Ongoing coverage of the International AIDS Conference in Bangkok is bewildering to those who are familiar with the current political battles in the HIV/AIDS arena, and no doubt disheartening or annoying to those reading from a distance. The AIDS industry is in full swing: government forces delivering glittering generalities; actors and ex-presidents discussing their "outrage" while eating five-course dinners in Bangkok hotel penthouses.
Non-governmental organizations (NGOs) provide so...read more
Ongoing coverage of the International AIDS Conference in Bangkok is bewildering to those who are familiar with the current political battles in the HIV/AIDS arena, and no doubt disheartening or annoying to those reading from a distance. The AIDS industry is in full swing: government forces delivering glittering generalities; actors and ex-presidents discussing their "outrage" while eating five-course dinners in Bangkok hotel penthouses.
Non-governmental organizations (NGOs) provide some context and much confusion. Some, like Doctors Without Borders or Partners In Health, push a consistent line that demonstrates their commitment and closeness to the poor who suffer from HIV and its related social pathologies [1, 2]. Others seem to care more about winning New York Times headlines than about the implication of what those newspaper stories will have for the poor. The American Foundation for AIDS Research in Manhattan, for example, produced a report that should have provided an evaluation of Thailand's generic production facilities within the context of technical suggestions and cross-border comparisons with other nations' production centers; instead the report was publicized in a manner divorced from its technical minutiae and left the impression that generic medicines from Thailand would kill millions [3]. This, in a context where the US AIDS Czar Randall Tobias is looking for any means to undermine generic manufacturing and return to an oligopoly system in the pharmaceutical industry [4].
The heavy focus on drug access at the conference does, however, serve as one piece of good news, in spite of the fact that many believe it is "distracting" from other matters (an issue I will deal with later in this article). The fact that the discussion is not about whether antiretrovirals can be used in poor countries, but about how to get them there, is a marked shift from previous years. But that is not to say that efforts like the WHO's "3-by-5" Initiative (three million people gaining access to antiretrovirals by 2005) are not being undermined [4]. The battles will continue over this and related initiatives, but what are the rest of us to do as we watch the actors and ex-presidents deliver glittering generalities? What positive outcomes can come for the poor when the wealthy of Manhattan produce statements of "outrage" while consuming pad thai in the security-fenced sector of Bangkok?
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