Addressing HIV: do conferences and papers help?

My initial reaction to the proposed title of the following article, "Addressing HIV: Do Conferences and Papers Help?," was strong and immediate. I also found myself sitting squarely on both sides of the fence: yes, of course, they help to expand people's minds and abilities to respond effectively to the epidemic, but there is so much wasted time and money involved in organizing most conferences. With the intention of exploring these reactions and putting them in an appropriate context, I decided to poll several colleagues, whom I have worked with, in defining and mobilizing the response to the worldwide human immunodeficiency virus (HIV) epidemic. The feedback I received on my mini-survey, which simply asked respondents to give me their immediate thoughts and feelings about the proposed title, filtered in from Canada, France, Senegal, South Africa and the United States. I have synthesized the general reactions and supplemented them with my own analysis of the question.

All of those who took the time to consider the usefulness of conferences and papers in addressing the problems engendered by the HIV epidemic agreed that both are indeed valuable in helping to deal with HIV and the acquired immune deficiency syndrome (AIDS). The basic premise of this point of view is that conferences and, through them, the presentation of papers serve at least to bring together people working within the epidemic, allowing them to exchange thoughts and ideas and to network amongst themselves. HIV and AIDS affect those who try to curb the epidemic's spread and to respond to its many consequences differently from other areas of work and life. Why is this the case? It is because few other recent developments carry with them both the urgency and the emotional and psychological impact of the HIV epidemic. People who devote their professional lives to dealing with HIV and AIDS often need more regeneration and support than those who work in other areas. Again, why is this the case? My simple answer is that even today people who immerse themselves in the epidemic, almost inevitably at both professional and personal levels, take upon themselves not only the enormity of HIV and its unabated spread throughout the world but also the stigma of a virus which is, at worst, synonymous with blame, shame and fear and, at best, an unpopular subject of discussion and reflection. For this reason, we must be able to come together, not only to present the latest developments in vaccine research, antiviral therapies and models for policy and programme formulation but also to rant and rave, complain, let our hair down, exchange ideas, offer support and advice and refuel our commitment.

Other advantages of papers and conferences include: the value of drawing attention to HIV/AIDS and related issues through the publicity generated by them; the role which some conferences can play in launching new initiatives, partnerships and, in some cases, even organizations; and the importance of learning what is being done outside of one's own country or region. This last advantage of large conferences and the papers presented has been particularly important for groups such as the Network of African People Living with HIV/AIDS (NAP+) and the African Network on Ethics, Law and HIV, both of which I have worked with intensively. Members of NAP+ and the African Network, particularly those with less mobility and those coming from countries with difficult internal problems, such as Burundi, the Central African Republic, the Democratic Republic of the Congo and Rwanda, to name a few, have been able to discover a whole world of work on HIV existing outside of their own national environments, which are often highly insular. At the same time, it has proven equally important for conference participants from outside of Africa, including donors, to learn about some of the very progressive responses to the HIV epidemic being formulated within Africa, often in those countries which appear to be enduring the greatest difficulties. These responses occur in many sectors, including law reform, creation of support and advocacy groups, formulation of compassionate and effective national policy on HIV, and the organization of workshops to sensitize specific groups and raise awareness about the multisectoral effects of HIV and AIDS.

Despite their consensus on the essential role of conferences in assembling and re-energizing people who work within the HIV epidemic, my colleagues identified a number of negative factors associated with conferences. First and foremost are the often vertiginous expenses in organizing large international conferences and producing papers. This is something for which the United Nations system has been Criticized in many areas of work. One colleague suggested that, the context of the United Nations, current cost-cutting and budgetary constraints may force people to work more effectively in organizing conferences and papers, and to waste less time and money. Other respondents to my survey maintained that it is extremely difficult to measure the impact of a conference or a paper on the HIV epidemic. "Did anyone not get infected, not lose their rights, get access to treatment, because of an international conference? Probably not", offered a colleague in France. Others expressed objections to large, comprehensive conferences with several tracks going on simultaneously. Some felt strongly that the fora which really "helped" were much more likely to be consultations, workshops and seminars, as these could more easily focus on capacity development and skill-building.

To further supplement the valuable thoughts of my colleagues, and to conclude, I would like to make two final points. First, experience and personal conviction have convinced me that everyone working within the HIV epidemic must at least attempt to contribute to alleviating the many different types of suffering and pressures endured by people living with HIV and AIDS. Particularly unhelpful in the context of conferences are extremely eclectic papers which dehumanize people living with and affected by HIV, treating them as almost purely anthropological specimens to be studied and commented on, rather than as partners and as human beings with genuine medical, legal, economic, psychological and emotional needs. The second point is that the United Nations and other funding institutions must not believe that the act of sponsoring conferences and commissioning papers are sufficient to address HIV. Many non-governmental, community-based and AIDS-service organizations the world over, despite a genuine need and willingness to dive into the heart of the thorniest HIV-related problems, struggle every day to exist on what little money they can raise from donors. HIV and all of its co-factors-poverty, gender disparities, social injustice, insufficient or discriminatory legal systems, and sexual health-are very real problems and need real solutions. The United Nations system and other donors must listen to the people and organizations working to provide these solutions, maintain a dialogue with them and ensure that they receive concrete support for their daily work.

Number of People Living with HIV/AIDS

Total:                                               30.3 million

Sub-Saharan Africa                                   21.0 million
South and Southeast Asia                              5.8 million
Latin America                                         1.3 million
North America                                             860,000
Western Europe                                            480,000
East Asia and Pacific                                     420,000
Caribbean                                                 310,000
North Africa and Middle East                              210,000
Eastern Europe and Central Asia                           190,000
Australia and New Zealand                                  12,000

Children and AIDS

Deaths of children under 15 years old
from AIDS since the epidemic began                    2.7 million
Children under 15 living with HIV/AIDS                1.1 million
Children who have lost their mother
or both parents to AIDS                               8.2 million

The 12th Annual World AIDS Conference called for the rich countries to help poorer nations better respond to the HIV/AIDS epidemic. According to a recently released report of the Joint United Nations Programme on HIV/AIDS (UNAIDS), 90 per cent of the 30 million people living with HIV/AIDS are in the developing world. Medical experts and representatives from international organizations called on richer countries to help poorer nations obtain better access to the latest drug treatments, which are unaffordable to patients in developing countries. UNAIDS announced that it would start a pilot programme to provide the drug AZT to poor women in Africa, Asia and South America. The United Nations Development Programme, the United Nations Children Fund, the United Nations Population Fund, the United Nations Eduction, Scientific and Cultural Organization, the World Bank and the World Health Organization are partners in UNAIDS.

Benjamin Weil is a freelance writer and editor, working principally with agencies and programmes of the United Nations system on issues related to HIV/AIDS in developing countries.