AIDS Conference 2018: A photo essay
I attended the AIDS 2018 Conference in Amsterdam on a scholarship from the International AIDS Society to present a poster on our work at Health Access Connect. Here are the highlights of my experience of the conference.
I passed Nairobi airport on my way to Amsterdam. The first thing that I noticed in Amsterdam is the ease of transportation. The metro and trains will take you anywhere! And there are bike lanes and pedestrian walkways all over the densely populated city. It’s a dramatic contract to Kampala in which traffic is often at a standstill and pedestrians are shoulder to bumper with cars and minibuses.
I met some of the other scholarship recipients and networked with other people who work in Uganda. The recipients whom I met included advocates for LGBTQ rights, a social worker who works with prisoners, quantitative public health researchers, journalists, clinicians, and pharmacists. My interactions with scholarship recipients was where I caught my first glimpse of the diversity and sex-positiveness of the conference.
The place was packed! The conference was overwhelming. Hundreds of sessions. Protest demonstrations. Quiet dance parties. Corporate presentations. It’s a lot to take in.
My goals going into the conference were primarily to 1) find organizations that are funding work similar to ours (aka look for money), 2) learn about cutting edge programs, and 3) connect with potential partner organizations.
The tracking-down-funding thing made the stakes pretty high! In this photo you can see a section of the exhibitors’ area. Lots of corporations (especially large pharmaceutical companies), foundations, and government aid agencies had booths (some with free espresso!) mostly for selling therapies and talking about their programs. I got a few good leads, but mostly people responded, “Ooooh, cool program. I’m not sure who’s funding that kind of thing.”
I spoke on a broadcast to the ViiV Healthcare staff. ViiV gave us the Connecting to Clinic Incubation Prize in 2017, and they continue to support our work with advice and contacts. It was nice to meet them in person and get their advice on where we should go next. The gist of what they said: “We want your model to spread all over the world! We don’t have funding right now, but we are willing to help in whatever way we can.” We feel fortunate to have this continued relationship, and it’s nice to get some pats on the back!
HAC’s work relates to other “differentiated service delivery” (DSD) models of healthcare. DSD takes the patient and his/her/their needs as the starting point for developing a model to reach them. Some key populations for HIV/AIDS are men who have sex with men, sex workers, injectable drug users, adolescent girls, and fishing communities (that’s where we target!). So under DSD, rather than having one strategy for giving anti-retroviral treatment, you would set up special programs for sex workers in Dar es Salaam, which would be different from injectable drug users in Kiev, etc.
Here’s our poster that I presented. I met a lot of people who were interested in what we are doing. People in the HIV/AIDS space are excited about a few things:
- We are reaching the most difficult-to-reach communities that other organizations can’t.
- We are using transportation networks that already exist in the country, rather than setting up something new.
- We are using microfinance and cost-sharing so that the program is low-cost and sustainable, even as funding for HIV/AIDS has declined.
I racked up quite a few business cards, and since the conference I’ve been meeting with researchers in Uganda around the world to learn from each other.
It’s hard to distill all that I learned (or all that I’ve forgotten!), but here are some highlights:
- The global push is 90-90-90. 90% of people living with HIV know their status, 90% of those are started on treatment, and 90% of those have suppressed viral loads. The costs of reaching remote and undeserved populations are high, and HAC is playing an important role in helping Uganda meet those targets.
- 2% of international HIV-related funding is dedicated toward key populations but over 40% of new infections outside of Sub-Saharan Africa involve these populations.
- 1/3 of sex workers in Sub-Saharan Africa are HIV positive.
- Only 1.4% of funding spent on combating drug abuse and addiction is spent on “harm reduction” programs, like clean syringes, pre-exposure prophylaxis for HIV, and antiretroviral outreaches. Most is used for law enforcement, including police action and imprisonment. Yet the public health community has mountains of evidence to show that harm reduction saves lives and is cheaper.
- One of the important topics at this conference of “self-testing” for HIV. There are cheaper, easier testing kits to use, but researchers and policy makers are discussing how to implement these kits because post-test counseling is a core part of testing. (Imagine people who find out they are HIV-positive; they need a trained counselor to help them understand what that means and think through next steps.) One approach that is getting traction is “supervised self-testing” so that there is an increase access to HIV testing and a health professional to help patients understand the results.
- Currently, the burden of HIV/AIDS is being shouldered by adolescents, especially adolescent girls. There was a lot of advocacy for programs that target schools and homes of adolescents.
- I also want to mention that there was a lot of representation from Africa and the Global South.
- Have you ever heard of the meme “Congratulations, you have an all male panel!“? It’s meant to draw attention to how conferences and sessions prioritize the voices of men. Well, none of the sessions that I attended had an all-male panel, and quite a few had an all-female or an all people-of-color panel. Kudos to the organizers.
There were some celebrities in attendance! I was able to see Bill Clinton, Elton John, and Prince Harry. Many people were energized by these marquee names, who emphasized, “What you all are doing is important, and together we can eliminate HIV!”
I did get to do a teeny tiny bit of sightseeing. And I made a few new friends at the conference. My favorite non-conference parts of the week were long walks through downtown Amsterdam checking out street performers, eating Indian food, smelling the … smells in the air. At the end of the day I got to chat with my Airbnb hosts about the conference, their lives, and whatever political news was swirling around.
Lastly, here are some of the photos from the morning runs that I had in northern Amsterdam. Notice the geese waddling in the mist and the lovely bike and pedestrian paths.
Peace out, Amsterdam! #AIDS2020 will be in Oakland-San Francisco. I hope we get the chance to attend!
Aspire for something big!
Highlight the voices of the people we work with.
Build connections.
Appreciate our access.
The next morning we rode on the back of a motorcycle for 45 minutes to our first stop: Bungo village. The buildings in Bungo were mostly made of wood or mud with corrugated iron sheets for roofs. Most doors consisted of a curtain of a sheet of fabric, or actual doors were made of the same board wood as the walls.
