“Hear us! Hear us! Hear us! Fatou, Amanda, Emmanuel, Fanta, Habib, Keny, Adjovi, Tatiana, Dieu-Donné, Patrick “… The activists of the Grandir Ensemble network (pediatric HIV Africa) took over the stage and pronounce the names of deceased children and young people -es as a result of AIDS. This is the highlight of the opening ceremony of Afravih 2022, the largest French-speaking international conference on HIV, hepatitis and sexual health. We are Wednesday, April 6, 2022 at the Palais des Congrès in Parc Chanot in Marseille. After a 100% virtual edition in November 2020 due to the health crisis linked to Covid-19, the conference returns for an eleventh edition in face-to-face format in Marseille. Grandir Ensemble is a network of eighteen organizations in eleven African countries. Its goal is to fight for the end of the HIV epidemic among children, adolescents and young people in West and Central Africa and Djibouti.
A strong message, a dead silence
Earlier, Grandir Ensemble activists organized a die-in in the hallway leading to the auditorium where the opening ceremony was to take place. All dressed in the same yellow t-shirt, they lay down on the ground. On the T-shirts is written the following message: “A child dies every 5 minutes of AIDS” in the world. Rodrigue Koffi, Grandir Ensemble coordinator and jurist, explains the meaning of this action: “Statistics show that West and Central Africa accounts for 90% of children and adolescents living with HIV. With this die-in, we want to remind the French-speaking world that these are not just statistics; they are human beings. HIV-positive children and adolescents are drowned in the overall response because there is no specific indicator for these populations at the level of major partners such as the American plan Pepfar and the Global Fund. They are invisible in the global response,” laments the activist. While walking towards the auditorium, the participants observe these bodies on the ground. Then on each side of the corridor which leads to the room, other activists have positioned themselves standing and form a kind of guard of honour. They carry signs with strong messages: “A child dies every 5 minutes, 864 deaths during the conference”, “120,000 child deaths in 2020” or “We are the survivors”. The effect is striking. The way to get to the auditorium is done in dead silence, like the impression of taking part in a funeral march. According to UNAIDS, 800,000 children living with HIV do not have access to treatment in West and Central Africa.
Science without borders: not for tomorrow
The rest of the ceremony is more institutional. Christine Katlama, president of Afravih, delivers the traditional words of welcome and insists on the need to strengthen our capacities to deal with the various pandemics while Covid-19 has weakened the fight against HIV. “We have to be ready (…). Knowledge is the key, that of freedom”, explains the infectious disease specialist who created Afravih in 2009. Bruno Spire, president of the Afravih 2022 conference continues with a vibrant tribute to the HIV community in Marseille. The researcher recalls that activists from Marseille were pioneers in reducing the risks associated with drug use. The activist also deplores the administrative hassles to bring actors in the fight against HIV from certain southern countries to Marseille: “Science without borders, unfortunately, is not for tomorrow”.
AIDS: a political disease
The following interlocutor Michèle Rubirola is the first Deputy Mayor of Marseille. The elected official announces the launch of “Towards Marseille without AIDS and hepatitis” and recalls how “the incredible mobilization of those affected” has upset the relationship between patients and caregivers with the principles of Denver in 1983 “At the time, I was beginning my career as a doctor” recalls Michèle Rubirola who affirms that, 40 years later, “AIDS remains a political disease” And the elected official recalls that new HIV diagnoses are not decreasing more in Marseille largely because of social inequalities that keep the most vulnerable people away from care and prevention. Marisol Touraine, president of Unitaid returned to the impact of Covid-19 on the most vulnerable people: “The sick have become sicker and the poor poorer”. The former Minister of Health under François Hollande wanted to convey three messages: to amplify prevention work, to strengthen partnerships between medical structures and community associations and to encourage rich countries to engage more in the global response to epidemics. Funding was precisely at the center of the speech by Françoise Vanni, director of external relations for the Global Fund to Fight AIDS, Tuberculosis and Malaria. “We need to redouble our efforts to get us back on track for the 2030 goals,” explained the director, who pointed out that the Global Fund had saved 44 million lives in 20 years and that at least 18 million were needed. dollars for the next period 2021-2023. Finally, Hakima Himmich, President of Coalition PLUS insisted on the importance of access to treatment for all: “Despite the confinements, despite the bombs, no one should miss ARV treatment” affirmed the infectious disease specialist, referring to the war in Ukraine. The activist also stressed the importance of community health and presented the book “Rien pour nous, sans nous”.
Nothing for us, without us: the book
On the occasion of Afravih, Coalition PLUS presented its book “Nothing for us, without us: 40 years of community mobilization against AIDS”. The book is the fruit of a reflection and an analysis of 40 years of fight against AIDS in the world. He is particularly interested in the contributions of community mobilization. “We want to try to clarify these aspects for associations where the concept is still vague and for decision-makers in the public health system who do not necessarily have a clear vision of it”, explains Dr. Hélène Rossert, the author of the book. This book is also intended as a tribute to activists in the fight against AIDS. The seven chapters of the book are relatively independent in their construction and can be read out of order according to each person’s interests.
Marseille launches “Towards Marseille without AIDS and without hepatitis”
From April 6 to 9, 2022, at Parc Chanot, Marseille is hosting the 2022 edition of Afravih, the largest French-speaking international conference on HIV/AIDS, viral hepatitis, STIs and sexual health. Generally, the host city takes the opportunity to make an announcement in the field of HIV. This was not lacking… since the City of Marseille officially launched (April 7), during an event at the Palais du Pharo, the association “Towards Marseille without AIDS and without hepatitis”, created on the initiative and under the the impetus of Michèle Rubirola, first deputy to the city of Marseille, explains the Destimed info site. A constituent general meeting took place on March 28th. The association “aims to fight against the epidemics of HIV and viral hepatitis”, but “also to collect public and private funds in order to finance the actions proposed by the board of directors of the association and to facilitate the access to testing, care, treatment and rights”. In addition to this initiative, Marseille wished to strengthen its commitment to the fight against AIDS and viral hepatitis by signing, in turn (April 7), the Paris Declaration, created in 2014, which mobilizes municipalities around the world in the fight against AIDS. Why such a commitment? The City explains this in a communicated. ” The goal ? Defining coordinated strategies to fight against the HIV and hepatitis epidemics (…) Beyond that, reducing AIDS in Marseille also means tackling the omnipresent invisible enemy of precarious people: discrimination”. For the Marseille executive, cities are “engines in the fight against AIDS and sexually transmitted diseases”. All the signatory cities of the Paris Declaration (in France, there are: Bordeaux, Lyon, Lille, Paris, Strasbourg and Nice) undertake to coordinate their public health policy, associative initiatives and scientific work to stop the epidemic which has already killed more than 36 million people in the world since its appearance, we explain. “Marseille was a pioneer in the fight against AIDS and viral hepatitis,” the statement also states, without explaining how. “Today it is a question of giving new life to this fight by bringing together all the actors: associations, elected officials, caregivers, institutions and medico-social personnel in order to drastically reduce the number of contaminations, deaths and discriminations. linked to HIV and hepatitis”, the City now explains. As in other large cities, the HIV situation in Marseille is worrying: the number of infections is stagnating and increasing in certain population groups, particularly people born abroad. Several factors are involved: social and economic precariousness, persistent difficulties of access to care and rights for certain populations, isolation of certain neighborhoods, etc.
Among its objectives, “Towards Marseille without AIDS and without hepatitis” supports “any action allowing to reach the milestone of “95 – 95 – 95” as defined in the Paris Declaration; i.e. 95% of people living with HIV screened, 95% of people screened put on ARV treatment and 95% of people treated with ARVs with an undetectable viral load. And the City of Marseille concludes: “We have understood that AIDS interferes where obstacles to access to care and rights remain or are maintained. To offer unconditional access to essential health services, to open up neighborhoods and communities, to offer rapid tests and prevention tools as close as possible to people’s needs… It is only thanks to this global approach and to a staggered mobilization on all fronts in the fight against AIDS and hepatitis that we can ensure that Marseille embodies this fairer city”.