Aids crises far from over

Opinion Dennis Altman

Twelve years ago a regional AIDS Conference took place in Melbourne. At the time concerns were growing about the impact of AIDS on global security.

The conference was part of a number of international initiatives: a resolution by the Security Council in 2000; the first special meeting on AIDS of the UN General Assembly in 2001; the initiation by President George W. Bush of major funding for international AIDS programs.

The 2005 Gleneagles G8 meeting was probably the high point of international mobilisation around AIDS. The British host, Tony Blair, backed by Presidents Bush and Chirac, was determined to highlight aid to Africa, which included a strong emphasis on HIV.

But Gleneagles also followed massive popular mobilisation, through the Make Poverty History, one of whose spokesmen, Bob Geldof, will be speaking at this year's conference, which begins today. A decade later the Millennium Development Goals, also a product of that time, are being reviewed by a complex global dialogue, now moving towards resolution.

During the 2000s, HIV therapies started to be rolled out in many parts of the world, confounding those who said they could not be made available to people in poor countries. Yet while strides have been made it remains true that most people infected with HIV globally do not know their status. Six thousand people a day are probably infected by HIV, almost all in low and middle-income countries and almost 70 per cent of them in Africa. 

Yet the fastest growing epidemics are probably among men who have sex with men and needle users, many of them in the Indo-Pacific region. There are alarming reports of increasing infections from areas of internal warfare stretching from Afghanistan to Libya.

The AIDS epidemic is not over, yet tragically as we have better tools to prevent and treat, international interest and resources are not rising to keep pace. In part this is because most of us in rich countries like Australia believe the crisis is over; AIDS is no longer a global emergency, but rather an ongoing problem among many.

Three interconnected reasons make Melbourne a good place to host a conversation about rejecting complacency. This is an epidemic that kills more than a million people a year.

Australia offers a safe political space in which people who are vulnerable because of their identities or behaviours can speak freely. Australia is, though with declining commitment, a significant donor of development assistance. And while Melbourne is far away, if one assumes a North Atlantic-centric view of the world, it is a perfect location for the three "southern" continents to meet and speak to each other.

While Australian assistance is largely directed to its immediate region, we reach across the Indian Ocean to many of the most affected countries in Africa, to whom we are linked through the Commonwealth. And we reach across the Pacific to South America, where some of the most innovative programs and research in middle-income countries have occurred.

The conference is occurring during final negotiations for a post-MDG global consensus on development, which will lead to a discussion at the General Assembly in September around Sustainable Development Goals. Australia is part of the working group.

The current goals make specific reference to AIDS, along with malaria and tuberculosis, and UNAIDS, the lead agency involved, is asking for an explicit commitment to ending AIDS by 2030 in the new statement. 

The conference will include several important sessions on the future of the MDGs, and Helen Clark, former New Zealand PM, now head of UN Development Program, will address these issues. How those concerned with AIDS reach out to others in the global development sector will help shape global priorities over the next decade.

Four months later, Australia will host the G20 meeting in Brisbane. At the most significant gathering of world leaders ever to meet in Australia there is an extraordinary opportunity to stress how the losses of life and productivity due to AIDS are linked to the Prime Minister's emphasis on economic growth. Not scaling up treatments and, especially, prevention will be a greater burden for countries like Papua New Guinea than increased support for effective anti-HIV programs.

There are economic as well as major humanitarian gains to scaling up the global response to the epidemic. The Abbott government has declared a particular interest in medical research and international health. The combination of the global AIDS Conference followed by a G20 summit is an opportunity for Australia to take the lead in reaffirming and funding an effective global response to what remains a major threat in some of the poorest countries in the world.

Dennis Altman is Professorial Fellow in Human Security at La Trobe. His latest book is The End of the Homosexual? [UQP] and he is a former president of the AIDS Society of Asia and the Pacific.

This article first appeared in The Sunday Age on July 20th

Image credit; Christian Heldt

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