“I am not a medical expert. I am not a scientist or a doctor. But if we are to give people with HIV and AIDS greater involvement in this epidemic, then we must all have a voice.”
- Justice Edwin Cameron
In July 2000, Durban hosted the 13th International AIDS Conference (AIDS 2000). It was the first AIDS conference in a developing country, more importantly in a country and on a continent with some of the highest HIV prevalence rates anywhere. The conference provoked historic change, launching a global movement to making life-saving HIV treatment accessible.
As we make our way back to Durban after 16 years, we are fortunate to be joined again by Justice Edwin Cameron, described by Nelson Mandela as ‘one of South Africa’s new heroes’. A prominent human rights lawyer during apartheid, he was the first senior South African official to state publicly that he was living with HIV. Today, Justice Cameron shares three things that have personally resonated with him the most and why the 21st International AIDS Conference (AIDS 2016) is so important.
The continued fight against AIDS denialism
Last week, to the distress and amazement of many, former South African president Thabo Mbeki defended his denialist positions, which critically delayed the roll-out of anti-retroviral treatments (ARVs) to South Africans. The delay unnecessarily claimed the lives of many hundreds of thousands, and inflicted unspeakable suffering. Former president Mbeki’s stance plunged my country’s AIDS efforts into a ghastly nightmare. The rate of infection increased rapidly until it was around 25 per cent in 2001, with efforts to inhibit mother to child transmission ineffectual. We are horrified by former president Mbeki’s continued intransigent opposition to the facts and science of this disease. But we have come a long way. His recent statements remind us of the importance of our activism, our commitment, our never-ceasing vigilance, and our continued determination to extend the right to life and the right to healthcare to all.
Progress with mother to child transmission
Now good news about strong, wise political leadership. We saw from early on in the epidemic that to set ourselves right in this grievous epidemic, we had to start with pregnant mothers. In July 2015, the World Health Organization (WHO) announced Cuba as the first country anywhere to eliminate mother-to-child HIV transmission (MTCT). This exhilarating achievement was due to Cuba’s comprehensive and universal health system. This provides early access to preventative and prenatal health care that effectively integrates services to diagnose, prevent and treat HIV and other sexually transmitted infections (STIs).
For me, this was a particularly inspiring moment in history, because Cuba had started the comprehensive HIV prevention programme only 16 years earlier, when the International AIDS Conference first came to Africa, and treatment activists, inside and outside the halls, demanded action. As someone with HIV in my body, who fell extremely ill with AIDS and was facing certain death without ARVs, I find it inspiring what strong political leadership and evidence-grounded policies can achieve.
The rise of democracy
My country, South Africa, has one the world’s most progressive Constitutions. It provides the right for speakers of any of the nation’s eleven languages to come to court, and promises enforceable rights of access to housing, water, food, education and healthcare. Generations of South Africans, led by Nelson Mandela and others, fought hard for these rights, and for our democracy. This year, AIDS 2016 will begin on Nelson Mandela Day – Monday, 18 July. The conjunction of these two days is poignant to my life, but also to that of many other Africans, who are fighting for democracy, and fighting for access to healthcare. Returning to the conference where Mandela raised his voice on the importance of dealing effectively with the epidemic strikes a deeply emotional cord for many.
Since Durban 2000, our joint efforts – scientists, activists, government leaders, policy makers – have made a huge difference to millions of lives across the world. This conference will provide a further moment to rally and regroup, to regain our energies and our sense of purpose for what lies ahead. Stigma, in particular, still casts its pall across the whole epidemic. Most bafflingly, it casts its shadow deep inside the hearts and minds of many of us living with and affected by HIV. Vulnerable communities – sex workers, LGBTIQ and gender-diverse people, injecting drug users, prison populations – they all deserve redoubled energy to reduce harm and improve treatment and prevent exposure.
Dealing effectively with HIV means only good science – grateful as we are to the scientists and doctors – it also means progress in our communities and societies to break down longstanding prejudices, hatreds and ignorances. Only when scientific advances are matched by social and cultural progress can this epidemic truly be contained.
In the words of Nelson Mandela, “Now is the time to intensify the struggle on all fronts. To relax our efforts now would be a mistake, which generations to come will not be able to forgive.”