Local organizers and elected officials launched registration for the 2020 International AIDS Conference at a media kickoff Monday, September 30. The biennial confab will take place July 6-10 in San Francisco and Oakland. Upward of 20,000 participants from more than 170 countries are expected to attend.
This year's conference is the first to be jointly hosted by two cities. That decision by the International AIDS Society is meant to highlight San Francisco's pioneering response to the epidemic over the past four decades, as well as the disparities that still persist in the Bay Area, nationwide, and across the globe.
"This conference is going to shed an incredible light on our cities, but it's also going to shed light on the fact that we still have work to do," said San Francisco Mayor London Breed, who last month announced that new HIV diagnoses in the city have fallen below 200 for the first time. "We still need to continue to make investments to get the job done, but because we are so close, I know we can get there."
Oakland Mayor Libby Schaaf also spoke at the event.
"I hope the world is inspired that two cities have joined hands toward our mutual goal of reaching the three zeros — zero new HIV infections, zero HIV-related deaths, and zero stigma and discrimination due to HIV status," Schaaf said. "If two cities can reach across a bay to collaborate, countries across this planet can reach across oceans and join together in this endeavor to end the epidemic."
Not everyone is happy with the location choice, however. Some local and international advocates oppose holding the meeting anywhere in the United States, citing a political climate they see as increasingly hostile to immigrants, people of color, LGBT people, and other groups heavily impacted by HIV. Others cite logistical difficulties, including the Bay Area's high cost, traffic gridlock, and often-dysfunctional public transit systems.
At the forefront
Speakers at Monday's event recalled the history of the AIDS epidemic and of the conference, which began in 1985 as a small gathering of researchers and public health officials in Atlanta. The last confab, held in July 2018 in Amsterdam, drew more than 16,000 participants.
The IAC was last held in San Francisco in 1990, when the death toll from AIDS was near its peak with no good treatments on the horizon.
"I was at that conference 30 years ago. It was a time of tremendous grief," said House Speaker Nancy Pelosi (D-San Francisco). "People were so angry — we were losing our friends, some of us were going to two funerals a day. Yet in the White House there was not a commensurate recognition of what was happening. It was a horrible experience at that conference. This one will be completely different because it will have hope."
San Francisco has played a leading role in addressing the epidemic, from its community-based care model in the 1980s to being the first city to promote universal early HIV treatment in 2010 to being on the forefront of same-day treatment and widespread PrEP use today. The AIDS 2020 theme, "Resilience," highlights the changes that have shaped the local HIV response.
At the same time, the Bay Area sees some of the same disparities as the country as a whole. As described in the latest San Francisco HIV epidemiology annual report, African Americans continue to have a higher rate of new HIV diagnoses, are less likely to be on effective treatment, and are more likely to die. Outcomes are particularly dismal among homeless people. Oakland, which has a much larger black population than San Francisco, has fewer and less well-funded HIV prevention and care services.
In 1990, activists felt governments, the medical establishment, and the pharmaceutical industry were not doing enough to fight the epidemic, prompting a week of protests by ACT UP and allied groups both on the streets and inside the conference venue. Some activists are already starting to talk about potential actions at next summer's meeting.
One target of the 1990 protests was the travel ban that barred HIV-positive visitors and immigrants from entering the country. For this reason, the international conference was not held in the U.S. for more than a decade after that. President Barack Obama officially lifted the ban in 2010, paving the way for the 2012 confab in Washington, D.C.
All are welcome
AIDS 2020 organizers and local officials said that the conference welcomes everyone, and they are making a concerted effort to ensure broad and diverse participation. One such step is expanding scholarships to enable more people with HIV, low-income people, and young people to attend.
"It can't be said enough that the teams behind AIDS 2020 are unequivocally united in our commitment to champion the needs to those historically silenced and ignored and to underscore how the face of HIV is changing," said local conference co-chair Dr. Monica Gandhi of UCSF and Zuckerberg San Francisco General Hospital.
Speakers at Monday's event focused on the big picture and gave few details about how the conference plans to deal with the challenges of housing a large number of people, many of them low-income, and moving them back and forth across the bay.
Gay state Senator Scott Wiener (D-San Francisco) worked with the California Legislative LGBTQ Caucus and Governor Gavin Newsom's office to secure $2 million in state funding for the conference. He was at Monday's news conference and joined by Assemblyman Phil Ting (D-San Francisco).
Organizers said they want to avoid a situation where the conference's scientific sessions are concentrated in San Francisco while community events take place in the East Bay. Most of the major sessions will be held at the newly expanded Moscone Center in San Francisco and the Oakland Convention Center. Conference planners told the Bay Area Reporter that they intend to have a Global Village — a community-focused space that offers free activities open to all — in both cities.
But some community advocates are not convinced by the organizers' good intentions. They expect the political climate to worsen in the run-up to the 2020 election, making it unsafe for members of key populations who bear the brunt of the epidemic. Despite lifting of the HIV travel ban, other laws still bar the entry of sex workers and people who use drugs. And, some say, hosting the conference will divert resources that could be put to better use providing direct services for people living with or at risk for HIV.
Late last year, a coalition of advocates, community organizations, and people living with HIV announced that they will host their own event in Mexico City at the same time —dubbed HIV 2020 — "to provide a safe alternative for individuals who cannot or will not enter the U.S. in 2020 or who cannot afford to attend AIDS 2020."
Yet local organizers, elected officials, and many community members remain undaunted by the opposition.
"As AIDS 2020 approaches, we must unite to face the challenges of a deteriorating human rights climate, oppressive and punitive laws in many countries across the globe, increasing xenophobia and social exclusion, and a widening gap between those with and without access to health services," said local conference co-chair Cynthia Carey-Grant, the former executive director of Women Organized to Respond to Life-Threatening Diseases.
"Strong partnerships are our greatest tool in ending the epidemic," she continued. "While research institutions produce unparalleled scientific advancements, civil society and activists — especially those people living with HIV and AIDS — make sure it is implemented through a human rights and social justice framework."
Congresswoman Barbara Lee (D-Oakland), a co-founder and co-chair of the Congressional HIV/AIDS Caucus, said she's excited about the conference.
"This is our moment," she said. "I'm so proud of this partnership between Oakland and San Francisco. This is something that has been worked on for a long time by so many people and took a lot of heavy lifting."
Register for AIDS 2020 at http://www.aids2020.org — the application for scholarships opens November 1.