Day 1 – setting the scene

Today's meetings were focussing on the big picture issues – global lessons learned (the very hardest of ways) over the last thirty years, especially in Africa.

Lessons Learnt from Africa

Revd. Cannon Gideon Byamugisha was the opening speaker – sharing some of those hard learned lessons – the most of basic of which is that care, treatment and prevention all fit together and cannot be tackled separately. Furthermore, each compliments the other. Gideon's approach has been christened SAVE – Safe Practices (this includes the sometimes derided ABC [Abstain, Be faithful, use Condoms], clean needle exchanges, prevention of mother to child transmission, etc, etc); Access to treatment (Universal Access for all by 2010); Voluntary, routine and stigma free counselling and testing; Empowerment of people and communities at risk of or living with HIV & AIDS.

Faith Communities and Global Responses

Joy Backory of UNAIDS gave an overview of the big picture from the UN standpoint, highlighting the importance of the 2001 UN Declaration of Commitment and the 2006 UN Political Declaration as commitment we as civil society groups can use to hold our governments to account for their actions to respond to HIV & AIDS – these are agreements that all UN member states have signed up to (see here for a report on the 2008 evaluation meeting on the progress towards achieving these declarations and commitments).

Key ways in which the faith communities and faith based organisations can have an impact is in breaking the silence on HIV & AIDS, speaking out against stigma and discrimination. We also have a key role in mobilising communities to respond – from primary health care to community education and support mechanisms for those affected.

UNAIDS is now establishing an ongoing working group on joint working with faith communities and FBOs, and developing an engagement strategy for use by all international bodies. The Global Fund for instance still has difficulties engaging with faith communities, and vice versa, as the large scale project funding is often at an operational level removed from the activities of all but the largest FBOs. However, in some countries faith communities are engaged with country coordinating mechanisms (CCMs) that act as conduits for Global Fund grants, and these good examples need replicating.

The key message is that the international response to HIV & AIDS needs faith communities, but we need to be willing and able to engage with the wider, global response

The Church in the Central Asian Republics: Challenges to an effective response

In the afternoon, we looked at the challenges for the churches in Central Asia in responding to the emerging pandemic there. In most countries of the region, the pandemic is mostly amongst intravenous drug users (IVDUs) and commercial sex workers (CSWs). Exact figures are hard to come by, as reporting is not well developed in some of the republics, and figures for Turkmenistan in particular are impossible to find. What figures there are almost certainly underreporting the scale of the problem. But roughly speaking Kazakhstan has a 3% HIV incidence amongst IVDUs, in Kyrgyzstan the incidence is only 0.8% among IVDUs, but soars to 5% of the prison population, many of whom are IVDUs. In Uzbekistan 30% of IVDUs are HIV+, while in Tajikistan it is 24% amongst IVDUs and 17% amongst CSWs. Government responses vary, but as HIV is an emergent problem and still confined to these 'at risk groups' it is not a major public health priority.

The churches are engaging with HIV in most countries of the region, but only in small pockets. Overall most churches do not see it as a spiritual or pastoral issue, and see it primarily linked to sin and worldliness, therefore not a legitimate issue for the churches to engage with. There is little or no worked out theology of AIDS or social engagement, and there are few resources available for churches on HIV & AIDS in Russian or other local languages.

Many churches have difficulties in working together – there is much distrust between churches and denominations. Furthermore, unless the pastor catches the vision, there is little chance of much being achieved as the work is very much led by pastors and members of the congregations (especially younger people) are not listened to or given room to develop their own ministries. In addition, the churches are mostly marginal or even persecuted, and thus not looked upon by government or wider society as a resource; if they reach out to affected people and communities they can face further hardships themselves.

However, the churches are often the only communities able to respond and help those affected. Churches are engaging with people living with HIV & AIDS because they are coming to the churches for help, having nowhere else to turn.

What can be done? Training of pastors in issues around sexuality, death, HIV & AIDS, drug use, stigma etc need to be part of seminary courses, and post graduate training is also needed for those already leading churches. Seeing people living with HIV as a resource, especially as educators (not just to peers, but to other church leaders and their congregations) will be key – especially to combating stigma and giving the pastors and their churches a vision to reach out to those affected. There are already national networks linking pastors and FBOs together, and these meet regularly across the region – at these meetings HIV is coming to the fore as a major issue. But it will take time for this to translate to a real transformation in the churches on the ground.

HIV Prevention in a Post-Christendom Culture

If the Central Asian Republics are post communist/post Muslim states, the problems of Western Europe are summarised in their being 'Post Christendom' – not post-Christian, but reacting against model of institutional Catholic and Protestant religion that has had long standing state approval. Richard Carston of ACET Ireland highlighted the challenge of engaging the church in prevention when it wants to keep its head down because society in Ireland now want to define itself as not being anything to do with traditional faith (especially, though not exclusively, Roman Catholicism). So the challenge is to couch prevention language that promotes Biblical values in language not associated with traditional religion. So the traditional answer to the question 'When will I lose my virginity' would have been 'only once you are married', whereas the approach ACET would take is to reframe the question – 'with whom will I enter a one-flesh relationship.'

The challenge is to tackle an increasingly heterosexual epidemic by mainstreaming the work, and standing alongside secular groups.