In South Africa, Making Our Voices Heard Again

by Craig McClure, Executive Director, International AIDS Society

IAS 2009 comes at a critical time. There has been huge progress since the International AIDS Conference was held in Durban nine years ago. Well over 3 million people are on ARV treatment in poor countries, prevention programmes have been scaled up, and health care workers and policy makers are leveraging HIV programmes to strengthen other areas of health care.

Great strides have also been made with malaria and tuberculosis on the back of the global movement to fight AIDS. Sexual and reproductive health, primary care, and maternal and child health are all benefiting from the scale up of HIV programmes. We know more than ever about how to prevent and treat HIV, and we know we must combine. Combine the right prevention interventions for each specific community with early testing and treatment. Combine prevention and treatment with human rights promotion and protection for all people. We just may be at the beginning of the end, or at least the end of the beginning.

And yet, just as we are finally beginning to put a dent in the epidemic, HIV is at risk of falling off the agenda of the world’s leaders. As the global recession sets in, reports of stock outs of ARVs in a number of countries in Africa are beginning to circulate, putting lives at risk for those who already have, or thought they had, access to treatment.

At the international level, there are voices calling for resources to be shifted to “health systems strengthening”. These people argue that disease-specific programmes are “distorting” overall health systems. What a load of rubbish. We must remember the disastrous state many national health care systems were in before the HIV movement raised the alarm over and over and over again, finally mobilizing political leaders to do something. We must remember the thirty million people who died of AIDS before treatment programmes began to be scaled up. We must remember the millions who still have no access to treatment. And we must remember the example the HIV movement has set for global health, by forging a true global, multi-stakeholder partnership.

The issue of resource needs is real and very urgent. We need more, not fewer, resources for HIV. We need resources for other diseases, too. We need resources for primary care. And we need resources for health systems more broadly. Health is a prerequisite for development, and we must remind our leaders of that over and over again. South Africa, at the heart of the HIV epidemic, is the perfect place from which to make our voices heard once again.