Activism and Science Come Together at the 14th Annual International AIDS Conference in Barcelona

News Feature by Paulina Novo

The chasm between the haves and have-nots was blindingly clear at the 14th annual International AIDS Conference in Barcelona, Spain. More than 15,000 participants showed up for the opening ceremonies, including the biggest turnout of actual people with AIDS in the history of the conference. They filled the stadium in magnificent Barcelona--a city of artistic contrasts and architectural beauty, where one can find Roman buildings, Gaudi-styled churches, parks next to modern buildings such as the Palau St. Jordi--where the event was being held.

Attendees came from around the world, with delegates representing 194 countries in Southeast Asia, the Middle East, Africa and Latin America. Not all countries, however, could afford to participate. The Mexican nongovernmental organization (NGO) sector was underrepresented simply because they could not afford to pay the fees and expenses needed to attend the event.

Thus, for all the talk of a united front against this dreaded disease, the conference itself separated into two very different groups. On one side of Fira de Barcelona were booths sponsored by pharmaceutical companies and other corporations. Glossy pamphlets, coffee and treats were offered by the mostly white men in suits doing their best to interact with curious passersby from diverse backgrounds. Often, it seemed they were doing their best to convince booth visitors that their companies had at least one altruistic program in countries where residents look nothing like the representatives themselves.

On the other side of the Fira de Barcelona was a conglomerate of NGO booths often staffed by a half-dozen or so caregivers, activists, and assorted others who managed to make it all the way to Barcelona. No coffee or free food were served, but other things were plentiful, from devastatingly real statistics of HIV's prevalence to African batiks, crafts and music.

The polarity was clear among the participants. The eclectic mix included Spanish princess Senorita Elena, pharmaceutical corporations, members of the scientific and gay communities, heads of state, PWAs and activists from all over the world. But more than anyone else, it was the work of activists that made headlines around the world.

When she attempted to make a speech, Spanish Minister of Health Celia Villalobos (now a former minister of health due to national elections that followed the conference) was drowned out by an angry group of Spanish AIDS activists protesting her denial of welfare benefits for PWAs unless they have a T-cell count of 50 or less. (Other press reports indicated, inaccurately, that the protest was due to the Spanish government restricting visa approvals for PWAs to attend the conference.) As she attempted to talk, she was continuously interrupted by whistles and yelling from the crowd as the rest of the attendees watched in disbelief.

A couple of days later, the interruption of U.S. Secretary of Health and Human Services Tommy Thompson drew more attention to the conference. Activists were upset about what many see as a paltry offer by the United States for the Global Fund to Fight AIDS, TB and Malaria (GFATM).

Even Uganda has contributed more money to GFATM (when calculated as a percentage of its gross domestic product) than has the United States, pointed out Sharonann Lynch from Health GAP (Global Access Project), a U.S.­based AIDS organization comprised of human rights activists, public health experts, fair trade advocates and concerned individuals, and ACT UP/New York. Lynch castigated America as one of the "stingiest of all countries" and, what is worse, she said, that stinginess "sets the bar so low for other countries to contribute" that it gives them an excuse to only make very limited donations to the fund.

The Geneva-based GFATM was established last January. The independently operated organization has already committed more than $2 billion for specific projects to fight the triple-pronged diseases, and it is hoping to attract even more funding. United Nations Secretary General Kofi Annan has calculated that $10 billion a year is needed to treat AIDS globally. The United States has pledged approximately $250 million to the fund, but it is estimated that its share of contributions to GFATM, again based on gross domestic product (GDP), should actually be around $2.5 billion.

When Thompson stood up to give his speech, activists, led by members of ACT UP/Philadelphia, ACT UP/Paris, ACT UP/New York and Health GAP, took over the stage and the microphone yelling, "Shame! Shame! Shame!" Despite the interruption, Thompson tried to continue his speech, but nobody could hear him.

After the protest, Thompson argued that the U.S. simply did not have the financial resources to make a larger contribution to GFATM. He also talked about setting up infrastructures in Third World countries before giving any money to AIDS programs. "The worst thing we could do would be to put money in programs that fail," he said. "Once they start working, they can be established everywhere, showing the world what a successful program is."

Thompson vigorously defended the Bush administration as being the most ambitious administration in the world as far as the fight against HIV goes. "People don't listen," he said. "People don't see all the things we are doing." While recognizing that the altruism of activists, he suggested they redirect their anger into getting other countries to contribute to GFATM.

Thompson also talked about the administration's history on the issue of needle-exchange programs, which it has not yet endorsed despite the contention by many activists that the programs help stop the spread of HIV. Thompson stated carefully that after reviewing the available scientific research, he'd concluded needle exchanges do "prevent the spread of HIV infection, and it does not contribute to the drug abuse." But at the same time, Thompson said that, because of political issues, federal dollars would not be spent on needle-exchange programs. That was in marked contrast to former President Bill Clinton's belated admission that he should have supported needle-exchange programs while he was president.

Clinton, who attended the Barcelona conference, had no problem criticizing the government's donation to GFATM. The star speaker at the "Staying Alive" youth panel, sponsored by MTV and in which dozens of young people from around the world participated, the former president asserted America is now spending $800 million a year in the fight against AIDS worldwide when its "fair share would be two and a half billion dollars, maybe a little more."

The difference between where the United States is in terms of its financial support and where it should be is less than the cost of two months in the war in Afghanistan, Clinton said, asserting that the United States should be able to come up with the money instantaneously. One young woman from South Africa asked Clinton how America was able to come up with billions of dollars in a matter of days after the Sept. 11 attacks, but could not come up with the money to invest for GFATM. Clinton replied that "People view the 3,100 people from 70 nations around the world [who died that day] in a different light than they view people who die of AIDS." He said individuals who perish due to AIDS are anonymous to all but those who love and care for them, adding, "for the first time in history, the whole world has to take responsibility for a global health epidemic."

Clinton talked extensively about the need for a worldwide plan to fight HIV/AIDS. He suggested that countries first figure out how much money each needs to fight HIV/AIDS, how much they can afford, and then negotiate with pharmaceutical companies to obtain fair prices or generic medications. Those nations should then approach the United States and other wealthy countries to fill in the gap. Clinton asserted that wealthy nations calculate their contribution to GFATM based on wealth and GDP. He urged young people to take action by figuring out what percentage of their GDP their country should contribute, and then work to make sure that amount is donated.

As the conference progressed, the activist presence remained strong. At a joint action, people from all over the world gathered outside the Fira de Barcelona to protest what they called Coca-Cola's "deadly neglect of workers with AIDS in developing countries." The rally's backdrop was a photo-friendly, 25-foot-high Coke bottle emblazoned with: "Coke's Neglect = Death for Workers in Africa: AIDS Treatment Now. End Medical Apartheid." Activists accused the huge corporation of excluding 98.5 percent of its African workforce from obtaining antiretrovirals. Those individuals are allegedly employed by affiliated companies, many partially or completely owned by Coca-Cola.

ACT UP/Paris, ACT UP/New York and ACT UP/Philadelphia initiated direct actions at the booths of several organizations and corporations like GlaxoSmithKline, the World Health Organization (WHO), the European Union and others to protest what they see as the pharmaceutical corporations' profiting by compromising people's lives.

Lynch accused corporations of engaging in a pattern of price gouging as a result of U.S. patent protection that stops the production of generic drugs. There will be an estimated 7 to 10 million people living with HIV as of 2003, and activists are demanding that at least 3 million people have access to treatment by 2005.

"Poor countries need substantial technical assistance in order to get funding, to implement, and to monitor treatment access programs," said Asia Russell of Health GAP in a joint press release from Health GAP and ACT UP. "That is the WHO's job. But the WHO is refusing even to use its voice at the table of the WTO to insist on a workable solution to the problem of how to export generics to countries without drug manufacturing capacity."

Many of the AIDS activists say that, despite their work, little has been achieved. For many, the conference was business as usual: UNAIDS reported the number of deaths around the world, WHO came up with the number of people that should be treated, but no new medicines or major scientific breakthroughs were introduced. Corporations hung on to their policies, which the activists say put profit before human life. Politicians used the stage to make new promises, but delivered little else. No one tried to deny the basic truth of the AIDS pandemic, yet a huge gap remains between those who have access to treatment and those who don't.

One young woman from Kenya summed up the feelings of many when she said, "It is frustrating to see your friends die every day and not be able to do anything about it."