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Feedback from the XIIIth International AIDS
ConferencE, held in Durban, South Africa, July 2000
Webplaced: 15th February 2001
summarised by Ian Hodgson
venue
opening
ceremony
tracks:
Closing
ceremony
the
challenge
the
venue
The International Convention
Centre
opening
ceremony
The experience of living with
AIDS: a child's view
the
‘tracks’
Track
A: basic science
- Worldwide expansion of subtypes
causing concern (types A-F appear in various combinations across the
world)
- HAART has proven
utilities: though viral rebound occurs almost immediately if
stopped
- Key point:
Development of HIV vaccine is most crucial challenge in HIV
research – acceleration of global efforts in AIDS vaccines strongly
requested
Track
B: clinical science
- Mainly directed at issues
in developing countries
- Key point:
reduction in maternal-foetal transmission demonstrated in numerous studies
by using levirapine and zidovudine
- Breast feeding
:
the debate continues re: developing countries, though studies are suggesting
that early introduction of mixed feeding in children <30 days increases
risk of HIV transmissionLogistics
of HIV in the developing world:
majority of 1000 Zimbabwean women counselled testing chose not to proceed,
and many of those who did chose not to return for result
- In ‘mature’ epidemics,
targeting ‘risk groups’ is ineffective – need sustained
intervention aimed at whole population
- Proliferation of community
self-help groups
across Africa is one ‘beacon of hope'
Track c:
epidemiology, prevention and public health
- HAART is effecting the
epidemic in the affluent north, though HIV transmission is increasing
- Explanations
for diversity and unpredictability of HIV pandemic remain vague –
including gender power dynamics, migration, social disruption
- Key point:
Some countries have achieved notable successes: Thailand and Uganda
– where political will and community action have been key factorsIn
the early stages of the epidemic, control of STIs can reduce HIV
transmission
- Exclusive breastfeeding
(i.e. not mixed) lessens risk of HIV transmission
- Key point:
African and Thai studies suggest spermicides are ineffective (or even
harmful) anti-HIV agents
- One point: young people
not prominent in the agenda at SA – need more innovative models for
interventions
Track
D: social science
- Key point:
Problem of increasing IV drug use in Africa
- In MWSM – need local
monitoring of sexual practice, as studies are generally not
identifying universal trends – e.g. elements associated with unprotected
anal sex
- ‘We are in for a long
haul’, and the effects of social and economic inequality need
factoring in to all considerations
- People are still afraid
to reveal their HIV status in all countries where HIV occurs
- Future issues
(selective): denial of HIV/AIDS link; understanding oppression within sexual
relationships
Track e:
rights, politics, commitment and actions
- HIV programmes cannot be
introduced in isolation of their context
– e.g. levels of poverty and cultural norms and practice must be
considered
Testing:
Now there is a real benefit to knowing HIV status in developed countries
African debt crisis
contributes to inadequate response to HIV epidemic
Widening gap
between rich and poor, and effects upon epidemic
Key point:
Access to essential medicines – dominated
the whole conference
Future issues (selective):
‘HIV orphans’; migrants and immigrants
Closing
ceremony
Nelson
Mandela
‘In the face of the threat posed by AIDS we must rise above our
differences and combine our efforts to save people’
The
attention of the conference, and then the challenge......
Daily News - Durban, Monday 17th
July 2000
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