When the Victorian Aids Council formed almost thirty five years ago, the world was only just beginning to deal with the scourge that we subsequently called HIV/AIDS.
In the face of inaction by governments indeed dismissive scorn was the more common response the gay community mobilised to take on three enormous tasks.
First, to establish approaches to care for those affected by HIV/AIDS.
Second, to persuade governments into meeting their responsibility to extend to all members of the community , the same levels of care, compassion and equity.
And third, to address and remove the stigma that attached to an HIV/AIDS diagnosis.
The HIV/AIDS epidemic generated some unusual alliances.
Had anyone in 1982 suggested that one of Australias defining achievements the opportunity to end HIV transmission would result from the cooperative efforts of gay men, sex workers and people who inject drugs, scepticism would have been the mildest of reactions.
Since AIDS first came to notice, it has claimed more than 35 million lives.
At its peak in the 1990s, around one thousand Australians died each year since the first death was recorded in Melbourne in July 1983.
The death rate from AIDS in Australia is now extremely low.
Thanks to improved advocacy around testing and treatment, the rate of new HIV infections has fallen significantly, although there are still 25,000 Australians living with HIV and around 1,000 new cases diagnosed every year.
When HIV/AIDS first came to notice in the US in 1981 and in Australia in late 1982, it quickly became a vehicle for discrimination.
Its first descriptor 4H disease singled out heroin-user, homosexuals, haemophiliacs and Haitians in a randomly discriminatory term that lumped together gender, race and disability in a single name.
And the successor term GRID (Gay-Related Immune Deficiency) was no better.
What enormous progress you have made in treating HIV/AIDS, in preventing HIV/AIDS, and in ensuring that the stigma that discrimination always brought has been removed.
Yet we still have a long way to go to ensure that the LGBTIQ community is accorded the same rights as all other members of the Australian community.
The current debate on marriage equality demonstrates this.
I am proud of the fact that I am part of the Labor tradition that saw the Hawke government, through the then Health Minister Neal Blewett introduce Medicare and properly sensitive and highly-effective HIV/AIDS management , care, treatment and prevention policies.
But Australias quick and effective action on HIV/AIDS would not have been possible without the strong advocacy and support of former NSW Senator Peter Baume who was Shadow Health Minister to Dr Blewett when HIV/AIDS first emerged in Australia in the early 1980s.
The work of Dr Baume and his successors in Opposition during the 80s meant that the national HIV/AIDS programs were carried forward when the Howard government came to office in 1996.
The policies carried on through the changes of government in 2007, 2013 and will, I believe will be secure whatever happens at the next election.
Prevention remains preferable to keeping HIV/AIDS in check.
Australias HIV/AIDS care, treatment and prevention strategies have comprised five main elements. I want to touch upon each of these quickly.
First, our national response has been largely community owned and operated.
Community groups have encouraged governments to provide treatment and research funding as appropriate, while ensuring that the delivery of support and services is undertaken by and with the involvement of those closest to those either affected by or at greatest risk of HIV infection.
This has especially been the case in the LGBTIQ community, which was hardest hit by HIV/AIDS, but was also extended to injecting drug users, sex workers and indigenous communities.
Second, peer support has been an incredibly important tool in helping those living with HIV/AIDS to cope.
Third, peer education has been critical in both consciousness-raising on the prevention side and information provision on the treatment side.
While public awareness campaigns do have some effect who will ever forget the grim reaper campaign? the most effective awareness and education campaigns involve conversation and discussion within the LGBTI community itself.
Fourth, associations like the VAC have been strong supporters of harm reduction and harm minimisation programs, particularly through the national needle and syringe campaign and encouraging the use of prophylactics.
And fifth, the VAC and its partner associations have played a key role in HIV/AIDS prevention. The principal avenues here are important:
- Health promotion across the entire LGBTI community
- HIV testing, including community-based rapid testing
- Encouraging awareness of and access to PEP, and
- Strong advocacy of the PrEP demonstration program.
Regrettably, things have not advanced so well in much of the rest of the world.
According to the World Health Organisation, there were more than 36 million people living with HIV at the end of 2016, with 1.8 million new infections recorded globally in that year. Africa accounts for 70 percent of the worlds HIV cases, and almost two thirds of the global total of new HIV infections.
In the Least Developed Countries, particularly in sub-Saharan Africa, HIV/AIDS by the late 1990s had reached epidemic proportions.
Thanks to a tremendous effort by many African national governments, international donors and agencies, and not least by the most-affected communities in many countries, the number of new HIV infections and deaths from AIDS has fallen considerably from the peaks of 10 and 20 years ago.
In our region, we have recorded considerable gains against HIV/AIDS but there are worrying signs that rather than continuing to fall, new HIV infection rates are plateauing or even rising in some countries and regions.
HIV/AIDS is still far too high in Papua New Guinea, where the implications of cuts to both the domestic health budget and a restructure Australias approach to supporting HIV/AIDS programs are concerning.
In many developing countries, there are continuing problems in HIV/AIDS management, treatment and prevention, principally because the problem is systemic.
Like the Victorian AIDS Council here at home, strong civil society organisations will need to play an increasing role in ensuring that the LGBTIQ community and other marginalised communities who are most at risk of HIV infection remain a priority of health spending as these countries transition to middle income economies.
We must do all that we can to assist our friends and neighbours to meet and defeat the challenges of HIV/AIDS and to improve their health systems.
To address the global HIV/AIDS challenge, we need concerted and increased international action. Given Australias success domestically, we are in a position of considerable credibility in working with like-minded countries to stimulate a more comprehensive and effective global attack on HIV/AIDS.
Due to the outstanding work of the VAC, in concert with your partner associations, the spread of HIV/AIDS has stabilised in Australia.
Indeed, we have real hopes of completely ending domestic HIV transmission in Australia within the foreseeable future.
But, as Elton John said, the HIV virus feeds on fear, stigma and discrimination. Our task now is to look beyond our borders and re-double our efforts to destroy fear, stigma and discrimination wherever they occur.
