AIDS envoy challenges governments, institutions on inaction

Stephen Lewis, the United Nations special envoy on HIV/AIDS for Africa, accused the United States of “neo-colonialism” for imposing conditions on its AIDS grants to developing countries in his strongest indictment yet of some world leaders’ stand on AIDS. In his closing keynote address to the 16^th International AIDS Conference, Mr. Lewis also slammed the South African government for promoting theories about the disease “more worthy of a lunatic fringe than of a concerned and compassionate state.” In his speech, marked by passionate, rapid-fire delivery, Mr. Lewis blasted governments and institutions like the UN for the continued “diminution of the rights of women,” and said that as long as men “control the bastions of power” AIDS will not be broken. “We will never subdue AIDS until the rights of women become part of the struggle,” said Mr. Lewis. “I challenge you, my fellow delegates, to enter the fray of gender inequality. There is no more honourable and productive calling. There is nothing of greater import in this world. All roads lead from women to social change, and that includes subduing the pandemic.” Mr. Lewis stated unequivocally that the abstinence-only education programs to combat HIV/AIDS “do not work.” He also lashed at the U.S. government, which last year imposed a condition that countries receiving federal AIDS grants must sign a statement condemning prostitution. Last year, Brazil refused such a grant amounting to $48 million, stating that HIV/AIDS education must include sex workers. Telling a government how to allocate aid is a “throwback to yesteryear” said Mr. Lewis, adding, “That approach has a name: neo-colonialism.” Mr. Lewis, who has been criticized for lashing out at governments in his capacity as a UN official, said he was merely doing his job of advocating for people affected by the dreaded disease. “It is not my job to be silenced by a government when I know that what it is doing is wrong, immoral and indefensible.”Mr. Lewis also called for more harm-reduction programs, including methadone treatment and needle exchange programs for injection drug users, saying, “they do work.” He said Canada and countries where HIV infection rates are on the rise because of drug use (like Russia, China and India) must consider such programs because “it’s a matter of public health.” He called the federal government’s plan to close Vancouver’s safe injection site “positively perverse” and said it would only serve to “invite HIV infection and death.” Mr. Lewis, who has spoken to Canadian Anglicans on many occasions, including General Synod in 2004, also:

• Questioned why programs to prevent mother-to-child HIV transmission continue to be beyond the reach of many in the developing world. “Hundreds of thousands are still being born HIV-positive,” he said. “What kind of a world do we live in when the life of an African child and an Asian child are worth less than a Canadian child?”
• Noted that the AIDS conference had paid scant attention to the issue of sexual violence against women and child sexual abuse as well as the plight of children orphaned by AIDS. Only three to five per cent of AIDS orphans receive help from governments, he said. (Sub-Saharan Africa alone has 12 million children orphaned by AIDS.)
• Urged more support for grandmothers caring for their grandchildren orphaned by AIDS. “We need programs to assist them, to provide them with sustainable income,” he said. “Every grandmother’s concern is, ‘what will happen to my grandchildren when I die?'”
• Recommended that male circumcision not be subject to “bureaucratic intervention” and said that while cultural sensitivities must be respected, governments should nonetheless ensure that there are well-trained professionals who can perform the procedure when it is requested. (In a moment of levity, he said that he had talked to an official from Swaziland who was falling in line to be circumcised and told him that he was already circumcised. “So we were in a joyous frenzy of male bonding,” he said.) Male circumcision reduces the risk that men will be infected by HIV-positive women by 70 per cent, according to French and South African researchers.
• Called for more funding for global AIDS intervention programs, saying “we are billions and billions of dollars short of target,” and unless such a gap is addressed universal access to prevention and treatment programs are “doomed.”
• Announced that he is ending his term at the UN by the end of the year and that he has requested that his successor be an African woman.

Meanwhile, Dr. Mark Wainberg, local host board chair and director of the McGill University’s AIDS Centre, urged conference delegates to redouble their efforts in turning the tide against AIDS. “Indeed, we will have failed unless we dramatically and rapidly expand by millions the numbers of people around the world with access to antiretroviral drugs and simultaneously scale up prevention,” he said. “Progress cannot be achieved if more people become infected by HIV each year than the numbers that are able to access treatment.” Only 1.6 million of 6.8 million people or 24 per cent of people living with HIV in developing countries have access to antiretroviral drugs that can prolong the life of those infected with the virus. In 2005, about 39 million people worldwide were living with HIV/AIDS, according to UNAIDS. Last year, there were 4.1 million new HIV infections; 2.8 million died of AIDS-related illnesses.