By Paul Jeffrey
The 18th International AIDS Conference came to an end on July 23 with a flurry of promises to once again struggle for universal access–the unfulfilled dream that all who need it would have access to care, support, treatment and prevention of HIV and AIDS.
There was good news in Vienna. Vaccine research is creeping forward. Trials of microbicidal gels appear to offer hope for greater protection of women. Male circumcision is gaining popularity in some regions. Lowered infection rates prove prevention programs incorporating behavior change are effective.
But there was also bad news, much of it centered around a fall off in financial support. A study released by the Ecumenical Advocacy Alliance showed a flatlining of AIDS funding for faith-based organizations working with HIV and AIDS–a serious problem given that faith-based groups provide up to 70 percent of health care in some rural and poorly-resourced countries.
“We’re really at a tipping point in the struggle against HIV and AIDS,” said the Rev. Donald Messer, executive director of the Center for the Church and Global AIDS. “Once the flavor of the month for funders, it seems to be going out of favor. We’re challenged today by AIDS funding fatigue. Some people are more interested in easier diseases to treat, less controversial ones like malaria. Some of the crisis is due to the global economic crisis, but it’s also clear that governments are not cutting back on military expenditures.”
The Vienna conference introduced what many are calling “Treatment 2.0,” a push to spend AIDS money more efficiently in an era when massive funding is now but a memory.
“The days of the big numbers are gone. Treatment 2.0 means doing more with what we’ve got,” said Nicoli Nattrass, Director of the AIDS and Society Research Unit and Professor in the School of Economics, University of Cape Town (UCT), South Africa. She said the growth in AIDS funding early in the decade was made possible by a worldwide economic boom. “It’s amazing at the end of the boom that we’ve managed to keep funding where it is,” she said.
Others can’t accept that.
“I’m sad to hear that the days of the big numbers are gone, because big numbers of people infected with HIV are what we continue to have in Africa,” said Peter Mugyenyi, director of the Joint Clinical Research Center in Kampala, Uganda. “Africa is a continent that must not depend on donors for its development, but we have an emergency in our midst.”
Michele Broemmelsiek, the AIDSRelief chief of party for Catholic Relief Services, said most faith-based groups are going to have a hard time with Treatment 2.0.
“At a certain point, you can’t do any more with less, you’ve reached every efficiency, you’ve maximized everyone’s time, you’ve figured out how to make patient flow work like a dream, there isn’t more efficiency to add to the system, and yet you’ve got to add more people to treatment,” she said.
“It’s a good Catholic premise that we be good stewards of the money we get, so we should be always striving to do more with less. But we also have to be realistic. There’s a lot of need out there, and the treatment facilities are doing the best they can. Many are operating on a shoestring budget now, so it’s hard to imagine there’s a lot more they can do with less support.”
Veena O’Sullivan, head of the HIV team for Tearfund, said the work of faith-based organizations is going to be even more important as fewer resources are made available for the fight against the virus.
“Bill Gates and others came here to talk about task shifting, but who are the people who are going to take on those tasks? It is the volunteer force, such as the 5.7 million people in Nigeria who volunteer to help others living with HIV and AIDS. These are the people who provide care and support, who come to take people to hospitals,” she said.
O’Sullivan said Tearfund’s partners and other faith-based organizations participated in new ways in the Vienna conference. “They went to discussions they wouldn’t have gone to six years ago. There’s a real desire to engage, to understand. All voices need to be heard, and our faith voices are as vital as the others. This conference was valuable in that everyone got to say what they thought. And they were heard. There was antagonism at times, but you have to take that on the chin and really work to understand the root of the problems.”
The Rev. Dr. Richard Fee, general secretary of the Presbyterian Church in Canada and chair of the board of the Ecumenical Advocacy Alliance, agreed that faith-based voices were listened to in Vienna.
“I’ve been amazed at how input from faith groups has been sought throughout the conference. They’ve been referenced in the scientific discussions, sought out in the Global Village, and many are saying they need greater involvement from faith-based groups in order to reach vulnerable populations. Yet we need even more dialogue between scientists and faith communities if we’re going to strengthen our common strategies to combat HIV.”
Father J.P. Mokgethi-Heath, an Anglican priest in South Africa, said religious voices were less segregated in Vienna.
“The voices of faith-based people were integrated into other presentations in a much better way than I saw in Mexico City [the site of the 2008 International AIDS Conference]. So we had a bigger diversity of people who came to listen to us, and they remarkably didn’t walk out on us,” said Mokgethi-Heath, a member of the International Network of Religious Leaders Living with or Personally Affected by HIV (INERELA+).
Vienna residents who belong to faith communities also benefited from having the conference held in their home town, said the Rev. Carsten Koch of the Lutheran Church of Austria. He served on a local committee that hosted faith leaders for a one-day “pre-conference,” as well as a public interfaith service at the beginning of the July 20 human rights march through the center of Vienna.
“HIV and AIDS is now an important theme for religious groups in Vienna, much more than it was before,” he said.
Some participants found particular aspects of the conference helpful. “We discussed for the first time in the plenary sessions the intersection between women and HIV and violence, something we deal with in Africa from a faith perspective but which doesn’t get enough attention,” said the Rev. Dr. Nyambura Njoroge, coordinator of the Ecumenical HIV and AIDS Initiative in Africa.
Sophie Dilmitis, HIV and AIDS coordinator for the World YWCA, noted there was welcome gender equality in selecting speakers for the plenary sessions, a first in the long series of AIDS conferences. “This conference has done a much better job of addressing the needs of women in the program,” she said.
Yet Dilmitis said young people remained under-represented. “We need to do better at involving young people, because youth need to become better activists. Our activism has become too polite. We need to be more angry, make people uncomfortable about the status quo, especially when it comes to young people,” she said.
Dilmitis believes that faith-based groups need to better organize their presence at future conferences, such as the one scheduled for Washington, DC, in 2012.
“One of things we heard in the pre-conference was Kevin Moody [the international coordinator and CEO of the Global Network of People Living with HIV], who put a little bit of pressure on the churches. He said that when churches and religious institutions accept people living with HIV and people with diverse sexualities, and when the church becomes a safe space for people who are diverse and have different needs, then we are going to get somewhere. It’s sad to have heard that call and then come to the International AIDS Conference and find so little on faith,” she said.
Yet Dilmitis said she wasn’t discouraged, and quoted a phrase used during a July 22 conference panel by Bishop Yvette Flunder, senior pastor of the City of Refuge United Church of Christ in San Francisco. “She said this work is not for wimps,” Dilmitis said.
Notes to editors
The 18th International AIDS Conference had 19,100 participants from 193 countries.
For more information on faith-based participation at the 18th International AIDS Conference, visit www.iac.e-alliance.ch. Photos on the site may be reprinted freely provided credit is given to the photographer/EAA. High resolution photos available by contacting sspeicher@e-alliance.ch
Media contact: Sara Speicher, +44 7821 860 723 (mobile), sspeicher@e-alliance.ch
