Ignore HIV at our own peril

June 15, 2011

HIV remains one of the most formidable challenges facing the human family and we ignore this challenge, literally, at our own peril.

This is clear from the final declaration agreed by the U.N. General Assembly High Level Meeting on AIDS that met June 8-10 in New York.

The cost in human suffering, lost opportunities and diversion of resources remains a challenge that no one can escape, but there is hope of better protection through increased access to anti-retroviral drugs, early testing, and recent medical breakthroughs.

Leaders agreed to advance efforts towards reducing sexual transmission of HIV by 50 percent and to push towards eliminating new HIV infections among children in the next five years. Transmission of HIV from mother to child can disappear, if we want it to and are prepared to pay for it.

They also pledged to increase the number of people on life-saving treatment to 15 million and to reduce tuberculosis-related deaths in people living with HIV by half by 2015.

But the real challenge is not just the health-related issues of HIV but the moral imperative to continue to engage issues most people do not yet fully understand.

Half the world's governments still see homosexuality, intravenous illicit drug use and prostitution as crimes and so these populations will not be significantly assisted in their access to life-giving information and healthcare without organized advocacy and informed conversations with those at risk themselves.

Our past history reminds us that the U.S. religious community, with additional leadership and expertise from newly created civil society AIDS organizations, took many years to challenge (and in some cases fight) our own government policies and attitudes of discrimination in healthcare and insurance systems. Together, we worked it out.

The High Level Meeting, during which more than 3,000 people and 30 heads of state came together at the U.N. in New York, was a similar political dance, this time on a global stage. The stakes are higher, with more people, unfortunately, suffering. However, there is a greater opportunity also to engage more people in the issues so they can become more mobilized to hold their governments and institutions more accountable.

A report from a panel of U.N. international experts is forthcoming on legal obstacles to universal access. This will be an important reality check for the declaration and it is timely, given the document's more general mandate. Technologies and social networking also will give younger people greater access to protecting each other, even when their parents and grandparents remain prudish or religiously opposed to evidence-based interventions.

There is also hope in areas that may not be so obviously related. On June 7, the U.N. Security Council adopted a resolution that was acclaimed as a major victory for curtailing sexual violence against women as a result of wars. The council recognized that U.N. peacekeeping operations can be important contributors to an integrated response to HIV and AIDS and U.N. Secretary-General Ban Ki-moon declared in his remarks to the meeting: "Now we understand that U.N. troops and police are part of prevention, treatment and care."

Yet reaction to the declaration and the three days of deliberations remains mixed. For many who attended the 2001 and 2006 UNAIDS Summits, this one lacked the urgency and optimism of the previous two. The Global Fund for AIDS and significant measurable targets through the Millennium Development Goals were all created at these previous gatherings. The goal of providing "universal access" was inspirationally created by all 174 member states. By the time diplomats gathered in New York to reflect on what had been learned and data of the previous years analyzed, it was clear many of the issues that needed to be addressed at this year's summit were seen as highly controversial, i.e. dealing with care and prevention efforts for men who have sex with men (MSM), sex workers and IV drug users. Global South delegates felt this was a Global North (activist) agenda.

Religious extremists also attempted to derail important civil society dialogue with the diplomats and politicians by submitting their own annotated forms of the draft declaration. In one case, the Arizona-based Family Watch International held a weekend retreat earlier this year for 30 delegations where all references to LGBT people and MSM were replaced by an explicit emphasis on "behaviors" that needed healing. Fortunately, FWI's recommendations were not incorporated into the final document.

Although Roman Catholics were reluctant to talk publically about condom and gay issues, there was a real concern from grassroots civil society organizations that the religious community had a responsibility to open up dialogue between HIV grassroots organizations and political and religious leadership. This is particularly needed in countries where there is little awareness about the harm certain laws and religious attitudes may be having on effective HIV prevention.

The declaration is simply a photograph of who and where we are in 2011 and our reaction to it will determine the success or failure of our common struggle with AIDS. I am hopeful, as was the case 30 years ago, that the declaration will create millions of global activists, new civil society organizations to meet unmet needs and new partnerships with the religious community to heal without judgment.

-- The Rev. Canon Albert Ogle is president of the St. Paul's Foundation for International Reconciliation at St. Paul's Cathedral in San Diego. He is co-author of the California War on AIDS 1987-91, the first comprehensive plan for the state. He is the founding executive director of the AIDS Service Center, Pasadena, and worked to establish the Anglican Church of Uganda's initial AIDS response 1991-1997. He is currently assisting Retired Ugandan Bishop Christopher Senyonjo to establish an AIDS program in Kampala targeting at-risk populations. He recently developed a conflict resolution curriculum for countries that have, until now, been unable to address controversial issues named at the High Level Meeting. With support from the Ford Foundation, he launched the course in Kampala in May.

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