UNAIDS: The First 10 Years

UNAIDS The First 10 Years60Many activists and speakers deplored the existence of two starkly different AIDS worlds.In one world, there was wealth and pills (an estimated US$ 20 000 per treatment per yearin the USA). In the other, AIDS care and treatment was inaccessible to most people livingwith HIV. AIDS activist Eric Sawyer (founder of ACT UP) said: “The cure isn’t here. We area long way from a cure, even for the rich. And for the poor, we’re no closer than we were10 years ago. Most people with AIDS can’t get aspirin”. For many, AIDS was still someoneelse’s problem – the political world had not formed a united front against it.Jeffrey Sturchio, Vice-president External Affairs of Merck & Co, Inc, illustrated how theactivists promoted their cause at the Vancouver conference: “What I remember about theVancouver meeting was that at one point the congress hall was full of people throwing fakemoney printed with the names of pharmaceutical companies to dramatise the point thatprices needed to come down. So, from then to the Geneva conference, those two years,[there] was that kind of public pressure”.Because UNAIDS was as yet an unknown entity, it had been a struggle to persuade theconference organizers to let Piot speak at the opening ceremony, but they fi nally agreed.He announced: “It remains unacceptable that people living with AIDS, especially – but notonly – in the developing world, should have to live without the essential drugs they need fortheir HIV-related illnesses … bold action is needed on many fronts. This will take pressurefrom all of us – including people living with HIV and NGOs in developing countries”.This was thefirst time anyof the UNorganizations orany internationaldevelopmentofficial had statedthat pursuingtreatment accessin developingcountries wouldbe a matter ofpolicy. It was thekind of visionthat would requiremobilization andmovement on aworldwide scale.This was the first time any of the UN organizations or any international development offi cialhad stated that pursuing treatment access in middle- and low-income countries would bea matter of policy. It was the kind of vision that would require mobilization and movementon a worldwide scale. But this would not happen for several years, and only after majornegotiations between senior UN officials, political leaders and Chief Executive Offi cers ofpharmaceutical industries, and activism on a huge and impressively sophisticated scale byindividuals and groups in the South and the North.At the conference, journalists sensed a change from previous gatherings. A piece in theSan Francisco Chronicle summarized the proceedings:‘The major focus of yesterday’s opening ceremony was political. It concentrated ongovernments that still drag their feet on the AIDS front, and on major pharmaceuticalcompanies whose new drug combinations – however effective in drugs so far – driveexpenses for people with AIDS to US$ 10 000–15 000 a year … [Peter] Piot voiced anger… at roadblocks to distribution of the latest medicine to those infected, “most of thesedrugs could be made accessible … if governments had the right drug policies and if doctorsprescribed appropriately”’ 8 .8Perlman D (1996). ‘Worry, hope at AIDS conference: breakthroughs have too high a price for many’. SanFrancisco Chronicle, 8 July.