At a recent landmark international conference, activists and political leaders deliberate on how to use cultural changes and recent medical advances to end the HIV/AIDS scourge
By FOLASHADE ADEBAYO/Washington
He is the traditional head of the Mumena clan in Zambia, Southern Africa. And for 12 years, he preserved the longstanding culture of his ancestors that outlaws circumcision of male children. In 2011, however, Jonathan Mumena turned his back on that tradition and began a difficult crusade to convert his shocked kinsmen. On Monday, July 23, Mumena chose the podium of the International AIDS Conference, IAC, held in Washington, United States, US, to tell the story of his conversion.
“It was my son Benjamin who came to me last year and told me ‘Daddy, I want to go for MC.’ I did not understand the term and he explained that he wanted to go for male circumcision. Apparently, he had information that HIV/AIDS transmission can be reduced up to 60 per cent by circumcision. I became a convert of my own son and I went for my own circumcision last year”, he said.
Expectedly, Mumena did not find it easy to uproot the stem of culture. But he was determined to provide his people a chance to cut the rampaging HIV/AIDS to size. “The last 30 years of HIV/AIDS has been a reign of terror and our part of the world has not been spared. People were dying in their numbers. I had to act fast. Male circumcision is the only programme that can give us 60 per cent protection against the disease. I had to make a decision to protect my people and myself. Culture is not cast in concrete. Culture must exist to protect the people”, he said to a rousing applause.
Mumena’s efforts have even paid off beyond the shores of his country. Last year, 44 legislators in Zimbabwe, went ahead to get circumcised in one single day. Such organised responses and leadership, according to Mumena, is needed to stop the spread of HIV/AIDS. According to the World Health Organisation, WHO, about 34 million people are living with the virus and almost half of them do not know their status. Community activists like Mumena work in their locality to reduce the spread of the virus.
Florence Ngobeni-Allen, a South African, had a more personal story. Like Mumena, she was at the IAC as a face of women living successfully with HIV. A mother of two, Ngobeni-Allen, shared her loss, gain and story as an AIDS activist. Fifteen years ago, she lost her daughter to AIDS. Nomthunzi was just five months old. Ngobeni-Allen’s life was shattered even as she later lost her husband also to the disease. “Losing a child to HIV is the most horrible thing a mother can go through. After I lost Nomthunzi, my life was never the same again. I desperately wanted to get out of the house because staying at home kept bringing back the memory of my child. That’s when I was offered a job as a counsellor with the Chris Hani Baragwanath Hospital in South Africa”, she said.
But Ngobeni-Allen found redemption again. She remarried and was put on Nevirapine, an antiretroviral drug to prevent transmitting the virus to her baby. Initially, she was afraid of history repeating itself. She feared that she would once again pass the virus to her baby. But today, Ngobeni-Allen is a proud mother of two boys who are HIV negative. “There is nothing a mother wouldn’t do to protect her baby. And now that women with HIV know that there is hope, there is finally a reason to stand up, fight the terrible stigma, come forward and be tested”, she said.
Mumena and Ngobeni-Allen are people who have experienced the destruction and pain that HIV/AIDS can bring to individuals and communities, but they are also part of about 25,000 people who converged recently in Washington to mull scientific breakthroughs in HIV prevention and seek more political action to bring these solutions to 34 million people living with HIV/AIDS worldwide. At the conference, hundreds of activists shared their personal experiences in HIV/AIDS leadership and mentoring to a global audience.
From July 22 to 27, activists, scientists, journalists, and politicians deliberated on strategies, shared ideas and best practices that have worked in their various countries and regions. The theme of the conference, Turning the Tide Together, was envisioned to capture the historic scientific findings, which have saved millions of lives and bolstered the hope for a possible vaccine.
Indeed, the International AIDS Society, IAS, and the entire HIV/AIDS community have reasons to hope. Just days to the conference, the Food Drug Administration, FDA, an agency of the US, approved the sale and use of Truvada, as a pre-exposure prophylaxis, PrEP, to be used to prevent HIV infection in people who are HIV negative. Taking a pill orally every day along with other safer sex measures like circumcision and condom, has been clinically tested to significantly reduce HIV transmission. For the HIV/AIDS community, this is a big step forward in reducing new infections and AIDS related deaths.
Speaking at the conference, Michel Sidibe, executive director, Joint United Nations Programs on AIDS, UNAIDS, said the world has made remarkable progress since 1981, when the virus was discovered. “This is the best of times for many reasons. For the first time, we have more people on treatment than people who need treatment. In South Africa alone, at least 300,000 people started treatment last year; 150,000 in Zimbabwe, and 100,000 in Kenya. In Africa, AIDS-related deaths have fallen from 1.8 million in 2005 to 1.2 million today. A powerful metaphor of our success is the story of the casket maker in Lesotho complaining about business, because people with HIV are not dying of AIDS anymore”, he said.
But the success story is not limited to the shrinking AIDS-related deaths. Mother to child transmission is as high as 400,000 babies in a year. But the intervention of developing countries through the Global Fund and other international agencies has kept that transmission on a downward slope. Meet Ebube Taylor, a 13-year-old Nigerian who is a beneficiary of that intervention. Taylor was born free of HIV because her mother, Florence Ignatius, who is living with HIV, accessed free drugs given under the US President’s Emergency Plan for AIDS Relief, PEPFAR. The PEPFAR, initiated by George Bush, a former US president was established in 2001 to provide free anti-retroviral drugs for people living with HIV. Some of these drug combinations are used to prevent the transmission from mother to child.
Taylor told delegates, “I want to thank the American people for providing life-saving drugs for people in developing countries. But I do not want to be the only success story. Many babies are still born with the infection because their mothers could not access drugs. Please do not stop now”, she pleaded.
The teenager was, perhaps, referring to dwindling global resources to assist developing countries in providing testing kits and treatment for people living with the disease. About $17 billion was spent last year to get these drugs to developing countries but about $7 billion is still needed to put 15 million people living in developing countries on treatment by 2015.
The effect of the global recession on donor countries was not lost on the organisers. European countries and even the HIV/AIDS community in the US lack aid. Around 1.2 million people are living with HIV/AIDS in the US and 18,000 people with AIDS still die each year in the country.
But Hillary Clinton, US secretary of state, assured the gathering that “we have gone too far to stop.” She renewed America’s pledge to continue the PEPFAR support for poor countries. “On World AIDS Day, President Obama announced an ambitious commitment for the US to reach six million people globally with lifesaving treatment. Now, since that time I’ve heard a few voices from people raising questions about America’s commitment to an AIDS-free generation... Well, I am here today to make it absolutely clear: The United States is committed and will remain committed to achieving an AIDS free generation. We will not back off, we will not back down, we will fight for the resources necessary to achieve this historic milestone”.
And the reason for such optimism is not far-fetched. More than ever before, the search for a cure for the disease has generated renewed optimism in the AIDS community. Last year, Thomas Brown, an American was certified as functionally cured of HIV. Brown often referred to as the Berlin patient had a bone marrow transplant in 2007 to cure his leukaemia. The American who is also HIV positive had to stop his antiretroviral drugs prior to and during his transplant. But few years after the procedure, Brown’s doctors were amazed to discover that the virus had simply disappeared from his system. Three years after the transplant, doctors screened his liver, brain and other body tissues but could not find any traces of the virus. Brown immediately became the only man functionally cured of HIV.
Such incredible developments, including the miracle of elite controllers have opened up the vista for a possible and impending cure. The elite controllers are a rare group of HIV infected people who have naturally ‘cured’ their infection. Specifically, they are a group of patients in France who were infected, started their ARV treatment early and stopped the treatment without the virus resurging in their systems. They are now providing significant knowledge on the importance of starting treatment early. There is also the Thailand Vaccine Trial, which had only 30 per cent ability in preventing HIV transmission but has also emboldened scientists working in the research field. “That the research around HIV cure is so prominent at AIDS 2012 is proof of how far the science has come these past few years, we now actively talk of potential scientific solutions in a way perhaps we weren’t some years ago”, remarked Diane Havlir, IAC co-chair.
But that is not the only breakthrough. For the IAS, organisers of the conference, there is yet another breakthrough. Hosting the conference in the US this year is in itself a significant breakthrough. Since 1992, when the last conference was held in San Francisco, the organisers have not been able to stage the conference on the US soil again due to a travel ban on people living with HIV. Last year, that ban was lifted by Barack Obama, US president, effectively paving way for the IAC to hold in America.