A fly on the wall at M2010

The 2010 international microbicides conference (M2010), held in Pittsburgh, USA, May 22-25 2010, was at the time the first scientific conference of its magnitude that I attended.

I have previously attended and presented papers at national and regional conferences as well as local and international workshops, but none of them was anywhere near gathering more than 1,000 participants of such a great professional diversity from nearly 50 countries that converged at the Westin Convention Centre for M2010.

From being a curious first time visitor to the US, witnessing rather awkward tax-

exclusive price tags, staying in a hotel that bills you for nearly everything you touch in the room, eating dinner at 8.00pm when the sun is still up, and enjoying shrimps for lack of a familiar dish; to the sheer number of people involved with the HIV prevention research field, the myriad collection of research and advocacy work on exhibition, and the bewildering creativity in advocacy, M2010 was, to me, an experience till then unequalled.

Naturally, my highlight of the conference was the presentation I made on how the Masaka MDP site prepared communities for the results of the trial of PRO 2000 candidate microbicide and how people within and outside the host community were informed and how they perceived and interpreted the results.

This work was part of my advocacy fellowship project for HIV prevention advocacy, and it meant a lot to me in many respects.

This is an idea I came up with on my own during the time of applying for AVAC/GCM fellowship programme mid-2009, and had since evolved and taken this presentable shape, thanks to the mentorship of the team at AVAC. I am deeply indebted to Emily Bass, Manju Chatani, Mitchell Warren and Angelo Kaggwa.

But probably it would not have been possible without the support of Pauline Irungu and Deborah Baron from GCM and Denis Kibira from HEPS-Uganda, and Vincent Basajja, Dr Zacchaeus Anywaine and other members of the trial team at the MDP site in Masaka. I will forever be thankful to you all.

With support from this team, my idea was able to metamorphose into a project, and then into a presentation – and into issues for clinical trials to address for effective communication of trial results. I consider the successful presentation of this paper a turning point in my career, particularly because of the challenges I faced in the run up to the conference.

I had to undertake an advocacy test of my own to gain approval to collect data from the trial site – a process that was complicated by a situation similar to putting a cart before the horse when I had my abstract approved earlier than data collection.

The second challenge related to racing against time to collect and analyse data, compile the report and prepare the conference presentation at a time when my host organisation could have been more understanding. This background underlines the value I will forever attach to my M2010 presentation.

Besides the presentation, there were several other highlights. It was inspiring to see my colleagues in the fellowship – Nomfundo Eland a.k.a. Nono from South Africa and Munyarazi Chimwara from Zimbabwe – shine at the conference.

AVAC’s Kay Marshall set up an impromptu interview for me with Sierra Leone-based UN radio service on the future of the HIV/AIDS response in Africa as donors reduce their support for the treatment effort. The interview was to be aired on Tea Break, a current affairs programme the following day.

It was humbling to receive compliments from the support team at AVAC and also from Aditi Sharma at the International Treatment Preparedness Coalition (ITPC). The programme host, Emmanuel Wilkinson, became a new friend, and he had no qualms offering to host me on his programme should I ever visit Sierra Leone when he is still in charge.

I am proud to have met so many people; made new personal and professional contacts and friends; and observed, interacted, rubbed shoulders and worked with experienced advocates.

For the first time, I met Dr Sheena McCormack, the international principal investigator for MDP 301; talked with Dr Ukpong from Nigeria about advocacy in an environment without an ongoing clinical trial and the community training manuals the New HIV Vaccine and Microbicide Advocacy Society of Nigeria has developed; Anna Forbes about life as an independent consultant in the HIV prevention research field; PATF’s David Brunner about advocacy in a country where HIV is not on top of public health problems; and several other people active under conditions of interest.
On the gist of the conference proceedings, the preconference was great in putting the conference in perspective; new findings on HIV risk factors stood out; as did the presentation on branding and marketing ideas for microbicides.
The advocates corner was a model of collaboration in advocacy, with AVAC, GCM, AMAG and IRMA, working so well together to put their issues to the field. To me, the advocates corner demonstrated that there is no limit to creativity in promoting our advocacy goals at critical moments.

I should say I was overwhelmed by the “new generation” of advocacy issues that I identified from the conference proceedings. Clinical trials should build the capacity of local institutions that participate in the research, but who has ever imagined that a site could fail to maintain equipment left behind by a trial? Does it seem possible to you that – after the best quality counselling you can imagine – the majority of people who sero-convert during a trial can fail to turn up for services at a referral facility?

Or, have we not been over-excited by the possibility of an ARV -based prevention option, so much so that seem to have “put all our eggs in one basket”? Doesn’t an AIDS vaccine – even a modestly effective one – still have a place in the HIV prevention puzzle.

These, and several others seemed to belong to my new generation of advocacy issues. I am sure each advocate got their own new issues to ponder or deal with – such is how dynamic and challenging the HIV field has established itself over the years to be.

It is obvious that not everyone will consider an issue as importantly as you feel about it. But at the end of the day, all these are issues that will require thinking, discussion and/or action. I have outlined them in my representation report at HEPS-Uganda, my host organisation; and will explain them in the next staff meeting.

They will also be part of the advocacy meetings organised as part of my fellowship project with the civil society in Uganda. Thank you all who contributed this life-changing experience.