Un-ravelling and Rebuilding – AIDS activism, rights and science: then and now Revolution and counter revolution in the response to AIDS Mark Heywood, Executive Director, AVAC Partners’ Forum, 24 March 2015

Structure

+ What we achieved: 1986 – 2010 + What we lost + The components of success + What needs rebuilding + The merging of social justice with

AIDS activism – the struggle goes on

Politics and AIDS: Some things to think about

+  “There’s nothing in this whole fucking AIDS mess that’s not political” – ??

+  Referring to the outbreak of what became known as Ebola in Zaire in 1976: “This is now a political priority!” Pattyn continued, and I thought: So that’s how it goes. Unless something is a political priority, figuring out how to save lives is not a big issue.” –??

+  “The lack of international political will was no longer an option when the realization dawned that Ebola could cross the ocean. When Ebola became an international security threat, and no longer a humanitarian crisis affecting a handful of poor countries in West Africa, finally the world began to wake up.” ??

+  “Science without politics has no impact, politics without

science can be dangerous, and without programs people don’t benefit… my years as an activist in medical school were probably at least as useful as my actual medical training.” ??

+  “If science does not synched up with human rights, there is little hope of bringing the epidemic to a conclusive end” ??

+  “In addition to the HIV-specific work laid out in these pages, it is essential to work towards fundamental, lasting and positive change in each of these areas. That will be history-making, indeed.”

1986-2010: What we achieved - power

+  Inclusion of PWA in science, policy making and agenda setting

+  Alliance between activism and medical research +  Recognition of health as a human right - with state and

private duties attached to it +  Law reform, nationally and internationally +  At its peak a truly global movement, co-ordinated with a

shared vision +  Massive mobilisation of resources +  Unprecedented delivery of medicines and new

technologies to poor and marginalised people +  Lives, lives, lives ….

2010-201?: What we lost - vision

+ Short term objectives and victories, clouded longer term strategies

+ Loss of independence – co-option into various structures

+ Activism, volunteerism and imagination… + “From the audacious to the absurd….”

The components of success

+  Make political issues moral and human rights ones – capture public imagination

+  Launch campaigns with clear messages and objectives +  Empower effective communities through treatment and

rights literacy +  Build alliances, including with the scientific community +  Use the law to assert rights and intimidate opponents +  Use the media +  Personal integrity and a willingness to sacrifice

http://blogs.civicus.org/civicus/2014/08/06/an-open-letter-to-our-fellow-activists-across-the-globe-building-from-below-and-beyond-borders/

What needs rebuilding or building?

+ An agenda, targets and campaigns + Alliances + Empowered communities + An independent funding base for an

activist-determined agenda

CASE STUDY: SOUTH AFRICA

Social Justice 101

Sources: Data from South African Department of Health Antenatal Surveys. www.doh.gov.za Global report: UNAIDS report on the global AIDS epidemic 2013 Johnson L. Access to antiretroviral treatment in South Africa, 2004 – 2011. The Southern African Journal of HIV Medicine March 2012: 22-27.

Initiation phase of the generalised

HIV epidemic

Phase of rapid HIV spread

AIDS mortality

phase

ART impact phase

Entry phase in selected high risk

populations

The HIV epidemic in South Africa: HIV in pregnant women & ART scale-up

Year

HIV Prevalence (%)

National Estimated number on

ART

2004 29.5 47,500

2005 30.2 110,900

2006 29.2 235,000

2007 29.4 382,000

2008 29.3 588,000

2009 29.3 912,000

2010 29.4 1,287,000

2011 30.2 1,793,000

2012 29.5 2,010,340 0

5

10

15

20

25

30

35

1981$ 1983$ 1985$ 1987$ 1989$ 1991$ 1993$ 1995$ 1997$ 1999$ 2001$ 2003$ 2005$ 2007$ 2009$ 2011$ 2013$

HIV

Pre

vale

nce

(%

)

Year

Sources: Data from South African Department of Health Antenatal Surveys. www.doh.gov.za Global report: UNAIDS report on the global AIDS epidemic 2013 Johnson L. Access to antiretroviral treatment in South Africa, 2004 – 2011. The Southern African Journal of HIV Medicine March 2012: 22-27.

Initiation phase of the generalised

HIV epidemic

Phase of rapid HIV spread

AIDS mortality

phase

ART impact phase

Entry phase in selected high risk

populations

The HIV epidemic in South Africa: Campaigns that Re-Shaped the Epidemic

0

5

10

15

20

25

30

35

1981$ 1983$ 1985$ 1987$ 1989$ 1991$ 1993$ 1995$ 1997$ 1999$ 2001$ 2003$ 2005$ 2007$ 2009$ 2011$ 2013$

HIV

Pre

vale

nce

(%

)

Year

Hoffman v SAA

TAC

Hazel Tau

SANDF

Dudley Lee

JCSMF

Court Case

+  TAC 1998 – 2007: +  Rise and rise +  TAC 2008 - 2013: +  Victim of success +  TAC 2013 – 15: The

revival of activism +  TB march today –

declare TB an emergency

+  Stop Stock-outs Project

+  Free State: Fire Benny

$*$$$$

$10,000,000$$

$20,000,000$$

$30,000,000$$

$40,000,000$$

$50,000,000$$

$60,000,000$$

Total$grants$

Total$expenditure$

Access and Quality

Accountability and clean government

March 30, 2015: 129 Community Health Workers on Trial

SAVE TAC, SAVE LIVES

+ SOUTH AFRICA NEEDS TAC NOW MORE THAN EVER!

+ Donate TODAY! + www.tacgivengain.org