Bangkok AIDS Conference
Sex, lies and AIDS Conferences
Presentation by Shaun Mellors - Chief Community Rapporteur
On behalf of the Community Rapporteur Team
XV International HIV/AIDS Conference, Bangkok Thailand
From Presidents to republicans,
princess's to priests, sex workers to politicians,
activist to advocates, drug users to youth, movie stars to pop stars
It is indeed difficult to do justice to the many varied community sessions and events that were covered in the conference program. This is a reflection of a few key issues as identified by the Community Rapporteur Team on sex, lies and AIDS conferences
Let us reflect for a moment on the conference theme - Access for all. What do we mean by access, access for what, access to what? Can we reduce access to questions of ARVs? Do we not need to talk about access to integrated health programs, health infrastructures, about access to education for all, about access to clear, candid and uncomplicated information? What about access to prevention technologies to condoms as well as microbicides/vaccines, and what about access to these conferences
For leaders to put question marks where there ought to be exclamation marks is irresponsible, if not immoral. People pay with their lives because we override science with ideologies.
ABC, for example, as a strategy is epidemiologically and programmatically sound as was discussed during the conference. By
severely twisting the concept, some have reduced the strategy to A, B with little or no attention to condoms.
As many people have demonstrated during this conference, condoms are a vital component of an effective prevention strategy and play a decisive role in preventing the transmission of HIV. While abstinence and fidelity are important factors in prevention, marriage and monogamy are increasingly a risk factor for many women where vulnerability is intimately linked to power and negotiation. Messages about monogamy to youth moreover are easily transformed as serial monogamy.
The Bangkok conference may be remembered for highlighting issues of women and youth, but women are not a homogeneous group and the diversity of lives and realities were not effectively reflected in the program content. We did not hear the voices of women drug users, women prisoners, lesbians, trafficked women, and the girl child? Women living with HIV have had a higher profile in the corridors, satellites and some programmatic sessions, but their voice was silent at the plenaries and other critical sessions.
We have to put the "sex" back into the epidemic, beyond just a route of transmission. There was no celebration of positive sexuality, no celebration of the lesbian, gay, bisexual and transgendered identities, no celebration or discussion of diverse sexuality, or of sexual rights. Although the issue of male to male sex behavior made it onto the program, the sessions focused covered it from a behavioral or intervention perspective and did not address sexuality and identity.
Access to treatment and the infrastructure to sustain that treatment requires strong leadership.
What or who defines a "leader", what does it take to be a leader, (slide) what constitutes a leader? Some of the sessions in the leadership track confused "leaders" with leadership. Not all leaders show leadership. For one week every two years many leaders are given a microphone and a photo opportunity and continue to make empty promises and unimpressive speeches without action after the conference week
How do we hold "leaders" accountable, and how do they hold us accountable, how do we ensure that we stop paying with peoples lives for failed commitments and empty promises? We require leadership and we have to hold , Graca Machel, Kofi Annan, Peter Piot, Randall Tobias, Manto Tshabalala Msinang, Richard Gere, Miss Universe and ourselves accountable for promises made and accountable for actions.
Khun Mechai (Community co-chair) publically declared and committed to have a monthly public meeting at the remembrance stone in the park to monitor progress and report back to the Thai community about promises that were made by Prime Minister Thaksin Shinawatra's commitments at the opening ceremony. We need more creative mechanisms for accountability such as this.
There were commitments made since Barcelona -- 3 x 5, Pepfart and funding to the Global Fund for example. But who do we hold accountable if this is not achieved. And how do we hold people accountable? The Director of WHO Jim Joung Kim said that we should not waste more time dwelling on what is not possible, but rather make it happen. Well 8400 people have died during this conference week, because they do not have access. We all need to be accountable to deliver now and into the future beyond 2005: what about 4 x 6, and 5 x 7?
The UNGASS declaration of commitment is falling off the political agenda, and is in danger of becoming yet another declaration of commitment sitting on our shelves as we struggle to move beyond the rhetoric. We can all be leaders, and are leaders in some way, doctors back home, nurses, frontline community workers, activists sex workers and drug users. We need to share the responsibility and be accountable to ensure that UNGASS, Global Fund and other commitments do not become more empty promises.
In 2002, we referred to the Bangkok conference as the "accountability conference", the conference where we would get answers, measure our progress on international commitments, and address issues of access for all, we have heard the terms -- commitment, leadership and accountability -- bandied around during the week, but has this lead to access for all.
How easy we forget our history, how quickly we become silent
Jack Singh, Suzanna Murni, Ashok Pillay, some of the activists from Asia and many other warriors, activists friends and loved ones who have passed on have fought the battles and guided us by not only questioning, fighting, making their voices heard, but also by providing leadership and a vision for the future. We have come a long way since the early days of these AIDS conferences, where there was no community voice and the voices of people living with HIV were silent. We acknowledge the battles that have been fought and won to ensure community participation and integration in these conferences.
Accountability is a two way process and part of accountability is taking responsibility. Protocol or not, what happened at the opening ceremony during the "Paisan exodus", was unacceptable and disrespectful, and we need to ensure that it does not happen again. Moreover, we need to take a critical look at ourselves, the conference participants and co-organisers, How can we, the co-organisers, and especially the community co-organisers, have agreed to the community representative as the last person on the programme? Surely we should have learnt from our history. We need to hold ourselves accountable, the thousands of us - the activists, community representatives, people with HIV, NGOs that also walked out. We owe Paisan, our community voice, a "collective apology".
We were pleased that Conference co-chair Dr Vallop followed through with commitments made at the closing ceremony in Barcelona - that community and PWA voices would be heard, and that the PWA lounge would NOT be placed in a parking garage.the PWA lounge needs special mention as the wonderful volunteers and staff of the community department and lounge created a piece of heaven right here in the conference center with very limited resources.
Access for all
The Silabha Art and Culture Programme demonstrated that culture is at the heart of everything we do -- it shapes our ideas, behavior, expression and perception of the world around us -- the cultural programme was truly extensive, interactive and covered the different components that depicted, love, life, sexuality and helped as connect as a global community
While not everyone can attend an AIDS conference, this conference has reached out into the broader community through such things as the Community impact project, skills building program, the Global village, the press, advocacy parade, and the film festival, to bring the conference messages and meanings to Bangkok, to Thailand and to the world.
Has the unified program worked? Did the abstract sessions acknowledge and highlight the role of communities in the response to the epidemic? Were community projects analyzed thoroughly for effectiveness and impact? Did Bangkok address and elaborate on the role of communities in designing, implementing or interpreting evaluation? We have made significant changes in these conferences over the years since 1988 when Stockholm added lunchtime community sessions. The conference program was full and diverse, ironically though many people thought that the quality was diluted as a result.
The Community Rapporteur Team therefore has the following
1. The abstract form and process should be reviewed and creatively changed to ensure that the lessons learned at the country level could be realistically captured and transferred to other situations and settings.
2. The abstract review committee should be renewed and reviewed to represent the diversity of experiences and realities on the ground and not simply a list that is passed on from conference to conference. Presenters need to be carefully chosen, and reminded to address "concrete strategies for action" or "the next steps are" as opposed to talking about the same issues and focusing on methodology.
3. Creative means for improving networking, interaction between sessions, and informal gatherings need to be developed.
4. The Global Village was a creative concept that brought the conference to the people, and should be adapted and perhaps even institutionalized for future conferences.
5. Each conference should report on commitments made at the previous conference and action on them.
Let us hope that in Toronto in 2006, we would have moved many discourses forward, identified effective strategies, applied what we have learned about the epidemic, and saved many more lives.
None of this presentation or work presented at the conference would have been possible without the support of the community rapporteur team, and the committed staff and volunteers at the community programme...we thank you!
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