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The highs and lows of the 10th ICAAP 2011

Sharing this for the benefit of colleagues within the AIDS Competence family - thank you!

An open letter to the LOC of the 10th ICAAP the chair of ASAP and the Executive Director of UNAIDS a personal perspective


As the dust settles on the 10th international conference on HIV & AIDS in Asia and the Pacific and the landfills and paper recycling plants of South Koreas bustling port of Busan await an onslaught of unused, unread and unwanted (?) IEC materials, toolkits and a plethora of CDs, badges and the like discarded in its aftermath. Like some bizarre tornado of HIV resources spinning wildly out of control and now dissipated into the remnants of an event that have left many questioning, yet again, the relevance, validity and justification for such a ostentatious display of, for the most part, mediocre responses to a virus that continues to challenge, provoke and perplex all of us in the most tantalizing way. Notwithstanding some great interventions in the region and interesting presentations and thought provoking plenaries and the growing might of communities there wasn’t a lot new was there?

The reality in the big bad world is that for the vast majority the real impact of the HIV virus is that shame, fear, stigma and negative impact it continues to inflict on the most marginalized and unjustly criminalised within our complex and diverse societies in Asia and the Pacific.


The 10th regional HIV conference must surely go down as one of the least inspiring yet paradoxically thought provoking and challenging conferences the region has witnessed in many a year. I cannot help but question and critically examine what I have just experienced and my rational for writing this is to provoke a reflection on what is this movement all about and reflect on what we have created in the process, if you want to respond and defend all the great work that is ongoing I for one wont argue but in the case of ICAAP I feel I must speak out in this open letter. As an invited member of the International Advisory Committee supporting the work of the LOC I know I must take my fair share of blame for the conferences shortcomings.  Failing to demand greater transparency on the preparatory work that took place and failing to demand that safeguards were in place to ensure the safety and rights of participants (most importantly local community participants) has to be a non negotiable issue for ALL future conferences including, but not limited to, sensitization of local media and broader communities and clear instructions to Ministries of Foreign Affairs to brief them in advance to ensure safe and guaranteed visas and travel in an out of the host country. In hindsight there were warning signs of troubles ahead during the initial planning meetings that took place earlier this year that could and should have been easily mitigated with better planning and foresight. A lack of Korean government commitment and a lack of strategically placed support and guidance from the AIDS Society in Asia and the Pacific (ASAP) who claim to be the custodians of the conference (whatever that actually means) I believe has been a key factor in the shortcomings of this conference. Consequently I hold myself to task for not having enough balls to demand the conference be put on hold till such time that a comprehensive set of safeguards could be put in place guaranteeing visa and border access for all, access to Methadone for our friends who are on MMT programs and most importantly an assurance that community protests could take place without fear of reprisals and excessive use of force from law enforcement officers.  The organizers might not have predicted it or for seen the events which took place in the Bexco conference centre but they had an obligation to have  a minimum package in place to safeguard participation just as the International AIDS Society demands when reviewing prospective  new country locations for the huge money spinner that we have come to know as the International AIDS Conference (don’t take it from me but go read their financial reports running effective conferences can is big business Vienna 2010 cost somewhere in the region of USD23 million!)[1].


Busan will remain an enigma for many of us who are now safely back in our own homes. On one hand we have one of the regions most modern and technologically advanced cities, even your coffee and sandwich comes with its own electronic warning device! Yet on the other  hand some of us also observed a very different viewpoint of a highly conservative and closed society that seems to have very little regard for  freedom of speech (ie the daily conference paper was seriously compromised when content was vetted and censored in light of the protest and arrests!), human rights and flagrant disregard and outright discrimination for the most vulnerable in the community. Our community friends who had worked so hard to put the conference together brought to light during the pre conference community events and at other sessions the huge challenges faced by the positive community and key populations struggling in such a hostile environment and I would really urge people to share these issues (but not names or photos please) more broadly to raise awareness on the context in which they struggle to provide counseling and outreach to a totally ostracized community.


To quote a good friend and fearless community activist who spoke passionately and eloquently at a plenary session on the rights of marginalized communities: “The absence of people who use drugs at this conference, which aspires to bring “diverse voices” together for “united action” on HIV/AIDS, only further compromises our ability to truly achieve universal access to HIV prevention and treatment; for without the rich contributions of people most affected by HIV, namely people who inject drugs, people in prison, undocumented citizens and migrants and ethnic minorities, men who have sex with men, sex workers, transgender people, and women, by not actively promoting their involvement in the response, we are denying them a right and we are perpetuating the bad practices of discrimination and denial that we deplore in others. I hope that from the outset, the next conference will take concrete steps such as ensuring on-site access to medical care including opiate substitution therapy for people who use drugs as a matter of course and that a conference that does not provide this is not allowed to happen.[2]


So what needs to change?  Now is the time for some serious self reflection not only from the organisers, hosts and supporters of ICAAP but also more broadly from the communities who continue to invest time and resources both human and financial in regional forums such as this. What is needed in my humble opinion is a thorough and multi stakeholder review of the core objectives of hosting such large scale conferences. Undoubtedly there is a huge benefit to communities and donors alike in the networking opportunities that these conference bring and seeing the bigger regional picture and alignment with our peers to improve a regional response. On the plus side the relatively smaller scale of ICAAPs and their regional focus have always been a key selling point, ie more cost effect and more relevant to the cross cutting issues that exist in the rich and diverse region that is Asia and the Pacific. Needless to say the Pacific and Papua New Guinea continue to remain unrepresented and underserved and most at risk. Similarly it would seem that yet again women remain far from centre stage when it comes to sessions, presenters, chairs and overall content  the community forum was particularly negligent in this regard. During the rapportuers closing one of the track presenters thanked participants for their stalwartness and surviving what felt like death by powerpoint – I couldn’t agree more. Too many sessions back to back with so many speakers crammed into short time slots it often became information overload and left me begging for an IT meltdown in order for real debate and interaction with participants and presenters such a wealth of information yet unexplored as the over zealous chairs often cut speakers off in their prime and more often than not left insufficient time for clarifications,  debate and questions around what had just been presented.


The UNAIDS and its co-sponsors Getting to Zero campaign:  Zero New Infections, Zero Discrimination and Zero AIDS related deaths was a mantra that became repeated throughout the conference from our colleagues with the UN power. Yet the community came away challenging the sincerity of this rhetoric given the UNAIDS lack of an immediate written response. The community was looking to leadership from Michel Sidebe the Executive Director of UNAIDS to condemn the excessive use of police force, arrests and intimidation on peaceful protesters. who were man handled and became embroiled in a tense stand off and scuffles with the authorities  after a peaceful protest march within the conference venue.

The protesters were executing their right  to demand access to affordable medicines for all to treat HIV and to put an end to the stigma and discrimination faced by Korean PLWHIV and LGBT and key population communities.  Michel himself has repeatedly urged communities to take the lead in spearheading a revolution to address these key issues yet when the barricades go up it seems the very organization that is promoting zero discrimination is perceived as sitting on the fence. To be frank we expect so much more especially given the ludicrous rhetoric that was churned out on day one of the conference in the name of ‘’AIDS Champions’. I still have no idea who or what are AIDS Champions but I seriously call into question the decision to host the meeting in an expensive meeting venue in the city miles from where the real community champions were wrapping up their 2 days of deliberations and in the process taking with them  our very own community champions who should have been speaking at the podium directly to our communities – shame on the organisers for this event in clashing with the community event and shame for not having the foresight to have a presence there to hear the outcomes and main issues from the communities. It should be noted also that neither the chair of the LOC or chair of ASAP attended any of the pre-conference community events.


No doubt there will be a lot of soul searching in what went wrong and what could and should have been put in place to mitigate the unfortunate incident regarding the protest and subsequent arrests. Not withstanding the communities imbroglio with over zealous security forces and the mood spoiler that set the tone and unease for the duration of the conference, other issues continued to plague such large scale events, tedious and uninspired speeches at the opening from a plethora of  financial backers of the conference which begs the question just how much does one have to pay to get to make an uninspired and jargon loaded speech? The exceptions in this instance being the speech by the President of Fiji a leader showing a real commitment and the two communities speakers  a very brave Korean putting his safety and that of his colleagues on the line by outing himself at such a high profile event and a stirring call to arms from an emerging and powerful regional advocate for the region. But yet again community are if not an after thought remain positioned at the end of a ludicrously long line of talking heads, yet stirring and passionate enough to carry the hopes of all the communities with them. One of the few reasons why these events keep me and many others coming back for more.

Its easy to be critical, and you can tell by reading this tirade I am overtly so. Yet in era of dwindling resources and an epidemic that continues to have a huge impact on the most marginalized its time for greater collective accountability and a serious radical rethink for a way forward for Bangkok ICAAP 11 if they are to remain credible within the HIV sector.

For the future credibility of ICAAP I plead with the organisers of the next conference to reflect on lessons learnt over the last 20 years of the HIV movement in the region. And would urge them to develop a robust and comprehensive strategy for meaningfully engaging all key populations and most at risk communities in the planning and implementing process and urge for us all to hold them accountable and transparent as a part of that process. The need to create space for innovation, constructive dialog and meaningful communications with all stakeholders that is both strategic, relevant and thought provoking both in the run up to, during and post ICAAP should be non negotiable.


And finally a five minute promo video by the Thailand Tourist Authority at the closing of ICAAP 10 Busan did little to reassure communities that the next ICAAP will be anything more than same old, same old. Images of Caucasian tourists enjoying the myriad of sights of Amazing Thailand with not a single Asian or Pacific islander in sight let alone and heaven forbid images of the outstanding work done in field of HIV prevention treatment care and support throughout the country doesn’t quite fit the bill. Surely a five minute promo on the successes of Thailands exemplary  MSM & TG friendly service clinics in Bangkok or the  amazing work carried out by sex worker networks such as Empower or the research at the HIV NAT centre would have been so much more relevant in this context? Do we really need to be sold on the ersatz image of Amazing Thailand to encourage us to participate in the next regional HIV circuit party? Maybe we do unless people stand up and say it cannot be business as usual.  Similarly a cultural performance by a couple of professional Khon dancers didn’t quite hit the mark – for anyone who had experienced the beauty, grace and powerful message from our Pacific Islanders friends in the exhibition center the previous day this performance and that of the multi-cultural Korean choir (with not even an AIDS ribbon in sight) left a somewhat sour taste in the mouth. Where was the community? Sorry ICAAP we can collectively do a lot better and I really hope that our Thailand colleagues are prepared to meet this challenge.


Despite a very clear and reassuring message from the hosts of the next conference that there is a strong commitment from the government, civil society and Ministry of health to ensure a successful conference. I do hope in the planning for 2013 our Thai hosts (who will no doubt be as gracious and welcoming as ever, in true Thai hospitable style) they will approach the challenges of HIV from a different and dare I say a community perspective? Will drug users for example  find the space they so rightly deserve on the Bangkok podium without fear of recriminations from a government intent on pursuing a renewed war on drugs that continues to show no impact and further drives the epidemic underground.  My fear is that if not, the tornado of indifference and whirlwind of rhetoric and mediocrity will once again be upon us in two years time.


Greg Gray


Please note that any views or opinions presented in this open letter are solely those of the author and do not necessarily represent those of others  or of the organisations I work for or at times represent


Greg is an HIV positive activist with over 20 years experience in the HIV regional movement and has lived in Asia for the last 28 years. International Advisory Committee Member for the 10th ICAAP, APN+ Advisor, ANPUD MSM advisor, Metropolitan Man Initiative advisory board member, advisor to Youth Voices Count a regional young MSM and TG initiative and full time Manager for the KHANA/Alliance Technical Support Hub Southeast Asia based in Phnom Penh Cambodia.


[2] Karyn Kaplan/ICAAP plenary, August 27, 2011/Busan

Drug Users and the Legal Framework: The Failure of the War on Drugs and its Negative Impact in the Region from a Community Perspective


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