Devex CheckUp: The massive AIDS conference that soured before it began

The 24th International AIDS Conference — the world’s biggest HIV and AIDS event, which takes place every two years — opens Friday in Montreal. But what was supposed to be an opportunity to take stock of the latest science and galvanize action against a disease that has killed over 40 million people has turned into turmoil over who gets to attend and have a voice at the conference.

• Several registrants, many of whom are African, have faced visa delays and denials. Winnie Byanyima, the executive director of UNAIDS, tweeted on Tuesday that her documents were repeatedly checked before her flight to the conference, saying she was “almost refused to board.”

• Many have characterized the visa denials as racism on the part of the Canadian government and called for such conferences to be held in the global south. Dr. Ayoade Alakija, a WHO special envoy for the ACT-Accelerator initiative, says she’ll participate in the event virtually rather than in person as a show of solidarity with all Africans who faced visa issues.

• The International AIDS Society, the conference organizer, is now offering a full refund for those denied their visas. IAS President Adeeba Kamarulzaman tells Jenny that she’s “very upset” over the visa denials. The organization originally aimed to hold the event in a middle-income country in Asia but pulled out after “the host government made it a condition that it would vet and thereby influence the conference programme.”

• The exclusion of many participants from the global south — Kamarulzaman says she isn’t sure how many — has raised questions about why global health conferences continue to take place in high-income nations, where costly and restrictive entry requirements can make attendance a challenging if not impossible prospect for many people from low- and middle-income countries.

• “Right now, if you are hosting a global health conference in US, UK, Canada, EU or Australia, you have decided that it’s acceptable to exclude people from the Global South,” tweeted Dr. Madhu Pai, a Canada research chair in epidemiology and global health at McGill University. “How global is your global health?”

According to UNAIDS’ latest report, new HIV infections dropped by only 3.6% between 2020 and 2021, marking the smallest annual decline since 2016. “Progress has been stalled, inequalities have widened, and resources have shrunk,” Byanyima told a press conference Wednesday.

Exclusive: IAS President ‘very upset’ over AIDS 2022 visa denials

One big number

That’s how many additional AIDS-related deaths could occur by 2030 if the current HIV response doesn’t address the stigma still associated with the disease, according to Avenir Health founder John Stover at a preconference held ahead of AIDS 2022.

But stigma is tricky to define, measure, and address, Devex Contributing Reporter Andrew Green tells us. It is also unclear whether an initiative that is successful in one setting will prove effective in another.

That hasn’t stopped researchers from grappling with the lessons of existing interventions. In a review of nearly 70 frameworks for addressing stigma, Laura Ferguson, a researcher at the University of Southern California, identified a combination of approaches that appeared promising, including community participation, education, and counseling.

Showing the money

Last year, U.N. spending on procurement shot up by 32.5% — and the largest portion of that money went to health spending, which ballooned by 94.5% to $10.6 billion. Devex Pro members can explore our data analysis to find out why, and see where the rest of the funding went.

Funding insights: How the UN spent $29.6B in 2021 (Pro)

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Some good news

Medicines Patent Pool and ViiV Healthcare today signed a new voluntary licensing agreement that allows the generic manufacturing and distribution of long-acting cabotegravir, an injectable form of HIV preexposure prophylaxis — or PrEP — in 90 low-income, lower-middle-income, and other countries.

PrEP is about 99% effective in preventing HIV transmission from sex. Seven months ago, the U.S. FDA approved long-acting cabotegravir, the first country to do so. But before that, most PrEP drugs have only been available in pill form taken daily or in some cases before and after sex. A single shot of long-acting cabotegravir can provide two months of protection against HIV infection. While manufacturers can start applying for sublicensing now, Unitaid predicts that a generic product won’t actually become available for at least four years.

Read: New agreement to increase access to long-acting injectable PrEP

Wait, there’s more

A new deal between MedAccess, the Clinton Health Access Initiative, and Chinese biotech company Wondfo will bring down the cost of an HIV self-testing kit to $1 — making it the most affordable such kit on the market with WHO prequalification and at least 30% cheaper than any other WHO-prequalified test. Globally, there are an estimated 5.9 million people who have HIV but don’t know they are positive because they have never been tested.  

Wondfo will make the test available at this price for public sector purchasers in 140 low- and middle-income countries. MedAccess, meanwhile, will provide volume guarantees — meaning if sales of the test fall short, the company will pay Wondfo to cover the gap.

Learn more: Price of HIV self-tests lowered to $1

What we’re reading

MSF Spain president refused entry into Ethiopia’s Tigray region a year after three of the organization’s personnel were killed there. [Devex]

The Serum Institute of India gives $2.5 million to kickstart AU health workforce project. [Devex]

Air pollution is likely to increase risk of dementia among older people, study says. [The Independent]