How an AIDS Conference Sidelined an At-Risk Population

As advocates, officials, and health care professionals gather in Durban, South Africa this week for the International AIDS Society’s AIDS2016 conference, another group of people have moved out—and not by choice. In an attempt to make Durban appear more attractive to attendees of one of the world’s largest conferences on any global health or development issue, homeless people, drug dealers, and sex workers were removed from the central city. In other words, the very people who are at increased risk of contracting HIV and not receiving treatment are now even more vulnerable, and essentially rendered invisible.

The sanitization of the city set the tone for the conference. For instance, organizations like UNAIDS have called for increased investment in harm reduction and HIV prevention measures for people who use drugs—calls that are echoed around the globe by civil society and activists. And indeed, one of the AIDS2016 conference’s stated objectives is “promoting HIV responses that are supported by and tailored to the needs of at-risk populations or people living with HIV,” including people who use drugs.

Yet people who use drugs are largely ignored inside the conference. What’s more, of the 446 abstracts that contain the keywords “harm reduction,” “drug use,” and “drug policy,” only six were accepted for oral presentation and three for poster discussion—an exceedingly small number considering how important this population is considered by those trying to end AIDS by 2030.

Quite literally, the rights of people who use drugs, and the policies that restrict access to harm reduction and health services, are not on the agenda at AIDS2016. Even if one counts the events held by people who use drugs and harm reduction activists in the Global Village, there are fewer than 40 that focus on these areas. If it wasn’t for the last-minute efforts of a few under-resourced individuals working for supportive organizations, there would literally be no place for people who use drugs to meet and discuss their issues, or to receive the life-saving harm reduction commodities they need.

Due to this last-minute push, organizers were able to tick the “inclusive” box. But while we have a place to congregate in the Global Village, people who use drugs are still left out of the conference’s main proceedings.

To some degree, this is par for the course: in HIV/AIDS advocacy, people who use drugs are often talked about, but seldom visible. UNAIDS produces excellent reports showing the importance of supporting drug users in reaching HIV reduction targets. They call for increased investment and access to harm reduction, the decriminalization of drug use, and the promotion of drug users’ rights. Yet UNAIDS has no dedicated focal point on HIV and drug use. The organization has announced that funding for the UN Office on Drugs and Crime’s HIV program will end, and their latest calculation of resource needs excludes antiretroviral therapy and 75 percent of people who inject drugs.

The HIV epidemic forced the world to pay attention to the needs of people who use drugs, because their vulnerability to HIV made the world in general more vulnerable to the disease. Through this self-serving benevolence, people who use drugs were declared an essential target for HIV interventions, and it was finally acknowledged that these people were being denied the rights that so many take for granted. Yet 40 years later, recognition of the needs of people who use drugs are still almost entirely tied to efforts to fight HIV.

As such, advocates for the health and human rights of people who use drugs have come to rely on HIV funding to do their work. Harm reduction as a philosophy that could benefit all drug users has been reduced to a set of HIV interventions. Therefore, since drug users are only visible through the lens of HIV prevention, it is very concerning that the world’s biggest gathering of HIV scientists, policy makers, health professionals, and activists has kept drug users, and even the narrowest definition of harm reduction, out of the main proceedings. People who use drugs are becoming invisible. But of course, we are still here. It is the world that is choosing to turn a blind eye. 

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It's terrible to be sidelined at a themed event.

This is the shadow of UNGASS ,the smallest possible reference made to people who use drugs,yet the key pops that are politically correct and open for debate men who have sex with men and sex workers are largely made up of pwud ,so what baffles me is how are the people in charge planning on treating these 2 groups when they refusing to acknowledge pwud so closely connected are key pops to pwud the 1 key population that intersects through all the others ,try treating a problem when you only allowing yourself a 1 dimensional view of it is plain stupid ,only a holistic approach to the key pops problem can in any way be effective and that means seeing us hearing our voices acknowledging our human rights and letting us get on with the business of saving lives.

Conferences like the one being referred to covers so much in few days and with many in attendance. It is also human nature to attend to the majority and this only means that individuals having drug challenge and those peddling drugs will always be left out when planning such huge meetings. To over come this, one sees the need to hold a huge meeting which targets the drug users and HIV. The theme could be selectively chosen to include the groups often are left out. There is a need and there could be groups, including the UNAIDS group itself. Thus the exclusion could be turned into a positive action.

Dear Shaun Thanks for writing this & as you know, we can understand why our abstracts got turned down. This is appalling++!! Why can't they get it that not only PWIDs are humans too AND if they are ignored then there is no stopping AIDS by 2030. Angry Chris

Wow, interesting analysis Shaun. And depressing. What has the world come to when there is a perceived need to 'clean up the streets' and remove drug users and sex workers from the conference site? AIDS industry gone mad. Also interesting to raise these questions alongside what looks like faltering UN leadership on PWID issues. We need to make the rhetoric match the reality.

These people were ignored and removed because the conference wasn't for them. It was for mainstream demographics who have more money.

The very people that are preyed upon during clinical trials are marginalised during key talks. The conference is about the elite that will air their opinions about our vulnerable who do not have centre stage is a sickening thought. This is a perfect example of how the vulnerable and their defenders are silenced. @ChrisFord - were your abstracts rejected? What was the excuse? Would love to hear.

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