AIDS 2008 Impact Report Available

The AIDS 2008 Impact Report, a report of the key learning from the XVII International AIDS Conference, held in Mexico City in August 2008, is now available here.

The report is also available on the AIDS 2008 homepage, as well as the IAS homepage.

According to the IAS, the report is not meant to capture all of the hundreds of sessions, events and activities at AIDS 2008 (as no one report could reasonably do this), rather it is an analysis/reflection on the key learning in the following areas:

- Epidemiology

- Basic and Clinical Research

- Biomedical Prevention Research

- Regional Focus

- and a section on how AIDS 2008 and previous international AIDS conferences have contributed to the overall response to HIV/AIDS

All analyses are referenced to sessions/abstracts.

Please note that several organizations are producing their own reports associated with conference activities, or key issues/areas of focus during AIDS 2008, and we will make them available on the AIDS 2008 website as well.

Homophobia continues to hamper HIV efforts globally

Efforts to replicate successful strategies in more countries are hampered by recent homophobic statements made by political leaders from Uganda, Poland and The Gambia. Comments from these leaders, and other politicians who call for the arrest, detention, and even killing of homosexuals, are reprehensible.

Craig McClure, Executive Director of the International AIDS Society, recently released the important statement below. Many thanks to the Global Forum on MSM and HIV for sending this out on their list.

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Homophobia continues to hamper HIV efforts globally
-Craig McClure, International AIDS Society

Mexico City/Geneva – (29 May 2008)


The International AIDS Society (IAS) today expressed its deep concern about continuing inflammatory and homophobic statements by political leaders in Uganda, Poland, and most recently by the President of The Gambia, and urged national and international leaders to reject homophobia and to take affirmative steps to reduce its impact on HIV.

One of the many lessons learned in the IAS' more than 20 years of leadership in HIV/AIDS, is that well-designed and appropriately targeted programs, implemented with the support of public health and political leadership, can effectively reduce HIV transmission in communities most at risk for HIV, including gay men and other men who have sex with men (MSM).

A report issued at the end of 2007, led by researchers at the Johns Hopkins Bloomberg School of Public Health in the US, provides solid evidence that HIV among MSM continues to be widespread, and in many cases, is exacerbated by stigma, criminalization and the lack of appropriate services. The study indicates that, even in countries with low HIV prevalence in the general population, the epidemic among MSM is raging.

According to UNAIDS, fewer than one in 20 MSM around the world has access to HIV prevention, treatment, and care – and even fewer in low-income settings. Compared to the HIV testing rates of 63-85 percent seen among MSM in Australia, Europe, and North America, rates among MSM in much of Africa, Asia, and Eastern Europe are often under 20 percent.

As it has been demonstrated in many different countries, reducing the social exclusion of gay and MSM communities through the promotion and protection of their human rights (including sexual rights and the right to health) is not only consistent with, but a prerequisite to, good public health. Once discriminatory policies are abolished and stigma and discrimination are confronted, country-based programs can be put in place to encourage gay men and MSM to stay free of HIV-infection, thus supporting national goals of reducing HIV burden.

However, efforts to replicate these successful strategies in more countries are hampered by recent homophobic statements made by political leaders from Uganda, Poland and The Gambia. Comments from these leaders, and other politicians who call for the arrest, detention, and even killing of homosexuals, are reprehensible.

In 2008, despite the accumulation of more than a quarter of a century of knowledge of successful HIV interventions, homophobia and the criminalization of homosexuality continue to be significant obstacles to the scale up HIV prevention, treatment, care and support. Though countries such as Cape Verde and South Africa have repealed their sodomy laws, and government officials in Kenya, Malawi, and Mauritius have begun discussions about the harmfulness of such laws, a resurgence of intolerance and homophobia, coupled with lack of action to repeal laws that violate the human rights of same sex practicing men and women, is posing a grave threat to the AIDS response in many countries.

Despite its much heralded success in promoting a public health response to HIV, Uganda continues to cling to a colonial-era sodomy law that punishes homosexual conduct with life imprisonment. And, Uganda is by no means the exception. Worldwide, more than 85 countries criminalize consensual homosexual conduct. Such laws give governments a pretext to invade people's private lives and deny them essential human rights: to live in peace and in health.

The XVII International AIDS Conference, to be held in Mexico City from 3-8 August 2008, will highlight successful work with MSM in several Latin American countries. The experience from Latin America, as well as from other parts of the world, can provide invaluable guidance to leaders from other middle- and low-income countries in Africa, Asia and Eastern Europe. [IRMA is presenting "Making Anal Sex Safer for MSM in the Developing World" at the conference.]

The very high proportion of MSM in Latin America who, over the past 25 years, became infected with HIV, developed AIDS and later died can only be described as catastrophic. But, in the past decade, in a growing number of countries throughout the region, there have been positive responses that continue to serve as shining examples to the rest of the world. If national and world leaders are serious about curbing the epidemic, programmes that bridge across sexual orientation, that protect public health, and transform stereotypes and prejudices must be a first line priority.

"Homophobia – whether propagated by government leaders, enforced by outdated laws, or perpetuated through stigma and discrimination – continues to fuel this epidemic, and should therefore be the number one enemy of those who are serious about ending this global tragedy," said Dr. Pedro Cahn, IAS President, AIDS 2008 Co-Chair and President of Fundación Huésped in Buenos Aires, Argentina.


With an international membership of more than 10,000, the International AIDS Society is the world's leading independent association of HIV professionals.

Why AIDS Research Is Wrong

Book review by Gordon Youngman - only on LifeLube

The Invisible Cure: Africa, The West, and the Fight Against AIDS

By Helen Epstein

Helen Epstein claims to have found the cure for AIDS, but it is no magic bullet. This American scientist turned health writer first began searching for a vaccine to prevent HIV back in the early 1990s in Uganda, which ended disappointingly. She has spent the time since then travelling around the continent, exploring the history of the virus, how it is spread and what Africans themselves are doing to cope, the results of which appear in her new book The Invisible Cure: Africa, the West and the Fight Against AIDS.

Despite her science background, Ms. Epstein is a good writer who manages to convey often jargon-filled polysyllabic terms and techniques into digestible reading (perhaps in part due to being the daughter of the late founder of the New York Review of Books Barbara Epstein). She tells her story in the first person and paints quick yet vivid portraits of the people she works with and encounters during her projects. This isn't a book about the struggle to make and get drugs to AIDS victims, but rather how health officials have misunderstood the nature of the virus in east and southern Africa, which led to ineffective prevention programs that inadvertently wasted donor funds over the past 15 years.

AIDS is a social problem, Ms. Epstein says, that is perpetuated by historically-rooted sexual behaviour (having few but concurrent sexual partners instead of serial monogamous relationships), the effects of post-colonialism and globalization, which are all linked to the battle between the sexes. Economies broken by globalization and a wide prosperity gap led to economic insecurity which fuels a web of relationships between men and women, which means the quick speak of HIV. A flip book-style chart showing this appears across chapters three and four, and is fascinating.

Ms. Epstein says AIDS is a serious public health problem that needs to be addressed through its social and political causes, not just through drug testing. She explores the tradition of community solidarity in Africa, and is convinced this capacity to help each other and endure is the key to fighting this scourge. She also examines the role of religion (both in the United States and in countries like Uganda) in fighting the virus, how foreign aid is like a bank machine, and the underground economy of AIDS. She urges industrialized nations to rethink their trade, development and foreign investment policies in order to help fix the economic problems, but her main thrust throughout the book is that AIDS will only be cured by social mobilization. Just like with the current fight against climate change, it is individuals and communities–not governments–that will have the greatest impact in changing the world.

The Invisible Cure is an interesting and very readable look at HIV/AIDS, charting its scientific history, critiquing how Western scientists presume to study the disease, and analyzing present-day grassroots social programs that are doing more to fight the virus than any vaccine ever will.

Morality Gets a Massage---The Nation

Morality Gets a Massage

[from the May 28, 2007 issue of The Nation]

So far, the most significant player to show up on Washington madam Deborah
Jeane Palfrey's much-discussed client list is USAID chief Randall Tobias,
the former pharmaceutical company CEO who ran Bush's global AIDS initiative
for its first three years. His ignominious tenure as AIDS ambassador was marked by a preference for pricey brand-name HIV drugs over cheap generics, which sharply reduced the number of people who could be treated. Ironically, given his regular "massages" from call girls, when we can surmise he ignored the abstinence-only instruction to "keep all of your clothes all the way on all of the time," Tobias was also an avid defender of the President's puritanical approach to HIV prevention.

Tobias was the hatchet man who forced every US grant recipient to publicly
condemn prostitution--even struggling outfits doing the sensitive work of
persuading destitute sex workers to use condoms. A forthcoming study from
the Center for Health and Gender Equity of five Asian countries where
commercial sex is driving the AIDS epidemic found that the policy has
resulted in the closure of drop-in centers for street prostitutes and a
scaling back of other successful prevention efforts.

It was Tom DeLay's ethically challenged Congress that slapped the global
AIDS initiative with a one-third abstinence earmark on prevention. Tobias
promoted this approach so zealously that in some countries, like Nigeria,
nearly 70 percent of all US dollars granted to prevent the sexual
transmission of HIV were channeled toward abstinence.

Tobias is not the first abstinence czar to leave his job after running afoul
of the moral agenda he promoted. Claude Allen, once the leading White House
abstinence advocate, stepped down as domestic policy adviser last year after
he was caught stealing. Ted Haggard, once head of the National Association
of Evangelicals--powerful boosters of abstinence-only spending--resigned
last fall after a gay hustler named him as a client. But Tobias's fall comes
as momentum is finally building against the $2.5 billion-and-counting
abstinence boondoggle.

Though the Institute of Medicine called for the elimination of
abstinence-only programs in 2000, Bush set about doubling their budget
instead. Last month the Administration's own study--mandated by Congress a
decade ago but delayed while ideological spinmeisters handicapped the
criteria to help produce favorable results--was finally released. Posted
quietly on the web without even a press release, it affirmed what every
academic study had found before: Preaching abstinence doesn't produce it.
Numerous studies show that contraceptive access cuts teen pregnancy rates
and condom education dramatically reduces HIV transmission.

As with opposition to the war, the American people are ahead of Congress on
this issue. A recent study found that 82 percent of Americans want
comprehensive sex education for their kids. Nine states have now turned down
the tempting pot of abstinence money, including "red state" Montana.
Abstinence funding should go the way of Randall Tobias. Legislation like the
Pathway Act, which would revoke the abstinence earmark on global AIDS
spending, and the Real Act, which would allocate funds for comprehensive sex
ed, both introduced by Barbara Lee, need muscle from Democratic leaders.
When the President's AIDS initiative comes up for reauthorization in two
years, Congress should strike the prostitution pledge and the ban on needle
exchange.

The moral contradictions of the abstinence-mongers speak eloquently to the
folly of basing public health decisions on religious injunctions and
fantasies of social control. It's time for Congress to stop this dangerous
crusade, both here and abroad.