J. Stephen Morrison
Senior Vice President, CSIS & Director, Global Health Policy Center at CSIS
As one would hope and expect, the opening session of AIDS 2012 featured considerable excitement over the International AIDS Conference’s return to US soil after 22 years, following the lifting of the ban on visitors living with HIV in October 2009. Interestingly, the celebration also brought forward some not so subtle and slightly amusing competition for credit. According to which speaker was at the podium, you could have guessed the true hero was alternately Congress, the Bush administration, and/or the Obama Administration.
Predictably, the session hammered home the conference’s overriding theme of ‘Turning the Tide.’ Conference co-chair Diane Havlir, Congresswoman Barbara Lee (D-CA), former head of the U.S. Office of the Global AIDS Coordinator Mark Dybul, and UNAIDS head Michel Sidibe, each argued that scientific gains and programmatic investments have made achievement of an “AIDS Free Generation” possible, but will require sufficient political will and sustained investments. The moment is ripe for courage and bold big ideas, to build on the remarkable achievements of the past decade and leverage the social movement that has formed around HIV/AIDS. The evening did not, however, bring forward much concrete detail on what such a strategy will entail.
There were several other notable aspects to the opening.
A surprising number of speakers went out of their way to thank America for PEPFAR and the transformative impact it has had both on the lives of persons living with HIV and health systems. Heartfelt expressions came from Dr. Elly Katabira, the renowned Ugandan researcher and co-chair of AIDS 2012; Michel Sidibe; Florence, an HIV + Nigerian mother and her 13-year-old daughter who was born free of HIV; and South African Deputy President Montlante.
Jim Kim, who only just ascended to the presidency of the World Bank on July 1, committed the Bank to make better use of its special strengths in building health and other systems, and ensuring social protection against catastrophe, including illness. He pledged to align the Bank with social justice movements, confront the absolute poverty of 1.3 billion persons in the world as a top priority, and elevate the Banks’ support to civil society groups to become a ‘signature’ of his tenure. In his view, the massive and successful investments in HIV/AIDS have generated lessons and new capacities that can bring substantial benefits in other development sectors, such as education and the environment.
Change is afoot in Africa. Deputy President Motlanthe and UNAIDS head Sidibe each emphasized the significance of the new shared responsibility framework adopted by the African Union members states at its recent summit. This step is seen as a signal of a much higher commitment within Africa to accelerate investments in AIDS, tuberculosis and malaria, and to be held accountable into the future. Each referenced the massive scale up in South Africa and the huge impacts in terms of testing, mother-to-child transmission and access to treatment.
Amid all the excitement, there is also cause for worry. Michel Sidibe admitted “I am scared for the future of global solidarity” of wealthy countries to assist poor countries, the financial situation is deteriorating, and it is not clear how to close a $7 billion funding gap. Dybul, at the conclusion of an eloquent appeal to stay the course, acknowledged that fatigue has indeed deepened among donors.
Modest efforts are under way to fortify the new U.S. national plan on HIV/AIDS. Secretary of Health and Human Services Kathleen Sebelius, in her keynote address, pledged to intensify efforts to bring forward new, more affordable drugs. She pointed to last week’s announcement by the White House of an additional $80 million to support ARVs in the United States, and announced four public-private partnerships – with Walgreens, Medscape, MAC AIDS Fund, and a consortium of eight AIDS drug companies.
All in all, the opening was overwhelmingly upbeat, and overtly quite United States-centric. It lacked an iconic charismatic personality. The audience would have to wait until the next morning for Secretary Hillary Clinton to rock the house.