Episode 4 - 2000: AIDS Denialism and Treatment Equity at the Durban Conference
The 2000 conference in Durban was enormously important in building momentum to change the approach to global public health. It was the first International AIDS Conference to be held in a developing country and, more importantly, in a country which had one of the highest HIV-prevalence rates in the world. The theme of the conference was Break the Silence, and the unprecedented media presence in Durban broadcast the staggering impact of the epidemic in sub-Saharan Africa to a world that had yet to fully grasp or respond to the scope of the region’s problem. In the first Jonathan Mann Memorial Lecture, established in honour of the pioneering HIV scientist and human rights advocate who died tragically in an airplane crash in 1998, HIV-positive South African High Court Justice Edwin Cameron decried the “shocking and monstrous inequity” in treatment access between the developed and developing world. Treatment activists, led by South Africa’s Treatment Action Campaign (TAC), staged well-publicized protests throughout the conference.
The incomprehensible stand of South African President Thabo Mbeki undoubtedly helped to boost media interest. In the month before the conference, he had declared that he doubted that AIDS occurred in South Africa and that if AIDS did occur, it was caused not by HIV, but by the poverty that was a result of its post-colonial and apartheid heritage. Further, he declared, AIDS symptoms were side effects of the antiretroviral drugs produced by Western pharmaceutical companies. His views were consistent with those of his Minister of Health, Manto Tshabalala-Msimang, who forbade the use of antiretrovirals to prevent mother-to-child transmission and accused clinicians of murder by poisoning. Within weeks of her appointment as health minister in 1999, the local organizers were summoned to Pretoria and berated for organizing such an event in South Africa.
The bizarre position taken by President Mbeki prompted 5,000 scientists from around the world to publish “The Durban Declaration” in nature on the eve of the conference, confirming the overwhelming scientific evidence about the etiology of AIDS. The AIDS denialism of the South African government led some researchers to suggest boycotting the conference. Despite these challenges, and the skepticism about the ability of the IAS and its local organizers to ensure its success and the security of delegates, the Durban conference proved to be a unique opportunity to address both treatment inequity and AIDS denialism. In the Closing Ceremony, former President Nelson Mandela spoke out against the irresponsibility of the South African government on AIDS.
In addition to the other achievements, the Durban conference provided local organizers with a financial surplus that supported several national conferences on AIDS over the following years.
A year after the conference, in June 2001, heads of state and representatives of governments met at the United Nations General Assembly Special Session dedicated to HIV/AIDS and issued the Declaration of Commitment on HIV/AIDS (UNGASS 2001). This Declaration recognized that the AIDS epidemic had caused untold suffering and death worldwide, and set out a series of national targets and global actions to reverse the epidemic.
The Global Fund to Fight AIDS, Tuberculosis and Malaria was established in 2002, and quickly became the most important financing mechanism for the three major diseases in the developing world.
The success in Durban provided the IAS with the impetus to organize another International AIDS Conference in the developing world as soon as possible. Toronto was scheduled to host the 2004 conference, but conference Co-Chair Mark Wainberg and his Canadian colleagues generously agreed to move the Toronto conference to 2006 so that Bangkok could host the 2004 conference.