Time to go home

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The International AIDS Conference is drawing to a close and with it, so is my long overseas journey. Tomorrow I’m off to London, then Singapore, then Melbourne and home. I’m ready.

The conference has been amazing – there is much good work being done out there and I’ve found plenty to be inspired by, challenged by, and occasionally angered by. I’ve met some fantastic people, including this guy, this guy, this guy and lots of others who aren’t so easily linked to. Plus I’ve renewed a lot of friendships built up over previous conferences and events.

The two “big deals” out of this meeting for me are the microbicides breakthrough (of course) and the focus on criminalisation of HIV transmission/exposure, and the complex legal, ethical and public health challenges associated with that. I’ll be writing about those two for an upcoming issue of Positive Living.

As the meeting winds up, it would be easy to be dismissive of the prospects for anything to really change in the course of the HIV epidemic – to judge the event as long on talk and short on action – but I’ll suppress my usual cynicism and say that I do think these events make a difference, if only to remind those of us working in the field of how much remains to be done and how comprehensively the leaders of the world have failed to take decisive and meaningful action to save people’s lives.

We are making progress. We have new prevention technologies coming on line – the successful CAPRISA microbicide trial will be a milestone in the history of the HIV epidemic, and there is every reason to expect that research into pre-exposure prophylaxis (PrEP) and treatment-as-prevention will give us new prevention tools and the hope of a prevention paradigm that goes beyond the “just use condoms” message that I have argued is unsustainable in the long term.

Unfortunately, not a lot of this is getting through to the people who have the power to make decisions, and so often we see public policy driven by prejudice, fear and moralisation rather than evidence of what works. As Gill Greer, Director-General of IPPF, said in a session the other day, “when morality gets in the way of policy, the result is too often morbidity and mortality.”

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