August 18, 2006

Sarah Adams, MCC AIDS Coordinator

The week is over. I think we’re all leaving here both energized and exhausted. The things I’ve seen and heard here in Toronto will no doubt take a lot of processing. My head is still spinning right now. Making any real sense of everything seems like an overwhelming task.

Stephen Lewis was the keynote speaker today. Let me start with some of the key issues from his perspective (many of which are certainly the subject of some controversy, so brace yourself!):

• A Western government providing funding for programming that forces another government to adopt the Western country’s ideological approach is akin to neo-colonialism.
• Harm reduction programs work. (e.g. condom use, needle exchange)
• Male circumcision should be done if it saves lives.
• Microbicides are essential for women’s protection.
• Prevention of mother to child transmission programs must be available to all.
• Nutritious food supplements are essential.
• Sexual violence against women must end.
• Rapid testing with an opt-out status may be necessary.
• Sexual abuse against children must end.
• The needs of orphans must be addressed.
• Grandmothers must be supported.
• The rapid role out of ARV treatment must continue.
• The South African government is the worst on the continent when it comes to supporting people living with AIDS.

Stephen Lewis got me thinking about my own list. What are my key issues as I leave this conference? These are the first ones that come to mind. Of course, the more I think about it, the longer the list grows in my head. In no particular order, here are just a few of my thoughts:

1. The church needs to develop its own evidence-based programming. The role of abstinence and faithfulness was hardly mentioned during the conference. If we believe that these tools work, then we must – like all the other researchers – prove they work. We know churches do amazing work. But we don’t always document it very well. What are we doing to prove to the wider scientific, policy-influencing community that our methods work?
2. At the same time, simple teaching on concepts we should all implement in an ideal world isn’t enough. Why? Because the world isn’t ideal. The world is full of poverty and migration, economic structures that are unfavorable to the developing world and unequal access to medical care, women that have no say over their own sexual health and children whose voices are unheard, families that lack food and widows that lack shelter, companies that make billions in profits and children forced to drop out of school to care for dying mothers. The world is unjust. We must work for justice.
3. New tools are on the horizon. As with other diseases over the years, answers will come. Means of dealing with the disease will come. It will take time, but our faith let’s us know that we will overcome this disease. We must keep working at it. We may require rest along the way, but we must not stop.
4. We need continual advocacy around access to medications. Amazing progress has been made. We need to keep the pressure on. Right now, only the first line drugs are affordable. It is only these first line drugs, which can loose their effectiveness for a patient within 3-6 years, that are widely available. What happens in year 7? Are we ready to face another massive wave of illness and death? Or can we do the ground work now to ensure the second line drugs will be available when people need them?
5. We must abandon stigma. As Melinda Gates so clearly stated, "Stigma is irrational." For what possible reason could it be necessary? Who receives any benefit from it? What good ever comes of it? Really, it is irrational.
6. AIDS is a giant. It’s powerful. It’s everywhere. It’s intelligent. It’s divisive. It’s political. It is huge! As a global community, we will never begin to address AIDS unless we work together. We have to respect the role of each player – governments, non-governmental organizations, the medical community, businesses, human rights groups, researchers, churches. We have to see the good in others and agree that we will all work toward a common good. We have to be willing to say, ‘I may not agree with you, but I know your actions come from the depths of your compassion and your desire to end this crisis.’ We have to learn to trust and respect each other. And we have to earn the trust and respect of others through our own action.

OK, I stopped at six. I tried to stop at five, but didn’t quite make it. Sorry. Again, the list could go on and on.

For those of you that would have liked to be here yourself, the Kaiser Family Foundation is a great on-line resource. On their website, you can find complete video and audio clips, as well as transcripts, from all of the conference plenary sessions and many of the workshop sessions. There is an amazing amount of information, and it’s all free. Find it at www.kaisernetwork.org

And finally, if you’ve been following the conference yourself and have any feedback that you’d like to share with us here at MCC, we would love to hear from you. Submit your comments or questions to me.

On behalf of the many people here in Toronto, and the many others active in the fight against AIDS that couldn’t be here, thank you for caring about this issue. Thank you for reading our daily up-dates. And thank you for the role you have played (or will play!) in the global effort to stop AIDS. Each one of us counts. Each one of us can make a difference.

Signing off from Toronto…