The announcement last week that Qld Association Healthy Communities (QAHC) would lose its funding for HIV prevention and some of its GLBTI programs set the tone for some serious reflection on the achievements of the partnership so far, as well as its possible fragility in the current political climate.
Keynote speaker Marilyn Wise (Centre for Primary Health Care and Equity) reflected on what she described as the 'system' of complex, multiple responses, that has evolved in Australia to contain HIV, and what we can learn from our successes in order to address the goals of the UN Political declaration on HIV and meet Australia's targets for HIV prevention and treatment. She observed that while we have made 'remarkable progress' in reducing the harm of HIV, our work sometimes becomes invisible to key players in the broader health sector and at the political level - citing Minister Springborg as an example - and decision-makers may forget that 'if you take away part of the system you leave an immeasurable gap that can’t be easily filled'.
Marilyn described the history and evolution of the HIV response in Australia as having moved from responding to a crisis to building a fine specialist system, to the current state-of-play - a nornalised response, where we 'thought we'd become a part of the wallpaper'. However she said, we shouldn't take our achievements and current position for granted. Other sectors (for example Aboriginal health)have had the same experience, which can by cyclical, of building up, only to be cut . 'These things have to be fought for, we can't count on it' she said. Marilyn also posed a number of questions that workers in HIV health promotion might need to consider when strategising to set and meet goals, such as:
- Who’s in the room? Ensuring we have an ‘inside’ voice in decision-making processes and are not always in the position of having to ‘push back’ against bad, or poorly thought out policy;
- What changes have occurred that should be taken into consideration? For example, emerging populations, changes in distribution of diagnoses, changes in healthcare systems.
- Has anything been lost from the HIV response that is needed now?
- What new approaches are needed for the future?