to provide adequate HIV services for key groups will undermine global progress on the HIV response.
Our poster presentation on the Paralegal Training Workshop conducted in partnership with the Legal Aid Council (Parimelazhagan Ellan, Shamala Chandrasekaran et al.) underscored the value of training peer outreach workers, many of whom are from or identify themselves with key populations, as community-based paralegals. Not only has the training empowered the outreach workers with a boost in self-confidence when dealing with law enforcers, it has also helped to improve their relationship with and build their trust in the authorities and vice versa.
Fifa Rahman, who served as IAS rapporteur for sessions on key affected populations, in her notes highlighted the need to end persecution of, improve health literacy, and expand targeted sexual and reproductive health services across all key populations. Kenyan police leadership on sex work was particularly exemplary, whereby possession of condoms is not used as evidence of sex work because police officers there carry condoms too.
MAF executive director Jasmin Jalil observed an interesting shift in private sector funding priority for AIDS programming from intervention to advocacy based activities, looking to evoke positive change in policies and enabling environment as well as in the quality of life of people living with or affected by HIV. Private sector partnership with the AIDS NGO sector must be approached from a solidarity standpoint as opposed to charity.
He was particularly impressed with the Aeroplan Frequent Flyer program in Canada, through which Canadian flyers could donate their accumulated frequent flyer miles instead of money to facilitate HIV work in Sub-Saharan Africa. To date, the program has donated over 59 million miles! Amia, a small NGO based in Canada is the nodal agency that coordinates the project with the Stephen Lewis Foundation of Australia, a corporate coalition that supports NGOs in Sub-Saharan Africa.
UNAIDS executive director Michel Sidibé introduced a rather bold and ambitious goal to end AIDS by 2030: 90% of people tested, 90% of people living with HIV on treatment and 90% of people on treatment with suppressed viral loads. He further added, “90–90–90 is not just a numeric target. It is a moral and economic imperative.”
His statement was corroborated by President Bill Clinton, who declared that an AIDS-free generation was “within reach”, with the proviso that the international community improves on early disease detection. “New tests and tools are the bricks, now we need the mortar – support services and infrastructure,” he added.
Undeniably, young people especially young key affected populations face heightened risks of HIV due to age-related legal barriers and protection issues, as Fifa Rahman noted in her presentation on ‘Legal and policy considerations in reaching young key populations’. To address this situation, she went on to recommend that young key affected populations must be involved meaningfully in the planning, design, implementation and evaluation of services.
In Malaysia, young people below the age of 29 constitute about one-third of all new reported cases of HIV every year. As sexually transmitted HIV continues to be on the rise, we need to be put an end to what Michel Sidibé described as “public hypocrisy on sex” and and promote universal sexual and reproductive health, education and rights.