The 2012 International AIDS Conference in America: The World is Invited, but Who Will Respond and Who Will Come?

The International AIDS Conference is coming to the United States this July 22-27 for the first time in over 20 years. This is the 19th time the global HIV/AIDS community will be convened for this event. It is the world’s largest—and most important—conference for bringing together service providers, advocates, policymakers and scientific and social science researchers to learn about and share advances in prevention, treatment, care and policy for an epidemic that counts 34 million living with HIV/AIDS worldwide. 

Organized by the International AIDS Society and held in a different country every two years, the conference shines a spotlight on the global HIV/AIDS pandemic and on regions most affected by the disease. This year, more than 20,000 people from more than 200 countries are expected to attend and some 2000 journalists are expected to cover it. The theme for this year’s conference is “Turning the Tide Together.”  I was selected to serve on two key planning committees for the conference and have been working with dedicated HIV leaders from around the world to assure that the conference highlights international collaborations, as well as scientific and medical advances that can cut across national borders and demographic silos.  

However, not everyone who could benefit from this conference will be able to enter the U.S. to attend, and I worry that many people here in the U.S. who most need to hear its messages might not pay attention. My concerns are twofold. 

First, despite the lifting of a longstanding legal barrier that prevented the conference from being held in this country, U.S. immigration policies still exist that may preclude key global stakeholders in the HIV/AIDS pandemic from attending. For more than two decades, U.S. immigration policy prevented persons living with HIV/AIDS from entering our borders. That policy ended under President Barack Obama. The repeal of that policy was heralded around the world and made it possible for the International AIDS Society to select the U.S. as this year’s conference site. However, persons with histories of being a sex worker or of having used illicit drugs are still not permitted by the U.S. government to obtain visas to visit the U.S.—even for just a short stay to attend a conference that might offer strategies for saving the lives of people they represent.   

This is problematic for an international conference dealing with the impacts of a virus that the entire world knows is transmitted by sex or through the sharing of infected needles. Without those key stakeholders present, the 2012 International AIDS Conference will miss a critical opportunity to include the voices and presence of people from around the world who struggle not just with HIV/AIDS, but from stigma and violence against them—people who desperately need the tide to turn to help save their lives.

The conference planners have sought to address this problem with the U.S. government in a recent letter to the U.S. President's Emergency Plan for AIDS Relief Ambassador Eric Goosby. The letter encourages the U.S. State Department to grant visas allowing these key stakeholders in the pandemic to enter the U.S. to attend the event. It remains to be seen whether these efforts will be successful. 

Second, I am concerned that the significance of the International AIDS Conference will be lost in the media frenzy around this summer’s other major events. This year the conference will be in Washington, D.C., a predominately black city that represents the great challenge of turning the tide of the epidemic in the U.S. Unfortunately, HIV/AIDS has fallen off the media radar in too many places, especially in the U.S., and this year’s conference will compete with high-profile events including the Summer Olympics and the U.S. presidential campaign. Yet, in the past when the International AIDS Conference was held in host cities in South Africa, Thailand, Mexico and Austria, the conference helped shed national and global light on the epidemic in sub-Saharan Africa, Southeastern Asia, Central America and Eastern Europe. That spotlight is needed on the epidemic in the U.S. 

Approximately 1.2 million Americans are living with HIV/AIDS and 50,000 new HIV infections occur each year in the U.S., with the African-American community being most disproportionately impacted in this country. Although only 14 percent of the U.S. population, Black America bears 44 percent of new infections in this country. The District of Columbia reports that more than 3 percent of that city’s residents have HIV (a rate higher than some African nations!). The good news is that our nation’s capitol is working hard to turn the tide for its residents with increased HIV testing, increased distributions of male and female condoms, needle exchange programs and a doubling of free HIV treatments over the past five years. National and global coverage of the District’s efforts could empower people all across the U.S. and across the global black Diaspora to take notice and to respond.

Fortunately, the conference planners have decided to have a plenary session on the U.S. epidemic. That decision was no easy feat. As a part of the conference’s main planning bodies, I know that planning committee representatives from other countries have worried publicly  that this year’s conference might be overtaken by U.S. issues, and that the 2012 conference might not give due attention to the overall global  pandemic. They need not worry, because the hundreds of abstract driven workshops plus symposiums, special sessions and plenaries will definitely cover the entire international gamut of HIV-related issues. 

Key African-American leaders, including Congresswomen Barbara Lee, have already accepted invitations to participate in this year’s conference. In addition, representatives from leading African-American civic and social justice organizations have expressed interest in attending, and the Black AIDS Institute will bring a delegation of African-American radio and newspaper journalists to cover the conference as well. Let’s hope these key leaders awaken and inspire more African-Americans to break down barriers in black communities of stigma and fear, and that all those journalists help spread messages about HIV/AIDS that Americans of all colors need to hear. 

The International AIDS Conference has become the world’s premier showcase for highlighting scientific advances. This year’s conference goal is to present strategies that could turn the tide for everyone. Indeed, there is much to share. For example, recent studies on microbicides for vaginal use in women have potential implications for all MSMs (men who have sex with men). Pre- and post-exposure prophylaxis treatment studies showing reduced infections rates in African heterosexual couples have implications for people in all societies and across the spectrum of human sexuality. New strategies in the U.S. to reduce community level HIV viral load in the 12 American cities with the nation’s highest HIV/AIDS rates can offer potential lessons for other cities around the world. And the U.S. federal strategies to integrate HIV prevention and care programs with efforts to address viral hepatitis and substance abuse could help turn the tide toward saving millions more lives both here and around the world.   

The conference is also an opportunity to address issues that the wider community of nations shares. Stigma, discrimination and access to affordable health care are challenges for Americans as well as for citizens of most other countries highly affected by HIV/AIDS. We oftentimes forget that an awful lot of people around the world are in the very same boat. What strategies might we hear from other nations?  What funders might be newly energized by learning about advances from science or from different communities? What forces might be strengthened by hearing speakers’ calls to action? Understanding our commonalities, learning innovative strategies to address them and committing to not stand or work alone are outcomes the whole world can use and that this conference can promote.  

At this time when global economies make the health and well-being of each and every one of us seem  more fragile and more tethered together than ever before, it is critical that we create and use every chance we can to reach across  international and cultural  divides to turn the tide together. The 2012 International AIDS Conference could be that opportunity for HIV/AIDS in America and for the world. Every person and every country will benefit from what is discussed and presented at this year’s conference because HIV/AIDS still touches us all. 

Let’s hope that all who need to pay attention will, and that all who want to—and need to—participate can come, and that their shared voices, stories, strategies and solutions will provide the energy and enthusiasm the world needs to work together to end  HIV/AIDS once and for all. It’s time to turn the tide together.    

Comments

Jesse Milan hits the nail on the head with this post. The XIX international AIDS conference is coming to the United States at a deciding moment in the trajectory of the AIDS epidemic. With recent bio-medical breakthroughs we finally have the tools to end the AIDS epidemic. The question is no longer can we end AIDS. The question is will we. And will we end it for everyone. AIDS 2012 will provide a global stage to talk about what we really know about the State of AIDS today, particularly the State of the AIDS epidemic and the response to it in the United States.
Phill Wilson
President and CEO of the Black AIDS Institute and Member of the Presidents Advisory Council on HIV/AIDS

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