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What’s Right – And What’s Not – On the Road Towards Epidemic Control?

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Maureen Luba
Friday, August 3, 2018
General

Maureen Luba is the African Regional Advocacy Advisor: COMPASS and AVAC, based in Malawi.

In 2016 when I attended the International AIDS conference in Durban for the first time, my impression from the conference was that the world was on track to achieving epidemic control. I was assured the 90-90-90 targets, if achieved by 2020, would mean we were on track to control the epidemic. I left the conference feeling hopeful, re-energized and geared to push Malawi, my home country, to increase and align its investments to the 90-90-90 targets. For me, the end to AIDS was near.

Two years later, I found myself attending the International AIDS Conference in Amsterdam. Three days before commencement of the conference, UNAIDS released its annual state of the epidemic report, this year titled Miles to Go. I was astonished to learn that we are in a prevention crisis, and that epidemic control might not be within reach as we had all anticipated.

Going through the UNAIDS report I was not sure what to expect from the conference itself. I had so many questions on my mind: What are we not doing right? When will HIV cease to be a crisis? For how long should we keep pushing? As I attended the conference I was hoping to get some answers, but sadly I left the conference with some unanswered questions. As time continues to tick and resources continue to wane, it is important that we all take a moment and reflect on this journey.

The critical issues that stood out for me included: the need to allocate more resources, the optimal use of resources currently available, recognizing and supporting the critical role of civil society organizations (CSOs), advocates and communities, the need for more prevention options for women and leaving no one behind.

One thing I liked about the 2018 conference was the tremendous recognition of community voices. I marveled at how community groups were rigorously engaged and given an opportunity to be heard. As a community representative myself, sitting on a panel with UNAIDS Executive Director, Michel Sidibe, I spoke about primary prevention and took advantage of the opportunity to remind UNAIDS and other key stakeholders in the room about the critical role that CSOs, and communities generally, continue to play in the response and why there is need to invest in it.

As a young woman, a champion and a passionate advocate for women-controlled HIV prevention options, being given a chance to make a speech at the International Partnership for Microbicides (IPM) reception was an opportunity to express gratitude to all partners present for the contribution they have made towards the development of the dapivirine vaginal ring and other products in the pipeline. It was also an opportunity to remind people of the need for continued support of women’s access to discrete tools that they can use without negotiating with anyone. Just reflecting on the conference itself, it is very clear to me that we still have a lot of work to do.

Achieving epidemic control will require pulling together strategies and engaging with the work of different stakeholders. It will also require that we reflect on past experiences; what has worked and what has not, whilst drawing on those key lessons to guide programming and implementation going forward. All this must be to put to use in the early adoption of policies that support interventions that work, addressing the social and cultural issues that have an impact on the epidemic, increased investing in research efforts focusing on women-controlled HIV prevention interventions and last but not least, greater involvement of the communities in the design and implementation of the programs.