Once marginalised issues now in the forefront

By Marwaan Macan-Markar
July 18, 2004

Bangkok - While the lack of major medical breakthroughs might have been the hallmark of the just concluded 15th International AIDS Conference, a radical shift that has occurred on another front, however, is hard to ignore.

Language used by AIDS activists, which once had been on the margins has, now, been embraced by the mainstream.

This shift has gained in significance, given that the language was echoed by establishment figures present at the world's largest AIDS conference held here from July 11 to 16.

The tone was set during the opening ceremony of the conference by Thai Prime Minister Thaksin Shinawatra. He promised to end discrimination against injecting drug-users (IDUs), a vulnerable group through which HIV is spreading in Thailand, and implement a harm-reduction programme for them.

That was a dramatic turn in attitude for an administration that had shown little mercy to drug users in this Southeast Asian country.

Last year, over 2,400 people were murdered -- many victims of extra-judicial killings, during a nine-month long 'war on drugs' launched by the government.

The conference also afforded a chance for sex workers -- another group whose work is also criminalized. They made their presence felt by openly engaging with the mix of scientists and policy makers - among the over 17,000 people who attended the global conference.

The previously hushed issue of men who have sex with men or MSM was also discussed openly. Delegates talked about how AIDS vaccine trials were conducted with the MSM community.

The mainstream conference discussions, previously centered on science and medical issues, took on a more human approach by talking about preventive behaviour and treating and caring for people infected with HIV or already afflicted with the killer disease.

What was palpable in the messages coming through was how AIDS was no respecter of governments who deny the human rights of people with HIV or those who could be easily infected, such as IDUs, sex workers and MSM.

As Dr. Joep Lange, co-chairman of the IAC, put it on the last day, countries that stigmatise, discriminate or force people underground with HIV or those vulnerable to it will not win, since "silence equals death."

This call for an open human rights centred approach to combat AIDS was at the heart of the Jonathan Mann Memorial Lecture delivered midway through the conference by Dennis Altman, president of the AIDS Society of Asia and the Pacific.

"Access to prevention is as significant as access to treatments, and an equally political demand, for it is about our right as healthy citizens rather than unhealthy dependents," said Altman.

Mann was the first head of the World Health Organisation's (WHO) global programme on AIDS, launched in 1986. He has been credited for beginning the debate to look at the AIDS issue as a pandemic that needs a broader human rights approach than, simply, looking at it from a public health perspective.

Eighteen years later, AIDS activists and grassroots groups who have been confronting governments and other dominant players to change their attitude towards combating HIV -- including the need for policies that recognises the significance of human rights in the equation -- feel vindicated.

"There has been a revolt of public opinion in our favour," Paul Davis of Health GAP, a New York-based health rights lobby group, said at the closing press conference given by AIDS activists at the global meeting.

Zackie Achmat of the Treatment Action Campaign in South Africa, too ,agrees.

"They have conceded that a range of people have to become part of the programmes for AIDS, including sex workers, MSMs and IDUs," he added.

One of the significant features of this conference was the delegates' sharp rebuke of the administration of U.S. President George Bush.

Many hit out at the fundamentalist religious ideology that has influenced Washington's policies in its efforts to contain the spread of AIDS and protect people in the developing world from contracting HIV.

"The Bush administration is demonising sex workers and we are now told that the (U.S.) Congress is considering a measure by which any organisation that does not condemn sex work will not be able to receive U.S. support," said Joanne Csete, director of HIV/ AIDS at the New York-based Human Rights Watch (HRW).

Washington's current policies that preach abstinence and fidelity as part of its global AIDS programme are "an insult to women and girls and an assault on women's rights," Csete added during an interview with ASG.

The victories that were won around the protection of people with AIDS in the United States in the 1980s through a human rights approach also stand to be undermined if religious ideology triumphs over rights to contain AIDS, she said.

Activists also expressed their anger at the painful reality that life enhancing antiretroviral drugs, for people living with HIV, continue to be produced in the rich industrialised world but not made accessible where they needed most - namely poor communities in the developing world.

Though expectations might have fallen short at the global conference, the space, however, provided for sex workers, MSM and IDUs to highlight their roles as fundamental players in the frontlines of the AIDS debate is with reason -- given their position in fuelling the spread of the pandemic.

For that, Asian countries may have to be thankful since the continent is being viewed as the next epicentre of HIV, following its destructive path through Africa.

Last year, one in four new HIV cases were reported from Asia, with main form of transmission being through IDUs, MSM and sex workers.

There are currently an estimated 38 million people living with HIV, the virus that causes AIDS, the Joint United Nations Programme on HIV/AIDS (UNAIDS) states in its latest report.

Of that number, 25 million live in Sub-Saharan Africa and 6.5 million live in South and Southeast Asia.

The pandemic killed 2.9 million people in 2003, bringing to 20 million the people who have died due to AIDS since it was first detected in the early 1980s.

And even the recent increase in funding commitments to halt the killer disease will fail as an antidote if HIV programmes are dismissive of human rights, Irene Khan, secretary general of the global rights lobby Amnesty International said during the conference's closing session.

However, it is a message that many governments have still not absorbed, she added. "Human rights are still far from becoming a vital component of AIDS programmes in many countries."

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