So, yet another AIDS jamboree opened yesterday, this time in Washington DC.
About 20,000 people from all over the world, broadly termed “those working in the field of HIV,” would have descended on this first rate city for a strange week-long ritual that has happened 18 times before.
Last time, it was in Vienna and people complained that it was too expensive to shop. Perhaps in Washington DC, they might not because there are far too many places selling cheap Chinese imports. They might complain that the American security guys ask too many questions.
No other disease has a dedicated conference of such a scale. Of course, no other disease also has so much money, so many organisations and so many people dedicated to it.
Malnutrition, infant and maternal mortality, malaria, tuberculosis and other preventable epidemics blight the world, but they don’t have dedicated conferences where people sing and dance, present “papers” say the same things again and again and make declarations.
This is called AIDS-exceptionalism, wherein people argue that AIDS is different.
It’s an age old polemic and let’s forget it for the time being because it will continue as long as AIDS exists. Both sides of the argument will present facts and skew them. But AIDS-exceptionalists will want more money and more conferences for sure. This is like one of those money-chains; if it breaks it will collapse a medico-social-industrial complex.
What happens in such conferences?
Every two years, an international conference called the IAC (International AIDS Conference) and an Asia Pacific conference called ICAP (International Congress on AIDS in Asia and the Pacific) and several small regional conferences happen on AIDS.
In effect, every year there is one big conference, mostly in exotic locations. The Asia Pacific conference venue usually alternates between poor and rich countries in the region, while the international conference happens mostly in first world cities because the poor country cities usually don’t have facilities to host 25,000 people and run hundreds of simultaneous sessions with state-of-the-art technology. Perhaps the only exceptions in the recent past have been Mexico and Bangkok. Otherwise, it is Geneva, Durban, Barcelona, Toronto, Vienna, Washington DC, Melbourne.
So what happens in these conferences and why so many people?
In the early days, say till 2000 or 2002, they had some purpose because issues such as treatment, certain socio-economic and political contexts, human rights and scaling up of interventions were still evolving. They used to attract both top-notch scientists and activists alike and were venues for breakthrough research findings. There was more content and less of drama. Scientists and iconic activists were the stars then.
But since the early 2000, the scientific community has moved away to specialised conclaves such as the ones on pathogenesis, treatment and prevention; and drug therapy. When the creme seceded, the AIDS conferences became song and dance events where people just get together to engage in farcical and repetitive rhetorics and celebrations with an affected air of activism. There will hardly be any real science, but some feeble attempts at social research, mostly by untrained NGO activists. And most of this social research will be either repetitions or recycles and will read worse than poor media reports.
The biggest beneficiaries are people from poor countries such as India, Bangladesh, Pakistan and Nepal, who would otherwise have never travelled. AIDS conferences need them – people living with HIV, junkies (the politically correct term is “drug-user” and not even “drug-abuser”), sex workers (no “prostitutes” please), transgender people in saris and thousands of activists who shepherd them and speak aloud for them.
Then there are the donors, the UN and hundreds of international NGOs and the Big Pharma. In fact, the BIg Pharma drives the show and they foot most of the bills.
Okay, the question again. What happens in these conferences? What do these sex workers, people living with HIV, AIDS-workers, donors, UN officials and others do there?
1. The first thing that one notices at these conferences is the restlessness of people because they simply walk. When they don’t walk, they will either stand in front of free internet-enabled computers or fill the eateries.
But where are they walking to and for what? They are walking from one venue to another spread over industrial scale locations. It is usually difficult to count the number of venues where simultaneous sessions are going on. The walkers will walk in and walk out of the sessions while some stay back. Usually, a pathetically low number of people actually sit down in those huge halls to listen to the frankly, boring, panelists.
2. The walkers include both the presenters and the delegates. The presenters may have done the same powerpoint a 100 times in other conferences, but still they are as enthusiastic as the first timers. They keep running from one venue to another throughout the day. At one session, they express moral outrage against a national government (say Pakistan, for harassing its homosexuals), while in another they display exhaustion at government apathy (say a poor Ivory Coast, which has no money to spend on children dying of malnutrition, much less on HIV) to AIDS.
3. An American middle-level UN official, in her fifties, was a classic example of the runners. At two of the conferences in Asia and the Pacific, she considered herself a star attraction every day. Grinning broadly in her trademark red-jacket, she organised, emceed, presented or chaired back-to-back sessions so that she finally landed herself a place in the conference montage playing on giant LED screens across the venue. Her obsessive conference extravaganza did burn a few hundred dollars of tax payers’ money that could have provided life-saving treatment to a few thousand people living HIV in poor countries for several years.