As HIV R4P focuses on those with highest burden, least access to services, the death of a Zambian President highlights fragility of leadership and public health

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Zambian President Michael Sata

Zambian President Michael Sata

A Zambian acquaintance here at the HIV R4P conference in Cape Town shared the news this morning that the country’s President, Michael Sata, has died. “It is too much,” she said, noting he is the second president to die in office in six years, and in the short history of the country that just celebrated its own 50th birthday. Sata’s death was not unexpected though, having been rumored long before it happened, after months of what the New York Times obliquely calls “months of largely unchronicled illness.” Politics interfere with straight talk, sometimes.

Sata, however was known for bluntness, and at one point took the position that if Zambia was going to succeed in confronting HIV, national policy should recognize that men who have sex with men exist and should be able to access information and treatment. Sex between men is illegal in Zambia, and has been since colonial law made it so. And while Sata, who was married to a physician, was speaking in the interest of public health, during the months leading up to the 2011 election that landed him in office, that stance was held against him, and he didn’t repeat it. Then came ill-health, and now he is gone.

In the meantime, sessions throughout the day here at HIV R4P in Cape Town today focused not just on the impact of criminalization, discrimination, and institutionalized bias on men who have sex with men, sex workers, transgender women, people who inject drugs and others pushed to the sides of societies, but on the impact the marginalization of hard hit people has on what researchers are able to learn, to apply science to its best advantage for all people.

“One of the key messages coming from prevention scientists is the need to reduce the stigma and uniqueness of these populations,” Colonel Nelson Michael of the United States Military HIV Research Program said this morning.

Bridget Haire, of the University of New South Wales in Sydney, Australia, began by mentioning that she is the great granddaughter of a sex worker, and told the impact of the U.S. Anti Prostitution Oath — written into the start of the President’s Emergency Plan for AIDS Relief– had on the ability of sex workers to participate in vaccine and microbicide research. Their input, it has emerged repeatedly at this conference would have furthered research that is intended to help women who face challenges to using condoms, but also want to keep a focus on a prevention method that protects them from other sexually transmitted diseases and from unintended pregnancies.

And Zoe Duby, interpreting some of the results of the VOICE trial of oral and vaginal HIV prevention that was confounded by answers that weren’t borne out by data, told that one problem researchers faced in learning of anal sex among female participants is that the practice is illegal where the research was taking place.

Joseph Chinga of the Gay and Lesbian Coalition of Kenya summed up much of it when he spoke of a need he sees, “to break down the barriers between reearchers and LGBT.”

The yield, according to the schedule here, could be an array of biomedical HIV prevention that would offer something to the individual needs of everyone.

So here at HIV R4P, where sessions throughout the week will focus on the intersection of health and human rights, the contribution to one of the countries hardest hit by HIV in southern Africa that might have been, is memorable.

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