Our story, our time, our future: Indigenous culture, continuity and centrality to the global HIV response

Our story, our time, our future: Indigenous culture, continuity and centrality to the global HIV response

HIV Australia | Vol. 12 No. 2 | July 2014

By James Ward1, 2 and Michael Costello-Czok1, 2, 3

In 2014 the International AIDS Conference (AIDS 2014) will be held for the first time in Australia, in the city of Melbourne. As a prelude to AIDS 2014, Sydney will host the International Indigenous Pre-conference on HIV & AIDS, on the land and home of the Gadigal people of the Eora Nation.

The Pre-conference is being jointly convened by the International Indigenous Working Group on HIV & AIDS (IIWGHA) and an Australian Aboriginal and Torres Strait Islander Organising Committee (AATSIOC).

International AIDS Conferences (IACs) have been held every two years since 2006, but this year is first time that the International Indigenous Pre-conference is an IAC independent affiliated event. This will significantly raise the profile of Indigenous people being part of not only the conferences, but of the global response to HIV.

The theme of this year’s Pre-conference is ‘Our Story, Our Time, Our Future’, a name which reflects and promotes Indigenous peoples’ culture, continuity and centrality in the global HIV response.

The three-day event runs from July 17–19, and includes keynote speakers, plenary sessions, presentations and yarning circles discussing culture, HIV and health, prevention and education, policies, programs and leadership, plus research monitoring and evaluation.

There are two main satellite forums attached to the Pre-conference: a forum for people living with HIV, and a youth forum. There is also a luncheon for leaders from the Aboriginal health and HIV sectors, to bring together people who have an interest in what’s happening with Indigenous communities and HIV, but are not able to attend the whole conference.

Our international keynote speakers will speak to current and topical issues related to HIV care, prevention and treatment, bringing with them experiences from Canada, the USA and New Zealand.

Over 250 delegates have registered to attend, from locations including Mexico, Guatemala, Chile, New Zealand, Canada, the Pacific, USA – as well, of course, from Australia. We are pleased to announce that we will be hosting First Peoples Elders from communities around Australia to be part of our conference, whose responsibility it will be to influence and spread the word among Elders groups nationally about HIV.

Why the need for an Indigenous conference?

A conference focusing specifically on Indigenous issues is important for a number of reasons.

1. Maintaining identity

Indigenous peoples’ identities are contested globally, both from within communities and, externally, from international bodies, through questions such as ‘who is Indigenous and who is not?’

In many countries Indigenous populations have endured multiple colonisation periods in history, and people’s rights to be recognised as Indigenous are far from achieving resolution.

This contestability lies at the heart of our conference, which provides an opportunity for all self-identifying Indigenous peoples (irrespective of their nation state’s stance) to come together to discuss strategies for moving forward as Indigenous peoples in the context of a world with HIV.

Quite often under a United Nations (UN) definition, Indigenous peoples’ identity gets lost in other population groups and they’re not identified as Indigenous – they’re identified under other sub-groups. So when the International AIDS Conference is held in a country like Australia or Canada, where there’s a resourced Indigenous population that is participating in the HIV response in many different ways, this presents an important opportunity for greater focus on Indigenous issues and Indigenous Identity.

For Indigenous people, a conference like this is not only about stepping up the pace in the HIV response, it’s also about acknowledging who we are as people in that response: what we’ve done in the past, and where we need to go in the future.

We wanted to make the Indigenous Pre-conference theme inclusive, and ensure that Indigenous people’s culture is a part of the conference. Recognising the centrality of maintaining identity is bound to enable Indigenous people to participate more effectively in the larger context of the conference.

2. Achieving recognition

A key aim of the conference is to raise the profile of the issues affecting Indigenous people globally. Very few high level documents relating to HIV, especially those produced by UNAIDS or the World Health Organization, mention Indigenous people as a key or recognised population at risk of HIV.

Of course, being Indigenous doesn’t place someone at special risk of HIV per se. It is the inequalities in health and the social determinants of health that profoundly affect Indigenous people, placing Indigenous people in special and urgent need of being recognised as a key population in international agency documents.

If Indigenous people don’t recognise ourselves in these documents then we don’t see HIV. There are a range of different issues around HIV that affect Indigenous communities differently.

One country’s success may be another country’s barrier. A key topic for discussion at this year’s Pre-conference is the impact of treatment as prevention (TasP) on Indigenous people.

Different countries are at different stages in their understanding of TasP, and coming to grips with just how it’s going to be implemented.

Specific issues relating to Indigenous people living with HIV, and how people are dealing with those issues nationally and internationally, are always at the forefront of every Indigenous Preconference.

The idea is that raising the profile of Indigenous people living with HIV internationally will build a stronger network, which can be utilised to assist some of the other developing Indigenous communities that participate in these conferences.

3. Securing our future

It is essential that we look to the future. While in Australia we have been successful in our approach so far, with HIV rates of diagnosis similar to non- Indigenous people, the fact that our communities remain vulnerable to HIV lays somewhat dormant, and innovation is missing in current HIV prevention responses.

We know what these vulnerabilities are. We know what we need to do, such as tackle persistently high rates of other sexually transmitted infections (STIs) – particularly in remote communities.

We know the other factors that make people sick in our communities – dispossession, poor access to health care, racism, stigma, discrimination; and we are familiar with the many social determinants of health affecting our communities: overcrowded housing, poor education and lower incomes.

Our Sydney conference is an important opportunity to discuss these issues in depth. A major focus area for AIDS 2014 will be national commitment and responses to the targets of the 2011 United Nations Political Declaration on HIV/AIDS. As global Indigenous communities galvanise towards these targets, the varying research, monitoring, prevention and treatment initiatives of countries will impact successes and barriers.

At our Sydney conference we will launch the Eora Action Plan, a charter for us to commit to into the future.

The Eora Action Plan (so named because we are meeting in the Eora nation, home of the Gadigal peoples of the Sydney basin) sets out clear goals:

  1. Reduce the number of newly diagnosed HIV cases among Aboriginal and Torres Strait Island peoples by 50%
  2. Eliminate all mother-to-child transmission of HIV among Aboriginal and Torres Strait Islander peoples
  3. Ensure antiretroviral treatments are available and accessible and correctly utilised by 80% of Aboriginal and Torres Strait Islander people living with HIV
  4. Move toward reducing rates of other STIs in Aboriginal and Torres Strait Island communities by 50%
  5. Reduce rates of sharing injecting equipment by 50% among Aboriginal and Torres Strait Islander people who inject drugs.

In Sydney, we will also launch the first national Aboriginal and Torres Strait Islander youth committee, whose job it will be to mobilise young people in the areas of healthy messaging around sexual health and HIV, STIs and reproductive health rights using social media as a main platform.

The committee, called ANTHYM (Aboriginal Nations Torres Strait Islands Youth HIV Mob), is an exciting initiative of both AIDS 2014 and the International Indigenous Preconference, and will serve us well into the future by ensuring that young people’s voices and perspectives are heard in future planning.1

More information about the 2014 International Indigenous Pre-conference at www.indigenoushivaids2014.com

AIDS 2014

After Sydney, many of our conference delegates will head on down to Melbourne to participate in AIDS 2014.

The AIDS 2014 main conference program includes a number of Indigenous-led sessions, including on leadership, and James Ward will be the first Indigenous person to present on Indigenous peoples issues in a main plenary session at an International AIDS Conference, on Wednesday 23 July.

A major focus of Indigenous activities at AIDS 2014 is Djamabanna Ngargee Birrarung Marr, the Indigenous Peoples Networking Zone at the Global Village.

The zone, which runs for the whole week of the conference, includes a program of activities ranging from cultural performances to informal discussions and interviews with people from the International Indigenous Working Group on HIV & AIDS (IIWGHA), the local Australian Aboriginal and Torres Strait Islander Organising Committee (AATSIOC), and relevant people associated with the International AIDS Conference.

A range of cultural activities has been organised around Melbourne to raise awareness about the conference and its objectives and outcomes. There’ll be community forums, social events, and gatherings. The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) has taken a leading role in organising and working with IIGWHA to plan and develop the Indigenous Peoples Networking Zone and local events.

On Monday 21 July the First Peoples Welcome event for conference delegates will be held at Bunjilaka, Victoria’s award winning Aboriginal Cultural Centre at Melbourne Museum – featuring guests from VACCHO and its members, Aboriginal and Torres Strait Islander delegates from across Australia and First Peoples’ representatives from around the world.

This event is of significant cultural importance to Indigenous people. Welcome to country is about Aboriginal people being welcomed onto the land before business takes place, and it is also hugely important for our international guests.

We invite you to come and join Aboriginal and Torres Strait Islander peoples along with international First Peoples from Canada, North America, Chile, Guatemala, Fiji, Aotearoa and many other Indigenous Nations to meet, discuss, learn and share information about HIV, sexual health, sexuality and harm reduction in our communities.

After the conference

We have planned a legacy strategy to build on the tremendous opportunities that hosting an international conference can bring.

After the Pre-conference and AIDS 2014 have finished we will announce an initiative that aims to bring about improved understanding and awareness of HIV in the broader Aboriginal and Torres Strait Islander community through an annual Aboriginal and Torres Strait Islander HIV Awareness Week.

Each year for the next four years, beginning in December 2014 and coinciding with World AIDS Day, we will run a week of activities in communities across Australia.

For Sydney and Melbourne we have commissioned nine pieces of art of special significance to HIV from renowned Aboriginal and Torres Strait Islander artists.

These artworks will be displayed during both the Sydney conference and at the Indigenous Peoples Networking Zone in the Global Village at AIDS 2014 and will continue to be showcased at future HIV Awareness Weeks.

AIDS 2014 has provided a massive opportunity to reinvigorate our responses regarding HIV within our communities as well as an opportunity to motivate the big agencies involved in HIV to include Indigenous peoples as a key population in future developments.

It raises the opportunity for us to be central to our HIV responses and for us to celebrate our successes. Drop by at Djamabanna Ngargee Birrarung Marr to have a chat or participate in many of the activities planned for AIDS 2014.

Acknowledgements

The Sydney International Indigenous Pre-conference is funded by the NSW Ministry of Health – HIV, STI and Viral Hepatitis Harm Reduction and Viral Hepatitis Branch, Centre for Population Health and the Commonwealth Department of Health.


The AATSIOC members include: James Ward, Baker IDI Heart & Diabetes Institute (Baker IDI); Michael Costello-Czok, Anwernekenhe National HIV Alliance (ANA); Mark Saunders, National Aboriginal Community Controlled Health Organisations (NACCHO); Michelle Tobin, Positive Aboriginal & Torres Strait Islander Network (PATSIN); Sallie Cairnduff and Darren Braun, Aboriginal Health & Medical Research Council of NSW (AH&MRC); Peter Waples-Crowe, Kat Byron and Andrew Bamblett, Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Trevor Stratton, International Indigenous Working Group on HIV/ AIDS (IIWGHA) Jessica Danforth and Krysta Williams Native Youth Sexual Health Network, James Saunders Mopoke Media and ANTHYM coordinator, Victor Tawil and Meggan Grose, NSW Ministry of Health.

Authors

1 Baker IDI, Alice Springs;

2 Co-convenors of the Australian Aboriginal and Torres Strait Islander Organising Committee (AATSIOC) for the International Indigenous Pre Conference on HIV and AIDS – Sydney, Australia (July 17–19, 2014);

3 Anwernekenhe National HIV Alliance, Newtown, Australia

Endnote

1 Further information regarding ANTHYM is available at www.anthym.org or on Twitter @ANTHYMAUS