|AFRICA REGIONAL NETWORKING
1. Quality of care and access to treatment is
dependent on useful and adapted information which should be accessible at the most
decentralised level. AfriCASO and UNAIDS have an urgent need to:
- seek and gather relevant information and to make
it available to community-based organisations and individuals;
- ensure a broad dissemination of this information
and to share it broadly through various methods;
- increase the numbers of conveyers of processed
information through the creation of information resource or documentation centres (such as
NGOs and support organisations); and
- enlarge and optimise the use of electronic
networks which would reduce the cost of communicating and increase information flow.
2. AIDS Service Organisations and community
groups of PWA need to enhance their advocacy and lobbying skills. AfriCASO and UNAIDS must
organise appropriate training in this area. Targets should include governments,
bi-laterals, private sector, scientific community (specifically for the human and
ethical-social dimensions of the epidemic), wherever there is an opportunity for
interaction and communication, through local, national, regional and international
meetings, or by creating the opportunity, through strategic alliances.
3. AfriCASO and UNAIDS need to promote the
formation of strategic alliances. These should cover:
- Within the community sector and its different
forms or organisation which share common goals and visions, and in respect of each others
- With other stakeholders, based on the interests
that link us to them and the environment in regard to access to care. This concerns
governments, leaders, the private sector, the cultural sector of society, the medical and
academic worlds, places where civil society mobilisation occurs, etc
at the local,
national, regional and international level.
Feedback will be gathered on the progress of
these issues by September 1999 to inform the Durban 2000 conference report-back.
ASIA/PACIFIC REGIONAL NETWORKING
4. That all conference co-sponsors, particularly
UNAIDS and ICASO, ensure that every action plan in response to HIV/AIDS includes:
- Inclusion of migration related issues (eg
cross-border, mobile/migrant populations, trafficking of women and children);
- Access to treatments as a fundamental
non-negotiable priority including essential medications related to opportunistic
- Lobbying for increased funding from highly
developed countries for international activities on HIV/AIDS;
- Attention to strategies to reduce global price of
treatments and increased support and research for the role of traditional medicines.
5. That IAS in conjunction with all conference
co-sponsors, particularly UNAIDS and ICASO, ensure that at Durban 2000, sessions on issues
for particularly marginalised communities eg, adolescents, sex workers, injection drug
users, be designed and presented by representatives of those communities rather than
organisations or researchers working with those communities.
LATIN AMERICA AND THE CARIBBEAN REGIONAL
6. LACCASO, GNP+, ICW and the AIDS Working Party
of ILGA will co-organise the Community Forum of the next Pan-American AIDS Conference
which will take place in 1999 in Brazil. This Community Forum will take place immediately
prior to the Conference.
7. The four networks, as co-sponsor of the
Pan-American Conference, request IAS and UNAIDS as organisers, to integrate membership of
all the Committees of the Conference, and, as in Geneva, to have a Community Planning
NORTH AMERICA REGIONAL NETWORKING
8. NACASO will develop a mailing list and
distribute, to begin creation of a mail and electronic communication tree for the region,
by the end August 1998.
Key areas of future collaboration and networking will include, but not be limited in any
- Increased communication
- Increased linkages
- Information dissemination
- Networking and skills building strategies
9. Key organisations and individuals within North
America will seek to increase knowledge and understanding of the cultural context(s) in
which we undertake our single and joint activities within Canada, United States and
10. NACASO will host a further regional meeting
by February 1999, planned to reach agreement on action items for the year 2000, following
COMMUNITY BASED RESEARCH NETWORKING
11. That IAS in conjunction with all conference
co-sponsors ensure that at Durban 2000 symposia, round-table discussions and rapporteur
summaries in conference plenaries be used to bridge the gap between discussions on
community-based research, theory, methods, practice and ethics in the CRV and discussions
on theory, methods, practice and ethics in the general conference proceedings (all
12. That IAS in conjunction with all conference
co-organisers ensure that a forum on community-based research be reconvened at Durban 2000
to study progress on discussions since Geneva and Vancouver on issues of theory method,
and ethics practice.
13. ICASO, Geneva 1998 Liaison Committee and
Durban 2000 Liaison Committee to give ongoing support for the electronic discussion forum
on community-based research with the purpose to identify, document, and disseminate
community-based research, theory, method and practice.
GAY MENS and other MSM NETWORKING
14. It was agreed that current HIV/AIDS decision
making networks do not reflect cultural, religious economic and sexual diversity.
Effective networking must acknowledge and respond to this diversity by extending links and
dedicating resources to develop new fora and networks both inside and outside the gay,
lesbian, bisexual and transgender communities. These must include other minority and
religious identities, positive youth, and human rights organisations, at all levels.
15. Gay, lesbian, bisexual and transgender issues
remain important for this and future conferences. Similarly, HIV/AIDS remains an issue
important to gay, lesbian, bisexual and transgender communities. These concerns should be
more adequately reflected in the program at the next conference. There must also be a
recognition of the differing needs of different regions of the world, especially those
within the global South.
HUMAN RIGHTS NETWORKING
16. UNAIDS to work with the Office of the High
Commissioner for Human Rights to establish and promote mechanisms for the documentation of
HIV-related human rights abuses/omissions and best practices at the national and
international levels including a Special Rapporteur on HIV/AIDS and Human Rights by Durban
17. UNAIDS to provide technical and financial
support to strengthen communication and networking amongst existing and emerging networks
on HIV and human rights, including:
- national workshops;
- e-mail capability;
- materials development;
- and that a report be submitted to Durban 2000.
18. UNAIDS to establish an international task
force to monitor the application of the International Guidelines on HIV/AIDS and Human
Rights through the development of specific national and international workplans and
The first report of the Task Force is to be
presented at Durban 2000.
MIGRATION ISSUES NETWORKING
19. We call on governments to stop the
deportations of people living with HIV and to abolish the double punishment of prison
sentence followed by deportation. Deportation is inhumane and degrading treatment.
Deportation is a form of torture. Deporting a person living with HIV to a country where
treatment doesn't exist means condemning that person to a death sentence.
We call on UNAIDS, in partnership with front-line
immigrant rights organisations doing work around this issue, from both North and South, to
initiate a consultation about this issue to document the practice of deportation and to
bring together NGOs, international organisations, and governments to discuss what will
have to be done for deportations to be stopped.
20. We demand that governments, pharmaceutical
multinational companies, and international organisations respect the principle of access
to the best available treatment and care on the basis of need (and not immigration or
21. Third World communities settled in the North
face extreme vulnerability to HIV due to their social and economic conditions. They face
violent racism and structural domination on a daily basis. In the North, Third World
people often find out about their HIV status only upon falling ill, because they are the
last in line for access to HIV testing. They are often the ones whose HIV infection remain
untreated. Worse, in some cases, they face the threat of deportation, often after they
have started treatment, to a country where treatment simply doesn't exist. There can be no
"Bridging the Gap" without equality and recognition for HIV prevention
programmes for Third World communities settled in the North, as well as equality in
support, care, and access to treatment.
We call on GNP+ and ICW to support
self-organisation efforts by Third World people living with HIV in the North. We expect
these organisations to come to the forefront to offer their support in the defence of
immigration rights and access to care for our communities.
We call on GNP+ and ICW to contribute to ongoing
efforts by immigrant rights organisations to document human rights violations (including
deportations and denial of treatment) which are responsible for thousands of unnecessary
AIDS deaths of Third World people living in the rich countries of the North.
We call on Governments to stop the inhumane and
degrading practice of deporting people living with HIV and to respect their fundamental
LIVING WITH HIV NETWORKING
22. ICW key contacts and GNP+ Board will work
together to ensure, by January 1999, good collaboration at the grass-roots level between
local groupings of ICW and GNP+.
23. ICW and GNP+ will:
- make "crystal clear" to their
constituencies each of their capabilities, policies, and structure; and
- strengthen communication from the global through
the regional to the national level, and back again through to country representatives.
FACING A FUTURE: LONG TERM SURVIVAL SYMPOSIUM
24. We call on the IAS and UNAIDS to make a
sustained commitment to bridge the gap in perspective between objective science and the
subjective experiences of people with long term HIV.
In particular, we call on them to see to it that
institutions and governments develop and sustain research programmes to increase
understanding of HIV as a long term condition, of the psycho-social needs of people with
long term HIV, and to the preservation of forms of social protection of people with long
term HIV for as long as they are needed.
25. We call for action at the community level for
the creation of options for living, for example in regard to return to work, tailored to
individual circumstances and needs, and for respect and support for treatment decisions,
whether they be to treat or not to treat.
26. Due to the complexity and multiplicity of
issues relating to HIV as a long term disease, we recommend that a conference be held
devoted to the topic.
COMMERCIAL SEX AND HEALTH IN THE SECOND DECADE
OF HIV SYMPOSIA
27. Donors must recognise the value of networking
and make funds available to appropriate networks of sex work projects at global, regional
and country level. Appropriate networks are those which recognise commercial sex as valid
employment and sex workers right to self determine.
28. Those conducting research concerning sex work
rarely use epidemiological methods of evaluation of such projects, and when used are
insufficient. Researchers must develop a method of evaluation that is based on sex worker
perceptions of project success.
29. This Community Symposium expresses great
concern and condemns the actions of the Hungarian police in Csongrad County that have
resulted in greater local STD/HIV risk. These actions include arrests and harassment such
that sex workers are forced to sell unsafe sex to meet fines and avoid imprisonment. This
requires working long hours so sex workers are prevented from accessing sexual health
services. We appeal to all regulatory authorities to prohibit any act of policing that may
impact negatively on HIV prevention amongst sex workers and to fund programs for police
30. Government must explore means to reduce the
reliance of transgenders on sex work as their sole source of income and enact laws which
provide a non discriminatory environment for transgender citizenship.
31. Those carrying out HIV and STD prevention
work amongst sex workers must recognise that such work must be done concurrently for
TREATMENT ACCESS BY THE SOUTH FOR THE SOUTH
32. Recognising that:
- The health infrastructure in the majority of
African countries is inadequate in meeting the challenges of HIV and AIDS care
- Antiretroviral drugs are already finding their way
into these countries through diverse channels
The group strongly feels that this should not
handicap initiatives to introduce availability of sophisticated care including the use of
The group recommends that access to treatment for HIV/AIDS should be integrated into
existing health care systems, into health policy development and into existing forms of
family and community care, while retaining a particular focus on it within these systems.
Communities and governments should work together to answer the following questions:
- How do we make voluntary testing and counselling
- How can we improve the quality of diagnosis and
- How can we best access available care and
prevention services in both formal and social and traditional systems?
- How can we mobilise communities and involve their
organisations in improving compliance to antiretroviral treatment?
- How can breakthroughs in HIV research and
resources allocated to HIV and AIDS benefit the health care system as a whole and improve
the care of other health conditions?
- How can the personal, familial and professional
cost of being an HIV activist be minimised?
- How could the cost of optimum treatment be best
The group recommended also the establishment of a
mechanism through which optimum services in terms of diagnosis, drugs, monitoring,
counselling and support as well as training can be provided . This would take different
forms in different countries.
33. The Latin American group noted that there
are several issues to be recommended to the countries in the region in order to improve
the access to treatment.
A. Social recommendations:
i) We understand that advocacy has to be
encouraged; therefore we recommend that the governments in the region should recognise:
- the importance of advocacy by the community;
- the recommendations of the scientific community;
- the participation of PWAs in political making fora
as a legitimate social group to discuss the issues.
ii) advocacy has to be encouraged in practical
- financing the actions of groups working in the
area, both in the scientific community as well as from the community as a whole,
- formation of medical ethical group specialized in
AIDS issues in the different regions in Latin America,
- stimulate the creation and financing of NGOs and
other social movement manifestations to work in this issues.
iii) advocacy in the region should address its
political actions with practical arguments, such as: it is cheaper to provide
access to treatment (medication for prophylaxis, for opportunistic infections and
anti-retroviral medication) than keeping the AIDS patients in the hospital; reminding
financial decision-makers of the impact on the economy as a whole, if a significant part
of the population are removed from the workforce.
iv) advocacy should include a media strategy to
create favourable public opinion for AIDS issues.
v) AIDS issues have to include additional areas
to only medical, since it is not only a health issue, but an educational and economical
B. Political recommendations
i) The group understood that there is the
necessity to formulate legislation in the region to allow specific access to treatment for
people with AIDS. This has to be done by:
- identifying individuals in the government
sympathetic to the issue (key persons);
- creating a media strategy by the government;
- participation of the community and HIV+ people in
the design, implementation, and follow-up of policies.
ii) Policy should include specific budget
allocation and accountability to implement the action in research, prevention and care.
iii) Budget allocation should not be made by cuts
in other health areas.
iv) We also recommend that the local governments
- on medical/pharmaceutical protocols and trials
- on medication price limits for anti-retroviral and
medication for opportunistic infections as well as for prophylaxis.
i) Creation of medical-ethics protocols to
ensure to respect confidentiality, privacy, right to counselling and guarantee of
continuation of treatment whenever started, including for post-partum women (women who
have recently given birth).
ii) Empowering of health and care professionals
on AIDS issues should be largely provided by government.
iii) Access to treatment should be affordable and
available nation wide.
iv) Access to information should be accurate,
practical, and in accessible language to ensure that people with HIV and AIDS are able to
make informed decisions.
v) Research in alternative and traditional
medicine should be encouraged.
Eastern and Central Europe
i) In the view of the very limited information on
Eastern and Central Europe, it is crucial that all information compiled by international
organisations (mainly UNAIDS) be made available at country level to NGOs.
ii) NGOs should be encouraged to analyse this
data and to set up an action plan for their country highlighting the deficits, and
identifying areas where international assistance is needed.
iii) information must be carefully translated so
that it may be used by all interested parties.
iv) UNAIDS and other international agencies
should provide technical assistance and support for NGOs.
v) EU is encouraged to directly support those
35. The 12th World AIDS Conference
should press governments/world leaders to ensure informed access to treatments, i.e.
informed access means dissemination of information enabling persons with HIV/AIDS to make
- Press governments/world leaders
- Intensify networking opportunities
- Regional conference (Asia/Pacific) should adopt
Access to Treatments as its direction
- Pharmaceutical manufacturers should declare their
pricing mechanism and distribution system
- Patent rights should be less than 5 years to avoid
- Increase training for care staff
- More availability/ lower price of basic palliative
- Support research on alternative therapies
- Set up laboratory facilities in sub-regions
- Increase dialogue on treatments access issues.
CULTURE: ART & ARTISTS RESPONDING TO AIDS
36. That future Conferences give higher
priority to interactive cultural activities in terms of both budget and program, and that
these be integrated into all aspects of the programme.
ALTERNATIVE AND TRADITIONAL HEALING PRACTICES
37. We call on all Conference co-organisers
(GNP+, IAS, ICASO, ICW, UNAIDS) to acknowledge the role of natural medicines and
traditional medical practitioners, as well as alternative and complementary medicines, in
AIDS prevention and treatment, and to advocate that this health sector be allocated an
equitable share of AIDS research, treatment and prevention resources.
38. We call on the organisers of future regional
and international AIDS conferences to set aside venues and opportunities for the exchange
of ideas and experiences related to traditional and alternative therapies, and further
urge that they support regional and global networks related to traditional and alternative
The Natural, Alternative, Traditional and
Complementary Medicines (NATC) Caucus of the International AIDS Society (IAS) will be
responsible for follow-up on the response to resolutions 37 and 38, and for promoting
AIDS, HUMAN RIGHTS AND ACTIVISM SYMPOSIA
39. In order to assure a stronger linkage
between AIDS issues and Human Rights issues all co-organisers of the 13th World
AIDS Conference should:
i) Identify partners in Human Rights, ethics and
- to exchange staff and board members and
- promote mutual relationships.
ii) Have more interactive sessions on human
rights, ethics and law during the core-time of the next AIDS Conference (i.e. between 9.00
iii) Ensure material on AIDS and human rights, legal and ethical issues is distributed to
all partners, including through UN Theme Groups on AIDS at country level.
HUMAN RIGHTS SKILLS BUILDING
40. Issues pertaining to the field of human
rights should be fully integrated in the fight against HIV/AIDS.
41. Human rights monitoring mechanisms must be reinforced.
42. Womens rights must be stressed in the fight against HIV/AIDS.
43. Vulnerable populations have the right to be educated and informed about HIV/AIDS.
44. Young women are the fastest growing
population of people infected with HIV. ICW believes that people in the world, from
governments to communities and families, must acknowledge the special vulnerabilities that
young women with HIV face in all regions of the world.
We must all seek out and listen to the experiences and voices of young women who are
living with HIV/AIDS. We are all responsible for protecting young women from exploitation
economically, sexually, and emotionally. Resources must be invested to empower, educate,
and support HIV positive young women.
ICWS Position on the Key Issues
Affecting Women Living With HIV/AIDS
ICW is totally opposed to mandatory testing in
all its forms. ICW advocates for universal pre and post test counselling, testing with
informed consent and access to test results. Sentinel surveillance testing is not cost
effective. We oppose unlinked testing of women and children for the purpose of monitoring
Women with HIV/AIDS need health care providers to act responsibly before dispensing
treatment to women and to provide adequate monitoring and follow up with proper
counselling and support.
ICW opposes trials using placebo controls where studies elsewhere have demonstrated
efficacy of the trial drugs. Such trials should be designed to compare with other
interventions of proven efficacy.
ICW advocates for research that is of direct benefit to the women with HIV/AIDS who are
involved, includes us in the development of trial protocols in our countries, and
preserves the rights and dignity of ourselves and our children.
ICW opposes research that is irrelevant to or which exploits women with HIV/AIDS who are
poor, uninformed or lack resources, unless this research will result in direct benefit to
them and their children. For example, we oppose vertical transmission trial on women with
HIV/AIDS if treatment is withdrawn immediately after they have given birth.
Regardless of what is or is not accessible to them in their situations, women with
HIV/AIDS have a right to know that monotherapy is not an optimal or a recommended
treatment combination therapy is.
ICW calls for all women with HIV/AIDS to have up to date accurate information.
Women with HIV need information on all therapies and strategies which reduce vertical
transmission and access to these if we choose to use them.
Women with HIV/AIDS need information about affordable female controlled prevention methods
such as female condoms and microbicides with access to them when they become available.
Women with HIV/AIDS need information on and access to affordable health care (conventional
and alternative therapies) and research into how the virus and treatments affect us.
ICW calls on governments and international alliances to re-focus strategies such as
prophylaxis against opportunistic infections and nutritional support to prevent
progression of HIV disease.
ICW calls for urgent research into the issue of breastfeeding.
Women with HIV/AIDS have a right to know that breastfeeding is a mode of transmission. We
need clarity on the percentage rates of transmission through breastfeeding and consistency
in the information given in different parts of the world.
Women with HIV/AIDS need more information and training on traditional and other affordable
and accessible alternatives to breastfeeding other than commercial formulas.