Quarraisha, Quarraisha, Quarraisha

by Dr Nesha Haniff

Well those of you who know me and have taken my classes on putting women's bodies at the center of science will know what today has meant to me. I went to the session entitled  "Safety and Effectiveness of 1% Tenofivir Vaginal Microbicide Gel in South African Women:Results of the Caprisa 004 Trial".
I knew that the results which were to be under embargo were leaked by the Financial Times and I saw the report this morning on the BBC. I was happy but cautious, could this be real?

I thought the news would be positive when I knew both Quarraisha and her husband  Salim Abdool Karim were going to be here. They usually alternate at conferences. So I was at session room 6 half an hour before the start  of the presentation. I wanted to be up front in the middle where I could see their faces. Is this the moment. Will microbicides be finally proven scientifically as a concept to put women's protection of their bodies in their own hands not having to negotiate with men about condom use?
I felt at once excited and worried. I have been here before with pro 2000, with carraguard, with buffer gel, savvy, nonoxyl nine-each time there was a failure it was if I had been dumped by a man in whom I had invested my hopes and dreams. When I sat there I thought, is this really true or am I going to be dumped again?

It was true, tenofivir gel had proven to be effective in 54% of those who used the gel.

http://abcnews.go.com/Health/AIDS/vaginal-gel-cuts-hiv-spread-aids-researchers/story?id=11199076&page=1

Having worked in HIV prevention for 20 years with women on the front lines of the epidemic and having had to tell women to use a condom  which I knew many times was not at all possible, I felt at this moment that I would be redeemed from this false prevention message for women.

I loved that Dr. Quarraisha Abdool Karim who has been a supporter of POA( Pedagogy of Action) for  many  years was the lead scientist. The second  PI was her husband. As they sat on the panel together  something I don't see very often -  South Africans at the center of this scientific breakthrough, there assembled, all the movers and shakers in the UN system, in the NIH, CDC. The Minister of Health of South Africa was on the panel so was the premier of Kwa-Zulu Natal. The room was packed, I sat with Dr. Dawn Smith who works in the HIV program at the CDC and a former student of mine. We both were excited because we understood this seminal moment.

South Africans can solve their problems.  Quarraisha Abdool Karim a woman, a scientist, a South African, married to her co PI and the team of CAPRISA dedicated to this struggle, prevailed  this time. It was the women of South Africa who were in the trials who were heroic. I know that this does not mean that I have to stop saying condom and that the rest of the story of empowering women must continue. But this is the beginning of hope and I feel that this time I will not be dumped. I take pride that I know Quarraisha and that the students at POA have had the great privilege of her taking the time to speak with them for many years.

In her last talk with my students I remember that she said. HIV is  killing our women,.our people. We must continue to try to solve this. We just can't give up. For her and CAPRISA this was an act of love for their country for their people. Khealeboga, enkhos, thank you.

Reflections from a Caribbean woman on Day 2

by

Dr Nesha Haniff

On the second day of the World Aids Conference held in Vienna this year, I am struck by many things.. The first is the large South African contingent at every level, both community, ngo and government. What I have enjoyed is seeing South Africans speaking about their problems themselves, not being spoken about, an important ideological change. The Caribbean also has a strong presence both at the level of recognition of the issues affecting msm and sex workers and  their voice on panels and presentations. The presence of Africa and Asia’s vulnerable populations are also voicing their struggles. They are here not as objects of oppression but empowered actors in their world making great inroads on the injustice of homophobia and sexism. Their presence at the conference is not to observe and be present as proof that the conference is inclusive but  that they have appropriated their place in the conference shaping their struggle  as they see it.

I loved the presentations on Hiati  by Dr. Patrice Joseph who spoke about Haiti’s  work on HIV for over thirty years  and did not say Paul Farmer’s name once. Everything  we have ever heard about Haiti and HIV is that Paul Farmer went in and saved the day. Now  I am not at all trying to belittle his work but  there was a Haitian doctor Dr. Jean William Pape  and a consortium of Haitian doctors and health professionals who have been in this struggle for years  starting GHESKIO the world’s first institution dedicated to the fight against HIV/AIDS. How  they continue their work under the present circumstances of Haiti was extremely moving. India  continues to impress me. The work on Avahan the India Aids  Initiative  funded by the Bill and Melinda Gates foundation was impressive. You walked into the room and you were given a voting device and as the presenters spoke you were then asked to answer questions and the results like an instant poll came up immediately. You were then asked to discuss why you voted a particular way. Avahan works in 6 states in India with more than 220,000 female sex workers, 80,000 men who have sex with men and transgenders, 18,000 injecting drug users and about 5 million men at risk. How they used technology to advance their cause and got their governments to respond was truly an exercise in the meaning of democracy.

President Clinton was the plenary speaker. He was as usual full of ideas and accomplishments in his long HIV work. For the first time at this level of the conference which has spent all of its focus on Africa and rightly so, the problem of HIV in the United States was discussed. The US now has the highest HIV infection it has ever had , it is now the third highest cause of death for African American women and African American MSM have the highest incidence of HIV. P:resident Clinton who has been an unflagging supporter of  Africa and the HIV cause now speaks about HIV in the US. This was significant. His talk was very moving. He spoke about a “bucket list” a list you make of what you want to do before you die. It made me sad that he thought of such a list for himself. I hope that his health is not tenuous. He also spoke of the latest scientific discovery about neurons and the idea in physics that  neurons must be both negative and positive. They found that there seems to be more positive ones than negative. It was how he closed, that in the end the positives will outweigh the negatives and it is how I feel this day.

There are more black people here at this conference

Dr Nesha Haniff is Senior Programme Advisor to Jamaica AIDS Support for Life and a lecturer at the University of Michigan. She dropped in at the Caribbean Lyming Zone to put her feet up and indulged in a gaff about the conference so far.

She said that she felt that this year, there were more black people visible and present. She was particularly happy at the visibility of South Africans - in the plenary sessions and on many panels. This is new and a massive shift from the time when as Bill Clinton noted, South Africa was a pariah in terms of its response to HIV and the advocacy and representation for South Africa was done by white researchers.

She feels this is happening with Haiti and that people who are not Haitians are speaking for Haiti. She cited an example as to how Bill Clinton referred to Paul Farmer  from Partners in Health as the Haitian saviour. This point she tried to address at the PANCAP plenary, noting that the names of the  Haitian doctors and others on the ground should be visible and their voices heard in fora such as the AIDS Conference.

She felt that the Caribbean work is becoming visible - with one study cited in the opening plenary , Robert Carr's active participation in the conference and the panel about HIV/AIDS in the Caribbean.

Dr Haniff was born in Guyana and worked there before moving to Jamaica. Her speciality is in the area of Gender and HIV/AIDS