The spectre of the MH17 outrage is casting a long shadow across AIDS 2014, the 20th international AIDS conference, which opened yesterday in Melbourne. Six of its delegates, including one of the world's leading HIV/AIDS scientists, Dutchman Jeop Lange, were among the flight's 298 passengers.
The mood at last night's opening was sombre and the six were well missed. But HIV has stalked many of the 12,000 people attending this week-long conference, so the threat of death has never been far from their minds. As Australia's eminent jurist Michael Kirby (pictured) said in his opening address last night, people affected by HIV/AIDS are no strangers to suffering, irrationality and hatred. They are also no strangers to death.
So the conference refuses to be bowed by an outrageous act. Instead, it is using the tragedy to spotlight an ongoing outrage: the human rights abuse, happening in many parts of the world, which curses the lives of people either infected or affected by HIV and AIDS.
It's true there has been significant success in pushing back HIV's advance over the past three decades. UNAIDS estimates that the global effort to fight HIV has averted 7 million deaths since 2002 and averted 10 million new infections. Globally, the rate of new HIV/AIDS infections continues to decline. New infections among adults in developing countries in 2012 were 30% lower than in 2001.
Advances in treatment have been a large part of the success, with an estimated 14 million people now on anti-retroviral drugs. But of the 35 million people living with HIV, more than half of them do not know they are infected. And the profile and intensity of transmission differs between regions, with Sub-Saharan Africa remaining the global centre of the epidemic with an estimated 70% of all new HIV infections in 2012. [fold]
The Asia Pacific's position is mixed. It has one of the world's lowest overall rates of HIV prevalence but because of the sheer number of people living across the region — 60% of the world's population — it is also home to the second highest number of people living with HIV/AIDS, at 4.8 million.
Over the past three decades, fears about HIV/AIDS have shifted from a concern for a potentially devastating impact on the general population to a situation where those fears have not been realised. In many parts of the world, and notably in Asia, the disease now largely affects three particular segments of the population: men who have sex with men; male, female and transgender sex workers; and people who inject drugs.
It is the identity of these populations and how they are regarded by broader society which presents a major challenge in responding to HIV/AIDS. Simply because of who they are, it is difficult for them to access the prevention and treatment services that are fundamental to a successful HIV response. In addition to dealing with the risks and reality of legal penalties, each of these groups often has to deal with the broader issue of popular stigma and discrimination which impacts negatively on their human rights on a daily basis. Prohibitive laws, discrimination and stigma combine to create major barriers for the key affected populations to access health services.
The extent of this discrimination and stigma shows through in these UNAIDS statistics: same sex acts are criminalised in 78 countries and punishable by death in seven countries; sex work is illegal and criminalised in 116 countries; people who inject drugs are almost universally criminalised for their drug use or through the lifestyle adopted to maintain their drug use; 42 countries have laws specifically criminalising HIV non-disclosure, exposure and transmission.
So it's not surprising there is a major push by the conference to spotlight human rights. Its organisers, who represent a 25-year history of successful partnership between science, community, government and advocacy, see Melbourne as a watershed for human rights and have released the AIDS 2014 Melbourne Declaration. Its call to end discrimination and eradicate criminalising laws is based not only on human rights but on hard scientific evidence that accessing prevention and treatment reduces HIV incidence.
The conference wants the memory of its dead delegates to galvanise a renewed push against hatred and irrationality, whether in war-torn Ukraine or a back lane in Melbourne.
Photo courtesy of AIDS 2014.