24 July 2014

Clinton advocates more efficient use of HIV resources

Bill Clinton told delegates at Aids 2014 that finding more economically efficient ways to respond to HIV is vital to saving lives and preventing the spread of the virus.

Just a month before the publication of a book by Pulitzer-prize winning journalist Lucinda Franks about the reasons behind his sex addiction, Bill Clinton, founder of the Clinton Foundation and 42nd President of the United States, is a key note speaker at the Aids 2014 conference in Melbourne.

Read: Could legalising sex work stop HIV spread?

Progress of incoming HIV epidemic

The former US President has told delegates at Aids 2014, the 20th International Aids Conference, that finding more economically efficient ways to respond to HIV is vital to saving lives and preventing the spread of the virus.

Mr Clinton, who advocates globally for health security through the Clinton Health Access Initiative (CHAI), made the comments at the conference in Melbourne as he reflected on the progress made so far in overcoming the HIV epidemic, as well as the challenges that lie ahead.

His speech, which attracted hundreds of scientists, activists and journalists, was briefly interrupted by protesters holding placards, demanding a "Robin Hood" tax on financial transactions to fund the fight against HIV and Aids.

Read: New technique forces HIV out of hiding place

Resources must be used effectively

Mr Clinton said meeting global HIV prevention and support targets is possible within the “existing funding envelope”, but only if resources are used more effectively. “The development of super-efficient systems can help us achieve the 90 / 90 / 90 goals,” Mr Clinton said, referring to the UNAIDS 2020 targets of 90% of people with HIV knowing their status, 90% of people with HIV receiving antiretroviral treatment and 90% of people on treatment having an undetectable viral load.

Mr Clinton said one of the biggest challenges is delivering care to patients in a better way in rural and remote areas. “How can we reduce the distance they travel to the clinics, the time they wait, the money they spend? How can we launch programmes to ensure they feel supported in their communities without the stigma that makes people still, after all these years, drop out of care,” Mr Clinton said.

Mr Clinton said ending mother to child transmission of HIV, and supporting children with HIV is another challenge – as well as a tremendous opportunity for sustaining progress in the response to HIV. “Almost 50% of all new paediatric infections occur during the breastfeeding period. So keeping these women in care until the end of the breast-feeding period is the single most important thing we can do to achieve an Aids-free generation.”

Read: Why life insurance is important for those who are HIV positive

Encouraged to step up pace

Mr Clinton indicated that the Aids 2014 gathering was more of a movement than a conference, and encouraged delegates and those involved with HIV around the world to step up the pace and continue to make in-roads in the global response to HIV. He also paid his respects to the victims of MH17 including the six delegates due to attend Aids 2014.

He said the delegates who died, through their work for the global HIV response “gave their entire lives to the proposition that our common humanity matters a hell of a lot more than our differences.”

Today’s conference activities (Wednesday 23 July) began with plenary presentations about improving outcomes for marginalised populations of people affected by HIV. The theme of the conference today, including the opening plenary session, was “Nobody left behind”.

Issues discussed included addressing the needs of people who use drugs through drug policy and harm reduction (Khuat T. M. Oanh of Vietnam), increasing support for people living with HIV and tuberculosis co-infection (Diane Havlir of the US), and reducing the impact of HIV on sex workers (Daisy Nakato of Uganda) and on indigenous populations (James Ward of Australia).

Also yesterday morning was a symposium on how momentous political and cultural change in South East Asia is impacting on the HIV response in the region and the lessons learned from countries which are moving through periods of major transition.

Other sessions included a discussion of how police forces can better support HIV prevention efforts, and how organisations from around the world are helping to reduce barriers to HIV prevention and care for transgender people.

Read: Experts killed – Blow to hope of Aids cure

Other symposiums

Yesterday afternoon featured a symposium on how religious faiths can work to overcome sexual taboos that have negatively contributed to the HIV epidemic. Other sessions this afternoon explored a range of subjects such as: responding to the HIV prevention and support needs of migrants, refugees and mobile populations; maximising the preventive benefits of HIV treatments; and novel ways to increase HIV testing among at-risk populations.

One of the most moving sessions of the conference was when a panel of people living with HIV discussed how they have directly and personally been affected by injustice, control and punishment based on their HIV status.

Their stories will deal with issues such as HIV criminalisation, reproductive rights, employment and migration as well as stigma and discrimination. Mr Clinton commented in the opening address that it is “unbelievable” that after all this time, “stigma and discrimination are on the rise in some contexts.”

The Global Village, the conference’s international showcase of community related HIV programmes and activities, featured a range events including HIV-related fashion shows, film screenings, music recitals and dance performances, as well as discussions on a variety of issues such as: understanding travel restrictions for migrants living with HIV migrants and travellers; empowering sex workers in Asia and the Pacific, and innovative approaches to engaging young people through social media and digital platforms.

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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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