The opening of the 18th World AIDS Conference in Vienna was backed by a large demonstration by activists and delegates from all around the world demanding donor governments keep their promises on funding the global AIDS response. Under the slogan “Broken promises kill – No retreat fund AIDS”, demonstrators marched to the conference hall and lay down at the main entrance to the opening ceremony, dramatising a slaughter.

A wide range of treatment advocates, NGOs, gay, transgender and female sex workers organisations both from the “north” and the “south” highlighted one of the key issues of the conference: that funding the fight against AIDS is crucial.

“The Global Fund to fight AIDS, TB and Malaria, our global mechanism to fight these three diseases, is at risk”, said Michel Kazatchkine, GF Executive Director during a workshop.

“To respond to global epidemics we need a global fund. The 2010 funds replenishment process we started today will be determinant to fulfilling some Millennium Development Goals by 2015”, he concluded.

The Global Fund needs more than 20 billion US Dollars in the next three years in order to keep scaling up HIV treatment, including the eradication of mother-to-child transmission of the virus in developing countries.

Using the global economic crisis as an excuse, most of the donor countries foresee equal contributions to the previous cycle, and even less in some cases. In the United States, media say that funding will has reached a “plateau” stage which would even affect the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiative. “Obama lied, we’ll die”, demonstrators cried repeatedly.

The German press informed today that German contributions to the Global Fund have been reduced by one third. The bad news is based on future predictions but even from an optimistic point of view, these countries have just approved their budgets for the current year.

On the other side of the financing issue, the scientific landscape is very optimistic. At his welcome speech, Dr. Julio Montaner, President of the International AIDS Society (IAS), said: “For the first time since effective ARV treatment for HIV was developed, there is a change in environment that shows that a sustained and wider access to treatment can not only save lives but also stop the epidemic. We must follow the same way in this promising moment.”

Several times,  AIDS history has shown us dialogues of the deaf between science and politics, where evidence produced by the former seem not to inspire decisions on the latter.

“Main barriers to achieving Universal Access in our countries are of social, economic and political nature. Thus, we must work urgently to base the HIV/AIDS response on Human Rights”, said Paula Akugizibwe of the AIDS and Rights Alliance for Southern Africa.

She also pointed out that: “Present threatens to global funding and low income countries’ poor domestic contributions are beginning to have a negative impact in our health systems. Our government’s and donor countries’ retreat to fund Universal Access show how volatile health response is, driven by political and financial wills rather than by respect of Human Rights.”

Important scientific progresses will be discussed during the conference this week. For instance, strategies close to finding a “cure” thanks to an improved understanding of immunity mechanisms of people living with HIV, who can naturally stop the virus from replicating. Science is “hard” to explain political inconsistency of those who have the power to save million lives and end one of the contemporary global health crises.

In hard times for resource mobilisation it is necessary to reflect on this and act quickly in the region and inside the countries, demanding our governments, our Global Fund Country Coordinating Mechanisms and implementers use the highest level of efficiency and effectiveness.

We must also demand our national authorities keep or increase their domestic investment in health, as well as keeping high pressure on leaders from developed countries at the upcoming high level meetings to fulfil their commitments, which sound almost rhetorical nowadays.

“Large steps must be taken towards repealing laws that criminalise HIV transmission, that marginalise and discriminate people living with HIV, minority groups, female sex workers and drug users, as this is the only way to facilitate access to HIV services and interventions”, said Paula Akugizibwe. This is key for Latin American countries with concentrated epidemics.

Both the demonstration and speeches which opened the conference highlighted two key subjects, funding and human rights, which will remain closely connected and will coexist not only for the rest of this week but also over the next few months.

We are standing at a crossroads in the history of AIDS, making the difference for millions of people in this planet. As for health, broken promises kill. Don’t give up, silence is death. In the AIDS response, speaking clearly and crying out loud has made a great difference, so don’t shut up now!

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