Highs and Lows Part 1

The Opening Ceremonies for the Olympics are happening this evening.  This is a pretty big deal to lots of folks, and though I’m not an Olympics fan, or sports fan really, I can see and appreciate the value they bring to culture and international relations.

I have a friend who is trying to engage me in conversation about them for the last couple days since I’ve been back, but I have my mind totally enraptured in another set of international relations issues.  I’m still processing, analyzing and worrying about the things I heard learned and experienced while in DC for the International AIDS Conference and the last Display of The NAMES Quilt. 

What has been weighing most heavily on my mind are the extreme highs and lows with regard to progress around HIV, mostly those that are associated with this conference. In this post I will discuss the first pair of them, and continue tomorrow with more.

High:  Two new HIV positive people have been found to have no sign of the virus in their body for a consistent two years, after a stem-cell transplant to treat cancer.  This is great news, especially with regard to research for a “cure.”

Low: US Visa policies prevented a major population of high-risk individuals from entering the country, therefore participating in the Conference.

High: the conference was back in the US for the first time in 22 years, because President Obama changed a US Visa policy with regard to people who are HIV Positive, allowing them to enter the country again.

Low: In the midst of new statistics showing that the “global South” is actually progressing in their fight against HIV/AIDS, we find a Major Pharma Company is challenging the Patent Laws of India to essentially REMOVE a generic version of a drug from the market, and increase the price of close to TEN TIMES what it is currently selling for.  This is the first time I’ve ever heard of a Drug company fighting to have a patent placed on a  drug that has already expired and the generic version has already been made available.  (Imagine, if suddenly, tomorrow, Tylenol brand was able to stop Wal-Mart, Walgreens, smiths, from making the generic version of their pain reliever and you HAD to go back to buying Brand Name Tylenol all over again!)

High: The NAMES Quilt was accessible and viewable for so many people who might never have had any other chance to see the memorial honoring their loved ones; their friends and family, sisters and brothers, sons and daughters. 

Low: While we have slowed the number of panels that are added, because Medications are keeping people alive, and we are slowing infections in the “Global South” we are still seeing the same rates, sometimes higher rates of new infections in the US, indicating that we are not solving the problem we are merely making the prognosis more pleasant.

There are, of course, hundreds more highs and lows for this first IAC to be held in the US in 22 years, and one of the largest gathering of people from across the US and indeed the world that DC has seen in a long time.  These, however, are among the most impressive that have occupied my mind since returning from DC. 

High: New News for “Cure Development” Though not as headline –grabbing as the “Berlin Patient”, was pretty impressive for so many of us.  As an advocate, it was hard not to get overly excited about The Berlin Patient.  But I had to keep telling myself, that “Miracles happen” and that a one-time occurrence, is not scientifically solid yet.  After the news of these two new patients came out, I am more hopeful than ever that we are merely step away from a cure!

For those who don’t know, a basic over simplified 101 on the topic.  HIV (the virus that causes AIDS) inhabits Immune cells, and reproduces itself within them, killing the Immune cells; also stopping the immune cells from replacing themselves with other healthy cells.  The new medications, known as Anti-Retrovirals, help to reduce the amount of replications of itself the virus can make. (I said I would oversimplify it.) 

These patients, the two new ones, and The Berlin Patient, all suffered from some form of leukemia, as well as HIV.  The treatment for the Leukemia was eventually, a Stem Cell Transplant.  Stem cells are the root cells in our bodies, and they replicate themselves and become whatever cells necessary, but with a “clean slate” so to speak.  When the Stem Cells were introduced in the patient’s body, to replace the Cancer-ridden blood cells they also replaced the HIV-infected blood cells.  Since the patient was on Anti-retroviral Medications through the transplant (this was new, usually HIV patients went off their HIV meds to be treated for cancers). This means, that we now have at least one idea of how to pursue a Cure to the virus! (It should be noted, that the donors for all three patients were immune to the HIV virus, which is an incredibly small population and complicates things a small amount. )

Low:  While President Obama finally reversed a decades old policy prohibiting HIV+ person from entering the United States, finally allowing the Conference to be held here, Other outdated policies regarding immigration/visitation in the US prevented two major stake holding groups from coming to participate.  In many countries around the world, Prostitution is legal. In many places, it is highly regulated and Sex Workers have licenses or permits to practice their trade, much like barbers and Make-up artists or lawyers and doctors do here in the US. But the US has an immigration/Visitation policy that prohibits anyone who has a Sex Work license, or has any criminal history of Sex Work from entering the country. It is the same with regard to Drug use charges.  This ban was highly unhelpful for having real dialogue around HIV/AIDs on a worldwide scale.  Consider the two issues we’re talking about; Drug use, (intravenous which can be a guaranteed transmission source- and non IV, which can impair or change decision making abilities, analysis and rational thought) and Sex Work.  Trading Sex for money is probably the largest global industry in existence still today.  People want sex, and many people don’t have much luck getting it without paying. (this is not a moral judgment simply a fact stated) and others, prefer to pay for it. Sexuality is fluid; there are no rights and wrongs (within the scope of consent) and who are we to decide what two adults can or should do within the experience of their sexuality?

How can we really discuss with any truth or progress, the epidemic of HIV/AIDS when we aren’t willing to face truth, people are still using drugs, and people are still trading sex for money.  How can we ever expect to bring an End to Aids, if we aren’t willing to face the truths and make them a part of our planning and policy making?

I met a fabulous woman in the global village, who is a former Sex Worker, Trans woman, with a Drug Addiction background as well.  She gave a speech the next morning at a plenary session, about the need to include sex Workers and Drug Users (current and former) in the policy making and planning around an end to the virus. What a brilliant point to be made, how stupid that it needed to be made at all! Why would we even think twice, to include the breeders and keepers of cattle, in the planning around Mad-Cow policies? Or would we dare have a planning session to discuss policy and prevention of teen pregnancy without involving Teenagers? Well yes. In the 60s, or 80s. Maybe even in the 90s a little bit.  But this is 2012.  News flash. People have sex. People use drugs.  Ignoring them as people will not make them stop, refusing to talk to them, or with them, about the struggles they face and the activities they participate in, will not stop them from contracting and spreading HIV!  And most of all,  continuing to criminalize these people, and strip them of their dignity, is definitely not going to make their “problems” go away.  We have such a puritanical ideology around these things, these days.   We still seem to think we will stop Drug use in the US and around the world by incarcerating people, En Masse, for the behavior, for their addiction.  And taking the Condoms away from Sex workers in NYC, and L.A. or using them as evidence for sex trade, is certainly not helping the problem. 

I was blown away to realize that, most of all, we were having a Worldwide conference in HIV/AIDS to discuss Turning the Tide, and we are unable to, or unwilling to talk about what’s just under the surface of the water. 

I’m happy about the new research, the promise of tomorrow, and hope of an End to AIDS. But I’m highly disheartened at the thought that we are so arrogant, so absolutely full of hubris as to imagine we will end this pandemic without discussing two of the greatest contributing factors to   the spread of the virus today.