Lighting Fires, Creating Change

In the weeks leading up to the five-day 24^th International AIDS Conference in Montreal, it was quite clear that HIV would not be the only virus discussed. Masking was, of course, required—a constant reminder that COVID-19 remains a threat. And as confirmed monkeypox cases continued to rise—during the conference the U.S. overtook Spain to become the epicenter of the current outbreak—there was a sense of disbelief that this was where we found ourselves. Once again.

AIDS 2022 opened on a somewhat grim note with a pre-conference report from UNAIDS showing just how fully the COVID-19 pandemic has disrupted that steady progress. Despite years of declining rates, new HIV infections actually rose in Asia and the Pacific in 2021, the report points out. It also notes that last year one person died of AIDS-related causes every single minute. These deaths, UNAIDS Executive Director Winnie Byanyima proclaimed at the opening ceremony, were all preventable and should be a cause of great concern for everyone in attendance: from government officials to researchers to activists to members of the key populations impacted most heavily by HIV. What stands in the way of achieving this goal of zero AIDS deaths, then, and what amfAR has made a steadfast commitment to dismantling, is a systemic lack of equity.

Notably absent from that opening ceremony was the Canadian government. The break from tradition was noted by activists who stormed the stage to protest the government’s arguably racist visa denials for participants primarily from Africa and West Asia. The absence was an uncomfortable reminder of the silence of world governments throughout the 1980s as HIV ravaged those who had been deemed undesirables.

It was, in tandem with the UNAIDS’ alarming report, a reminder just how fragile much of the progress we could so easily take for granted really is.

The conference itself was full of fascinating research and powerful advocacy from the people on the ground. Scientists presented innovative and fascinating research that pushed the boundaries of what we know about HIV, including two likely cures: the City of Hope patient, a stem-cell transplant recipient, and the Barcelona patient, who appears to be an exciting case of an exceptional post-treatment controller. And the conference’s global nature provides just the sort of incubator necessary to foster the collaboration needed to continue to fight back against the virus. It was quite common to find researchers trading notes, offering to share data, and planning joint proposals both after presentations and in the halls throughout the Palais des congrès, where the conference was held.

Throughout the conference, it was noted that, at every step, the progress made in the fight against HIV has been thanks to the work of activists. They made their presence known at AIDS 2022 as well. Theirs was a message of equity, taking governments and corporations to task for failure to note what has become abundantly clear: the health of one is the health of all. A lack of equity caused and continues to cause needless suffering from HIV, vaccine hoarding by wealthy nations is partially to blame for the continued spread of COVID-19, and it seems that we are due to watch the cycle play out once again with monkeypox.

A particularly fiery speech that interrupted an update on the monkeypox outbreak noted that current cases have been linked back to a smaller outbreak that began five years ago in Nigeria. And while those cases went almost entirely ignored by the global health community, the United States sat on a stockpile of effective vaccines, which it had even once destroyed in 2008 rather than share with other nations.

The work of these activists can be draining, repeating largely commonsense messages to the brick wall of bureaucracy day in and day out. Their tirelessness and candor are so often thankless and their refusal to back down is the fire behind every advancement made in the fight against HIV.

Robert Kessler is amfAR’s Program Communications Manager.