Insights from AIDS2014

 

 RESULTS advocate Jeremy Picone with the #DeadlyDuo TB and HIV

AIDS2014 was the 20th International AIDS Conference and was held in Melbourne from the 20th – 25th of July 2014. The Conference had a very somber beginning with the loss of a number of delegates in the MH17 airline tragedy.  Nonetheless it proceeded, as it should have, and was a great tribute to those lost who had dedicated so much of their lives to improving the health and well being of others.

Over 14,000 delegates from nearly 200 countries, including 1,200 journalists convened at AIDS2014. There were those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It was chance to assess where we are, evaluate recent scientific developments, lessons learnt and collectively chart a course forward.

Following on from the RESULTS National Conference  RESULTS staff, volunteers and Board members joined our global health advocacy partners from  ACTION at AIDS2014 with the purpose of profiling the issue of tuberculosis (TB)  in the fight against HIV and AIDS, as well as the important role of the Global Fund to fight AIDS, TB and Malaria in combatting these diseases.

These efforts were also greatly enhanced by working closely with international superstar and humanitarian Ms. Yvonne Chaka Chaka. The media that we were able to generate in the lead up to the Conference events also helped us to secure high profile meetings.

We were also proud that, for the first time ever, at an International AIDS Conference, TB was recognized as a neglected issue in the fight against AIDS, and this deadly duo was spotlighted with a dedicated TB+HIV Networking Zone.

Why was it important to profile TB and an AIDS conference?

TB is the leading killer of people living with HIV, causing one in five HIV-related deaths. TB is the most common presenting illness among people living with HIV, including those who are taking antiretroviral treatment. At least one-third of the 34 million people living with HIV is infected with latent TB and those co-infected with TB and HIV are 21-34 times more likely to develop active TB. So in reality, TB and HIV are two diseases that often attack as one.

The substantial progress made in the fight against HIV over the past years is threatened by the neglect of tuberculosis (TB). By ignoring TB, we risk undermining the huge financial investments made to help people living with HIV.

A new research report was released by ACTION at AIDS2014 entitled From Rhetoric to Reality: An Analysis of Efforts to Scale Up The Response to TB-HIV. It showed that joint TB-HIV activities are neglected by HIV programs and overwhelmingly carried out by TB programs, and that global guidelines to address TB-HIV have not been prioritized by leading donors and affected countries.


Here, three of RESULTS Australia's attendees share some personal insights

Maree Nutt, CEO:

It was very inspiring (and at times overwhelming) to be part of such an amazing conference where so many people, institutions, governments and organisations come together united for a common cause. Our ACTION partners, our staff and volunteers did an incredible job highlighting the issue of TBHIV as well as the role of the Global Fund in a variety of forums. Often with Yvonne Chaka Chaka by our side, we were also able to secure several meetings with senior government officials and parliamentarians during the week

Sarah Kirk, Global Health Campaign Manager (Tuberculosis):

The TB/HIV Networking Zone was a buzzing place during the conference. TB activists from all over the world presented, discussed their projects, argued for new initiatives and shared their wisdom.

The thing that struck me the most was how common TB really is – we hear statistics like 1/3 of the world is infected with latent TB, and in some populations (prisoners and miners), this can be up to 90%. However we don’t often hear about people who were happily going about their everyday lives before they got TB. Housewives, school boys, nurses, builders, journalists, grandmas, nuns and researchers. So many people from all over the world “I tested positive for TB” “I was treated for TB”.

For something as deadly as TB, it is frightening how ordinary and normal it is to have to take a 6 month-2 year course of drugs and injections.

The thing is, everyone at that conference were the lucky ones. They responded to treatment, they “only” caught TB, not MDR or XDR TB. They “only” had years of drugs with terrible side effects.

Lucky huh.

Nicole So, Volunteer and #DeadlyDuo Mascot:

I have never been inside a mascot costume before. It was heavy and cumbersome.

Mostly, people wanted to hug me. Or pretend to fight me. But one lady chased and punched me. The force rattled me and almost made me lose my balance. I couldn’t see her, the costume takes away most of my peripheral vision as well as give me blurry vision. But I could hear her say, ‘I hate you. I hate you. You took my brother. I hate you.’

Before this happened, we posed for lots of photos. It was fun and people were often amused to see us. But this incident made it real, it caused me to think about the harsh reality of so many People Living with HIV and AIDS, and the repercussions on the lives of their loved ones.

HIV causes the progressive failure of the immune system allowing for opportunistic infections to take hold. TB is the number one killer of PLWHA. Perhaps it was TB that took her brother’s life.

This emphasised the need to further our message of the important of TB and HIV coinfection. No one was punching TB!

Click here for some photos from  the very colourful AIDS2014

AIDS 2014 – Where can the Global Fund obtain additional funding?

Mark Rice, Aaron Oxley, Carol Nyirenda and Christoph Benn

By Mark Rice, RESULTS Australia's Global Health Campaigns Manager

RESULTS Australia staff and enthusiastic volunteers joined our ACTION partners,13,600 delegates and 6,000 visitors to the Global Village at the AIDS 2014 Conference in Melbourne on 20 to 25 July.  Our daily updates during the week shared some of the excitement and highlights from the Conference. Beyond these highlights, it is also important to note how well we met RESULTS Australia’s first objective for AIDS 2014, which was to obtain a commitment from the Australian Government for an additional contribution of $125 million for the Global Fund to Fight AIDS, TB and Malaria in 2014 to 2016.

In his address to the Opening Ceremony of the Conference, Deputy Prime Minister Warren Truss only restated the Government’s three-year commitment of $200 million announced last December.   However, we may have more time than we had anticipated to seek a supplementary payment by Australia to the Global Fund.

At a session on Closing the Resource Gap for the Global Fund in 2014 to 2016 that RESULTS Australia organised at AIDS 2014, Dr Christoph Benn, Global Fund External Relations Director, indicated that the United States Government may extend an offer of a matching contribution to other Governments’ pledges, originally due to expire in September, by several months.  If an additional Australian pledge is to have the maximum impact, it is essential that the Government announces it while the US matching funding is still available.
      
This means that RESULTS Australia can continue to seek a supplementary contribution for the 2014 to 2016 period over the rest of this year, before we switch our focus to requesting a significant contribution by Australia in 2017 to 2019.  Dr Benn noted that the next Replenishment Conference for the Global Fund is likely to take place in mid-2016, so we would need to start campaigning on pledges from early 2015 to increase our chances of success.

The other presentations and discussion at the session on Closing the Resource Gap for the Global Fund concentrated on how to obtain additional funding from established donors, new national donors and private donors:

The increased and early UK pledge:   RESULTS UK’s Executive Director, Aaron Oxley, explained some of the factors that contributed to the pledge of up to £1 billion ($A 1.8 billion) by the UK Government, announced ahead of the December 2013 pledging conference:

• Having a firm, cross-party political commitment to increase overall aid by the UK meant that extra funding was available. Campaigners had strong evidence to argue the Global Fund is an excellent use for increased UK aid and in strong alignment with UK’s own goals and objectives.
• Campaigners helped create political space for a large increase by having a specific request of £1 billion. This was double the amount the UK had contributed in 2010 to 2012, and campaigners used this number consistently in communication with the public and MPs, highlighting the impact it could have on the three diseases.
• By having strong relationships with Government officials, RESULTS UK and other organisations made a credible commitment to create a strong positive (or negative) public response to a UK pledge. They collectively delivered on that commitment with an overwhelmingly positive response.

Kenya becoming a first-time donor:   Allan Ragi, Executive Director of KANCO, set out how campaigners in Kenya had obtained support from the Kenyan Government for its first-time Global Fund contribution of $2 million announced in December 2013.  The key elements in this success were:

• Relating the request for Global Fund contributions to the provisions in the Constitution of Kenya to rights to services, including health services. 
• Having both State Governors and members of the national parliament take up the request for Kenya to become a contributor.

Zambia as a potential donor:  Carol Nyirenda, Public Health Patient Advocate for CITAM+, explained that campaigners in Zambia are seeking additional domestic spending on health by the Zambian Government, so it can use contributions by donors more effectively, and is also asking Zambia to become a Global Fund contributor.  An important role for campaigners in Zambia is to educate Parliamentarians and officials on both the need for health programs, and the process for obtaining resources from the Global Fund.  Members of RESULTS Australia would be familiar with the role we also have of educating our Parliamentarians on issues, as well as making specific requests for action.

Private sector contributors:  Dr Benn noted that the business sector will support the Global Fund if their contribution is consistent with their business goals – for example, mining companies operating internationally have an interest in a healthy workforce.  If we as advocates know of businesses which are potential contributors, the Global Fund would welcome receiving contact details from these businesses.

These lessons from other countries will be valuable for us in seeking further contributions from the Australian Government in the current and future Global Fund replenishments.

"Inspirational. Enriching. Regenerative." - Your experience at AIDS2014

Angie (far right) with RESULTS and ACTION friends at the AIDS march

AIDS2014 is the 20th International AIDS Conference and will be held in Melbourne from the 20th – 25th of July 2014. For the first time it will feature a dedicated hub for discussing the deadly duo of TB-HIV. Despite TB's status as the leading killer of people with HIV, responses to these two diseases are often disconnected, and collaboration on HIV and TB programs is weak in many places.
      
The TB/HIV Networking Zone at AIDS 2014 will provide a space for HIV and TB communities – researchers, affected communities, advocates, policy makers, donors, and more – to come together and chart a way forward for addressing these deadly diseases together.

We interviewed RESULTS Hobart Group Leader Angie about her experience at AIDS2012 and encourage all RESULTS advocates to consider joining in the activities at AIDS2014's Global Village following our National Conference.

1. What did you enjoy most about AIDS2012?
Being in Washington for AIDS2012 was an incredible experience. The Global Village was amazing and listening to such a variety of plenary speakers streamed live from the conference was a huge privilege. My favourite part was the AIDS march where thousands of people marched from the four corners of Washington to meet for a massive rally outside the White House! Incredible. And RESULTS marched with ACTION right up the front from our corner. Unbelievable!!

2. Describe your experience in 3 words.
Inspirational. Enriching. Regenerative.

3. Why do you think RESULTS advocates should join in with AIDS2014?
We need to learn from past mistakes with Malaria and TB that just because we 'cure' or 'eradicate' these diseases in our own country, it doesn't mean they are gone forever. We need to continue the fight for all three of these diseases, to get the best possible drugs and equipment to the wealthy and impoverished alike in all countries, and to eradicate AIDS, TB and Malaria across the world. WE ARE THAT GENERATION!! And if that fact ignites some passion in you to help fight this cause, AIDS2014 will inspire you beyond measure. Don't just think about it. DO IT!!!

4. What made your AIDS2012 experience unique? What did you get out of it that you couldn't get anywhere else?
I feel incredibly privileged that as a member of RESULTS working with the amazing advocates from ACTION, I was part of a movement that brought awareness to people from all over the world about TB and its relationship to HIV. There were so many people at the conference who wandered through the Global Village and almost fell over backwards when ACTION advocates would share this knowledge. The educative experience on a personal level was huge and bringing that awareness to others both in Washington and back home to Australia was life changing.

Don't forget to register for the RESULTS National Conference - and if you're keen to stay on and join in the activities at the TB-HIV Networking Zone at the AIDS2014 Global Village, please contact info@results.org.au

Saving Lives - How RESULTS advocates help fund the Global Fund

Immunisation in the Indo-Pacific: Is Australia up to date?

by Samantha Chivers, Global Health Campaign Manager (Maternal, Child and Neonatal Health) with RESULTS Australia

On World Immunisation Week this year, RESULTS Australia is celebrating the work of the GAVI Alliance, a public-private partnership that has had phenomenal success in getting underused vaccines to children in the poorest countries in the world.

It is clear GAVI is a worthwhile investment for Australia, as it aligns very strongly with Australian foreign policy priorities in several ways.

Here are five reasons why:

1.
GAVI was rated extremely highly in a 2012 Australian Government evaluation, as it “[saves] lives through cost-effective and evidence-based interventions”. Australia’s Foreign Minister Julie Bishop has recently publicly praised GAVI, calling it “the kind of thinking we need”.  GAVI also strongly emphasises results-based financing, which aligns with Australia’s interest in linking aid spending to performance benchmarks.

2.
In 2011, Australia pledged $200 million to the GAVI Alliance. This funding alone vaccinated an estimated 37 million children against a range of childhood diseases, including 3.3 million children vaccinated against pneumococcal pneumonia. These vaccinations will avert over half a million future deaths.

Our investment has also supported the development of stronger health systems in over 50 countries, including Indonesia, Myanmar, Vietnam and the Solomon Islands. This will not only provide the foundation for successful immunisation programs, but also prioritise strong and sustainable health system financing within recipient governments.

3.
Australian partnership and leadership in the Indo-Pacific region is vital. GAVI has a large influence in the Asia-Pacific region: seventeen of the countries that have received GAVI support are also Australian aid priority countries.

It also shows the strength of Australian research: GAVI focuses on rolling out new and underused vaccines, and this has most recently included human papillomavirus (HPV) vaccine to protect girls and women against cervical cancer, an Australian-developed vaccine. In two years, 21 of the poorest countries in the world have been approved to introduce HPV vaccine with GAVI support, including Laos and the Solomon Islands. Through negotiating a new record low price of $4.50 per dose of HPV vaccine, GAVI hopes to reach more than 30 million girls in more than 40 countries by 2020.

4.
The GAVI Alliance works to improve global vaccine markets to ensure adequate supply of appropriate, quality vaccines at low and sustainable prices. This involves working with private pharmaceutical companies in countries such as Indonesia, to support their access to global vaccine markets, so they can make new and underused vaccines for their own regions. GAVI has had great success in creating jobs in vaccine production. In 2001, there were 5 vaccine suppliers to GAVI, 1 based in an emerging market. By mid-2013, there were 12 vaccine suppliers to GAVI, with over half now based in Africa, Asia and Latin America. One outstanding example is the rollout in late 2013 of the locally produced pentavalent vaccine in Indonesia: protecting children against five diseases in one shot, this will now be produced by the Indonesian pharmaceutical industry.

GAVI is also very conscious to introduce regional-specific vaccines. Japanese encephalitis (JE), for example, is a serious mosquito-borne viral disease that kills over 15,000 people per year. Late last year, Chinese manufacturers obtained qualifications from the World Health Organisation to begin producing JE vaccines. This vaccine will be going to eight countries in Asia at risk of JE transmission.

5.
Consistent with recent trends in Australian aid, GAVI will be investing more time and resources in strengthening health systems, especially in fragile and conflict-affected states. Considering the intense focus of the Australian military and the foreign policy department on building the governance and resilience of countries like Myanmar and Afghanistan, developing strong policies to ensure equitable access to immunisations will assist in building strong health systems.

The countries that make up the Indo-Pacific are diverse and complex, and so are their needs. Extreme poverty co-exists on the same streets as comfortable families and the megarich, more so than anywhere else on earth. RESULTS Australia works to ensure the poorest countries in the world benefit from evidence based health policy.

Vaccines decrease poverty. There it is. GAVI works with the poorest countries to get new and underused vaccines on the ground to the families that need them. GAVI is on track to immunise half a billion children by 2015, and save more than nine million lives by the end of the decade. Although Australia works with a smaller aid budget than in previous years, GAVI is an excellent investment for Australia, and for the world.

This post was originally published on the ACTION Global Health Advocacy Partnership blog