Dakar AIDS Conference – Abdoulaye Wade calls for less talk and more preventive action

[8 December 2008 - 08h34]
[mis à jour le 9 December 2008 à 17h34]

With over 9,000 participants representing 130 countries, this was an unprecedented gathering of scientists, associative movements, community assemblies and political leaders…

And the 8th International Conference on AIDS and Sexually Transmissible Infections (STIs) recently held in Dakar (Senegal) was most definitely a success… in terms of communication. Yet Senegalese president Abdoulaye Wade, the official host, appears to be irritated by this fact.

It’s certainly true that this is the second conference of its type to be held in Senegal in the last 15 years. “We need more focus and practical action, and more prevention in particular”, our colleagues at Dakar’s daily newspaper Quotidien reported the day after the president’s comments. President Wade also stressed – somewhat provocatively – that “even if antiretrovirals are free, today we need to talk about the essential”.

And it seems that “this essential” has changed in character. As UNAIDS points out, there has been a lot of progress in access to treatment in just a few years. Three million seropositive people in low-income countries now receive treatment, and in Namibia the percentage of seropositive individuals receiving treatment has risen from 1% to as much as 88% in only 6 years. But there are limits to what medication alone can achieve.

…and Roselyne Bachelot calls for “lack of information, shame and fear to be combated”...

For those infected, particularly in Africa, the hardest battle today could be that for a decent life. More so than in wealthier societies, the status of sexual minorities leaves much to be desired. Their recognition, the information they receive and the way they are dealt with vary greatly. And social stigmatisation can be terrible with the status of seropositive individuals and those suffering from the disease criminalized in the legal sense of the term. “Originally designed to protect (them), a law adopted in September 2004 (in Chad, hence the name of this model Act: N’Djamena , ed.) has led to a series of criminal laws being introduced in western and central Africa criminalizing seropositive individuals”, representatives of the association Sidaction point out. In fact, this law considerably extends the concept of intentional transmission. “For example, in Benin, simple exposure to HIV is criminalized, even if transmission does not occur; in Burkina Faso, HIV transmission by an individual aware of their status is classified as attempted homicide; in some countries, mother-to-child transmission can even lead to criminal proceedings…” This development is so worrying that UNAIDS and the International Federation of Family Planning Associations (IPPF) have come together to draw up a “Stigmatisation and Discrimination Index on People Living with HIV”. This is still under development but a site available in English sets out the scale of the problem.

As French minister for health, Roselyne Bachelot-Narquin has pointed out, “stigmatisation and discrimination are the wrong response and create genuine problems.” And with this in mind she calls for “lack of information, shame and fear to be combated…”, as they are all obstacles to action. She also calls for the implementation “of new strategies and new tools such as rapid screening tests, (because) being unaware that one is seropositive means the risk of late diagnosis, making treatment more difficult. And it can also mean exposing sexual partners to the disease.” And in this respect the issues are the same, whether we are talking about a country in the North or the South. Which has led the minister to say that “the fight against HIV is not a question of nationality, skin colour or geographical origin. It is a fight that belongs to humanity as a whole.”

So, “more focus and prevention” as Abdoulaye Wade has demanded? The Dakar conference has once again been an opportunity to examine the scale of the problem. It has also provided – and we shall return to this – an opportunity to remind ourselves where our priority action should be targeted and of the commitments made by various bodies… so that down in Africa, HIV is not forgotten by those in the North…

Source : From our special correspondent at the 8th International Conference on AIDS and Sexually Transmissible Infections (STIs), Dakar, 3-7 December 2008.

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