The Oscars won by Matthew McConaughey and Jared Leto are tributes to their brilliant, occasionally comic, eventually harrowing performances in Dallas Buyers Club. But as Leto’s acceptance speech acknowledged, the awards are also about America coming to terms with a dark injustice in its recent history, one which finds echoes all over the developing world today.
It seems abhorrent that people affected by HIV would have to form underground buyers clubs simply to get access to the most basic of drugs that would help to prolong their lives. But that is not just how things were in 1980s Texas, it is still the reality for tens of millions of people living with HIV. And the reasons are the same: the stigma and prejudice attached to HIV – so perfectly portrayed and then suffered by McConaughey’s character – remains a huge challenge in many countries across the world, preventing individuals seeking or receiving help just when they need it most.
As a result, Buyers Clubs still exist in many of those countries, requiring the people leading them to risk penalties and punishment in order to provide access to essential drugs. Jay Chin, an activist from China coordinates the SALT campaign – Securing Access to Lifesaving Treatment – which grew from the simple Buyers Club he set up to access generic medicines that were not available in China, taking huge risks in the process.
But even in countries where drugs are provided to HIV patients, the battle remains – just as in 1980s Texas – to ensure they are the right drugs, provided early enough.
Price reductions on generic drug production are crucial if we are to meet this challenge. We can’t afford for already over-stretched healthcare systems in developing countries having to turn people away simply because drug treatment is prohibitively expensive.
CAFOD and our local partners overseas are working hard to increase access to quality HIV treatment. For example, in Cambodia, we have been supporting the local HIV and AIDS Coordinating Committee, which found that many people were being given expired or almost expired drugs. As a result of our joint campaigning, this was brought to the attention of the Global Fund – the UN body set up to fight TB, AIDS and Malaria – and they successfully put pressure on the Cambodian government to strengthen their procurement systems, and change their suppliers. Patients already given the expired medication were supplied with new drugs.
However, though stigma and access to affordable drugs remain major challenges, other complex problems persist which are simply the product of poverty. In parts of East Africa, for example, lack of health clinics mean that many people find out they are HIV positive too late for effective treatment; the equipment needed to monitor progress made on the drugs is not available; thousands of people simply cannot afford to get to the city hospital to collect the drugs, and if they do get there, staff shortages mean waiting times are too long.
This is where the role of local churches in vital. On the face of it, a group of nuns working in a remote village or a sprawling slum in Kenya may not appear to have much in common with Matthew McConaughey’s character, but much of the work they are carrying out is the same; the nuns have the authority, resources and reach to tackle stigma in communities and get support to those who need it most.
The UN has recognised that the work of local church groups in these poorer communities has been crucial in fitting together this complex jigsaw of access to quality healthcare. In Rome, last month, the network of Catholic aid agencies – Caritas Internationalis – met with the UN to discuss how to strengthen and support the role of faith based organisations to help meet their target to reach at least 15 million people living with HIV with antiretroviral treatment by 2015.
Dr Luiz Loures, Assistant Secretary General of the United Nations and Deputy Executive Director of UNAIDS, said at the meeting:
“The faith communities have the scale and the means to move us forward. You care about dignity of the person – and it is only this unique combination of access to drugs and dignity that can provide the necessary drive to reach the end of AIDS.”
Since the start of the epidemic, as Jared Leto said last night, 36 million people have died from AIDS-related illnesses, and – while it remains a condition that can affect anyone – it is the poorest and most vulnerable people in the world who are most likely to live with it and die from it for lack of basic treatment. We must tackle that injustice, and ensure the film Dallas Buyers Club stands as a fitting testament to the past; not a mirror on the present for many of the world’s poor.