“HIV is not just a virus, it’s a reflection of the unfairness that continues to persist in all our societies,” said James Chau, president of the China-United States Exchange Foundation, as he made his introductory remarks at the opening plenary of IAS 2023, the International AIDS Society conference being held in Brisbane, the third largest city in Australia.
While speakers addressed a number of themes, they focused on worldwide uncertainty, disparities in global health and the need to include community as partners.
Sharon Lewin, president of the International AIDS Society and director of the Peter Doherty Institute for Infection and Immunity in Melbourne, outlined some of the news expected to be announced at the conference.
“New findings from a trial in Africa found that cisgender women overwhelmingly prefer long-acting injectable PrEP to taking a daily oral pill, providing proof of the high need for equitable global access to this critical prevention tool,” she said. “The REPRIEVE trial has definitively demonstrated how we can prevent adverse cardiovascular outcomes that still occur more commonly in people with HIV. And a sixth person [already making headlines as the Geneva patient] may be cured of HIV after a stem cell transplant, but in his case, the donor was not genetically resistant to the virus. COVID-19 has taught us that with significant investment and global commitment, transformational advances in science can and really must move faster.”
Lewin also pressed for the continuing need to invest in research and innovation in HIV research, for better prevention tools and treatment options and improved efforts to include marginalized communities and address health disparities. She also addressed stigma and anti-queer sentiment.
“The rise in increasingly hostile and discriminatory laws against LGBTQI+ communities, sex workers and people who inject drugs is a major concern,” she said. “We must actively oppose these attacks on human rights through our influence and our advocacy as individuals and as the IAS. The goal of the IAS is to unite the HIV response to overcome HIV as a threat to public health and individual well-being. In a world of increasingly conservative and populist governments, this is more important than ever.”
The point was driven home in a stirring address by Dr. Alegra Wolter, the first openly trans physician in Indonesia.
“With the rising polarization of good versus evil, us versus them, sensitive issues are being politicized with malicious intentions impacting the lives of many, including persons living with HIV and other vulnerable groups who are left behind,” she said. “Today, on this beautiful day, I humbly represent both sides of the table. I come to you as a professional and also as part of a community heavily impacted by HIV.
“I honor my friend who stopped her ART treatment and chose not to continue because she felt that life was not worth it,” she added. “May her soul rest in peace. What saddens me the most is that her reality is not far different for many.”
She described the work ahead. “Our challenges now rely on the integration of care into health systems along with the streamlining of universal health coverage and a person-centered approach free from stigma and discrimination across all life dimensions,” she said. “What is the human rights-based approach to health?
“A wise friend once told me not everyone is given the privilege to help others,” she added, “and now, more than ever, we need to challenge our charity point of view and tokenistic approach, turning it into true compassion. What can we do to help? What can we do to make things better?”
In his welcoming remarks, Mark Butler, a Labor Party member of Australia’s parliament, noted that the government had worked with organizers, especially at the community level, to bring in as many delegates from overseas as possible. In a veiled reference to what has happened at previous conferences in the U.S. and elsewhere, he remarked, “I’m very pleased to say that not a single visa has been refused on the basis of a person’s HIV status.”
Butler touted the news that Australia is on track to become the first country in the world to eliminate new acquisitions of HIV. He credited “three pillars” for this accomplishment. Australia’s federal government has been consistent and united in its efforts despite political changes over the decades since the start of the epidemic in the 1980s, he said. In addition, affected communities—including people living with HIV, sex workers and injection drug users—along with clinicians and researchers worked in partnership. “And thirdly, we’re proud that it’s been comprehensive from the earliest days—condom programs, needle and syringe programs and more recently, public subsidy programs for treatments for PrEP and for testing,” he said.
“I also want to say that the U=U call to action is strongly endorsed by the Australian Government. It’s a straightforward reflection of the science and it’s already incorporated into the country’s eighth National HIV Strategy,” a plan that was launched in 2018.
As the opening plenary drew to a close, its tone changed to honor the HIV clinicians and researchers who were on their way to Australia for another international conference, but were lost in a tragedy.
“The last time I stood in front of many of you was hosting the opening of AIDS 2014 down the road in Melbourne,” Chau recalled. “It was a moment marked by resilience and grief and profound loss when our friends and colleagues were killed when traveling to Australia to join us—298 people died that day when [Malaysian Airlines] flight MH17 was shot down over Ukraine, among them six champions in the fight to end AIDS.”
Pim de Kuijer, Lucie van Mens, Maria Adriana de Schutter, Glenn Thomas, Joep Lange and his partner Jacqueline van Tongeren were aboard the ill-fated flight.
Chau introduced a string quartet from the Melbourne Conservatorium of Music, who somberly performed on stage.
“Let us recommit ourselves to carrying on their legacy,” he said.
The many faces of IAS 2023
More than 5,000 came together in Brisbane, Australia for IAS 2023—volunteers, presenters, indigenous performers and advocates among them.