Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Reflections on Vienna 2010


Human rights of transgender people were a theme at the IAC 2010 © Gideon Mendel/Alliance

Over 19,000 people from 197 countries gathered in Vienna to review ways to overcome the ever present challenge of the HIV/AIDS epidemic.

At a time when the focus on HIV and AIDS appears to be diminishing it is easy to forget that there are still over 33 million people who are living with HIV and every year 2 million people die from AIDS. HIV/AIDS is still very much with us.

Please scroll down to read our reflections from the conference on:

  • The Alliance at Vienna
  • A focus on drugs and HIV
  • Human Rights, Right Now!
  • Show us the money!
  • What’s preventing HIV prevention?
  • Maternal health, children and HIV
  • Clinical Developments
  • Community Voices speaking their world

The Alliance at Vienna

The Alliance had a strong representation at the conference, with delegates from 20 countries attending to share their views and bring their experience.

In particular, Alliance Ukraine’s work on injecting drug use and prevention of HIV was heavily featured throughout the conference, including a mention by World Health Organisation at the opening ceremony.

There was the strongest representation yet from the Middle East and North Africa (MENA) region with a combination of activists and representatives of vulnerable groups, NGO’s working on HIV issues, UN regional offices, researchers and health care workers.  

Delegates from linking organisation POZ in Haiti attended and were able to shared the current concerns and challenges they are facing following the earthquake that hit Port au Prince  in January and the support they now need to reach those groups particularly vulnerable to HIV.

Linking organisations from Africa, Latin America and representatives from the Alliance Secretariat and European partners attended to give poster presentations and speak at workshops.

A number of civil society organisations affiliated to the Alliance were awarded the prestigious UNAIDS Red Ribbon Award  for outstanding contribution to the AIDS response.

A focus on drugs and HIV

Given the conference was held in Europe it wasn’t a surprise that drug use and HIV were a particular focus. Eastern Europe and Central Asia, especially Ukraine and Russia, have some of the fastest growing HIV epidemics in the world due to the transmission of HIV through injecting drug use.

The Alliance’s message that harm reduction is critical to prevent the spread of HIV in injecting drug use was echoed around the conference.

Following a trip by the British Medical Journal (BMJ) to Ukraine to view the work being done in the country by Alliance Ukraine and their partners a substantial article was produced for the conference. Read a copy here.

The conference also saw repeated calls for legal reform to decriminalise the groups most at risk of HIV, such as men who have sex with men, sex workers and drug users.

Anya Sarang who is a board member of Alliance Ukraine and Director of Andrey Rykov Foundation for Health and Social Justice, gave a particularly powerful speech criticising Russia’s drug policy and highlighted the tragic consequences of ‘the war on drug users’. She called for a drug policy based on human rights and harm reduction. See her speech here.

Human Rights, Right Now!

This was the theme of the conference and it is evident the importance of addressing human rights if we are to successfully tackle the HIV epidemic.

Whether taking human rights to the forefront of the advocacy agenda and requesting changes of laws that harm or hinder prevention and support work to certain groups, or collaborating with human rights organisations to document rights abuses and highlight how the abuse of such rights is hindering access to health services, we need to get better at addressing this.

The Alliance is working through our new strategic plan to further develop our focus on integrating HIV and human rights. Read the latest survey of Alliance linking organisations on human rights and HIV responses.

The Vienna Declaration is the official declaration of AIDS 2010. It calls for drug policies that are based on scientific evidence and the decriminalisation of drug use, as well as the meaningful involvement of affected communities in developing policies and programmes. Over 14,000 people have already signed and the Declaration will stay live until the International AIDS Conference that will take place in Washington D.C. in 2012.  

A huge rally through the centre of Vienna was one of the highlights of the conference. Check out this great video produced by the Hungarian Civil Liberties Union to get a flavour of this colourful and inspiring event.

The Alliance Secretariat and the Alliance Ukraine took the opportunity of the AIDS conference to secure both national and international media interest to highlight the plight of Dr Illya Podolyan who has been jailed for providing substitution maintenance therapy, legal in the Ukraine, to dependent drug users and we will continue to maintain pressure on the Ukrainian authorities for the release of Dr Podolyan .

Show us the money!

Funding the HIV response dominated the conference. It’s an issue that the Alliance has been particularly focusing on over the last two years because of our concerns that with the economic crisis funding for HIV is seriously threatened.

Michel Kazatchkine of the Global Fund used the conference to highlight the dramatic funding shortfalls. In 2008-2009 donations from European countries fell by $600 million and the Fund estimates it’s running a deficit of between $4 and $6 billion. If the current levels of demand continue on the Fund for the next two years it will need between $17 and $20billion.

Now is not the time to drop the focus on HIV and meeting MDG 6. We are starting to see progress and so now should be the time for governments, donors and civil society to increase efforts to push the epidemic into reverse.

Available funding needs to be used in the most effective ways – which means using resources to support most-at-risk populations and addressing some of the human rights challenges to enable this to happen but it also means investing in effective and proven prevention efforts.

But with the current economic climate there are some very big questions about where funding is going to come from. There still needs to be money for the AIDS response and it needs to come from donor governments meeting commitments to 0.7% of GNI as ODA; African governments meeting their Abuja Declaration commitments to allocate at least 15% of their domestic budgets to health; and exploring the potential for new innovative sources of funding such as financial transaction taxes like the ‘Robin Hood Tax’.

What’s preventing HIV prevention?

“It’s like a dripping tap,” said Alvaro Bermejo, Executive Director of the Alliance, “If we don’t turn off the tap of new infections we are going to find it increasingly difficult to provide treatment for the ever growing number of people living with HIV. We have to focus attention on HIV prevention.”

The Alliance took the opportunity to discuss our forthcoming campaign on HIV prevention and ask delegates, ‘What’s preventing, prevention?’ which will help to inform the development of the campaign. See here for details and read our Campaign Prevention Manager’s blog.

On the issue of prevention there was much discussion about the need to scale up use of ARVs as a way of preventing further infections. Whilst it may effective and recommended, the Alliance is asking is it practical at a time when AIDS funding is declining in part due to the economic crisis?

Maternal health, children and HIV

There is a growing recognition of the relationship between HIV and maternal and child health, but more still needs to be done to bring the AIDS community and the maternal and child health community together and encourage the two communities to work collaboratively with each other.

In research presented at the conference by the Africa Centre, children born to mothers with HIV in a rural district of KwaZulu Natal were 75% less likely to die before the age of five if their mothers received antiretroviral therapy but the impact of HIV spending on MDGs 4 and 5 on child and maternal mortality is limited despite the available evidence of the impact of HIV on child and maternal mortality.

At a pre-conference symposium on HIV and children, organised by Teresa Group and the Coalition on Children affected by HIV and AIDS (CCABA) of which the Alliance is a member of the steering committee, the focus was on family-centred prevention, treatment and care for children, with a strong emphasis on eliminating paediatric AIDS, reducing maternal mortality while expanding and connecting to other child services

UNAIDS Executive Director Michel Sidibé and others called for support to virtually eliminate parent-to-child transmission in the 10 most-affected countries by 2015 and avert more than two million infections using a family centred approach.

It was clear however that a family-centred approach can only work with a change in attitudes towards people who use drugs, men who have sex with men and sex workers and it must address the legal barriers and the stigmatization of these especially-marginalized populations.

Clinical Developments

The biggest of the medical developments to be announced at the conference was the proof that an effective microbicide is possible.

A new vaginal microbicide gel containing the anti-HIV drug tenofovir (Viread) reduces the risk of infection with HIV for women using it by 30 per cent.  

For women who used the gel during four out of the last five times they had had sex, the risk of HIV infection was reduced by 54%.

The trial called CAPRISA 004 was conducted in South Africa and involved 889 HIV-negative women who were randomised to receive the tenofovir-containing gel or a placebo. They were monitored for two and a half years.

Community Voices speaking their world

A team of over 20 key correspondents attended the conference and reported on a huge range of issues coming out of the discussions. Bringing their own perspectives from the community and seeking out the perspectives of those who are not normally heard at the conference. The KCs produced a huge array of articles. Read a selection of them here.

The Alliance supports the KC programme which at its core ensures that we are reminded of the daily realities of living with HIV.