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Not as large or energizing as previous AIDS conferences, the Vienna 2010 jamboree officially kicked off on Sunday night at the Messe Wien Center. Soothing classical music wafted through the auditorium, creating a somewhat surreal setting for a conference that will be characterized by frustration and bitterness about the world's flagging funding commitments to combating AIDS. Protestors gathered their banners and posters and marched through the auditorium shouting: "Broken Promises Kill. No Retreat. Fund AIDS." From their positions at the podium, the conference co-chairs agreed that many leaders have reneged on their promises. Julio Montanter chastised his own government of Canada for hosting a G8 summit that focused on Maternal and child health (see here and here), while ignoring previous pledges to universal access to AIDS treatment. Michel Sidibe, UNAIDS, echoed these sentiments and said he is "scared" by what he sees (flat-lining funding, treatment denials), especially when we have made impressive achievements (for example, almost 5 million people are on treatment) in the AIDS response. I listened to one speech after another, trying to make sense of this frustration and hoping that I could find something optimistic about being here at the end of a decade of rising global funding for AIDS.

Health is a human right and we need to ensure universal access, not just for AIDS, but for all life-saving treatments. Past promises, such as the 1978 Alma Ata Health for All by 2000 Declaration, languished until HIV emerged on the global scene. So, there is much to be thankful to the AIDS movement for, but the organizers of this conference didn’t effectively encompass this positive messaging into the opening ceremony, both in terms of content and form.

AIDS Conf Photo

Content: A significant achievement in the AIDS response has been the sheer grit and determination of AIDS advocates and activists—they have set new records in raising billions of dollars for eight solid years. Today, however, support levels are changing and AIDS champions are understandably frustrated. Despite a new funding environment, messages of disappointment and fear could be better balanced with messages about what we can learn about effective treatment, prevention and care.

An opening ceremony should be inspirational, not just to mobilize resources, but to create a buzz about innovation in programming and the potential to learn. I'm looking forward to attending sessions in the next few days because I left the opening ceremony quite deflated and uninspired.  There is SO much to learn, among other things, about: how combination programming for prevention works for women and girls; whether programs can be scaled and if they are scaled up, are they sustainable; how HIV/AIDS and reproductive health programs are being designed to "integrate" services; etc.

Form: Personally, I'm tired of both rants and long, technical presentations in an opening ceremony of an IAS conference. The audience here includes thousands of people from all walks of life—political leaders, sex workers, celebrities, researchers, advocates, pharmaceutical companies, young people, etc. Messages about what has been achieved and what has not need to be punchy, direct and evidence based. Today, the balance wasn't right. The epidemiological round up of the global epidemic induced many jet lagged participants into deep slumber and others left in droves as slide after slide of data-intensive tables and graphs flashed by on six screens in a large and dark auditorium.  (You get the picture.)

Only three talks that captured my attention: one by Sidibe because he was passionate, a basic science talk on a cure for AIDS by Sharon Lewis from Australia that explained potential strategies for working with latent T-cells towards a cure, and a human rights talk by Paula Akugizibiwe from South Africa. But even these could have been sharpened and shortened significantly for this forum.  With the kind of technology and expert communication specialists we have these days, it is a shame that such a visible global health platform isn't able to get the quality of its messaging right. (This might be a worthwhile investment for the IAS to get the biggest bangs for its many bucks.)

Despite these initial frustrations, I'm optimistic that I will learn new and useful information from the sessions I attend in the next few days and that the money to bring me and 19,999 others here will be well spent. Stay tuned!