AlertNet Deputy Editor Tim Large is at the 15th International AIDS Conference in Bangkok. Here are some tidbits from his notebook on the third working day of the world's biggest AIDS meeting.

Wednesday, July 14, 2004

Start the day with a relaxing massage at a booth set up by the Department for Development of Thai Traditional and Alternative Medicine in the conference's Global Village community space.

My masseuse is Weerapan Dhareethai of the Minsitry of Public Health. Surrounded by baskets of herbs and roots, she tells me how the government is trying to augment Western medical approaches to HIV/AIDS with home-grown therapies for boosting the immune system and treating related conditions.

"We're opening many clinics in general hospitals," she says. "We have resources in this country. Why don't we use them? It's cheaper than importing Western medicine."

***

Sticking to the theme, I drop in on Musanje Kyabagga, secretary general of Uganda's Traditional Healers and Herbalist Association, at his shrine of reeds and thatched grass. He shows me inside and explains how spirits are invoked to diagnose patients.

He says 80 percent of Ugandans with HIV/AIDS resort to traditional methods at some point, although healers refer them to Western doctors if needed. The idea is to make the most of both schools.

"In Uganda, if you are using these herbs, you can last 20 years or more," he says. "AIDS kills, so let us combine together."

STIGMA IN NIGERIA

Interview with Omokhudu Idogho, programme manager for HIV/AIDS at ActionAid Nigeria. He says AIDS in western Africa mirrors the epidemic in southern and eastern Africa. It started in high-risk groups such as sex workers before taking root in the general population.

Nigeria's prevalence rate peaked at 5.8 percent in 2001 versus 1.8 percent in 1989. It's since fallen almost a percentage point, thanks to government and civil society programmes.

"We have the second-largest ARV programme in the world, after Brazil, in terms of the public health system, putting 12,500 adults on ARVs," he says.

The challenge now is to tackle stigma, especially strong in Nigeria, he says.

"We've seen a case where a lady who was living with HIV/AIDS who was working at a hospital lost her job and sought judicial intervention. Even the judge went so far as to say we do not want the lady to come into our court. We've also seen children sent out of school because somehow their parents' status was known."

AIDS ON THE MOVE

If you want to protect millions of the world's migrant workers from HIV/AIDS, you'd better think outside the box. That's the gist of two new reports from CARE on mobile populations, including undocumented immigrants.

The reports - one on migrant fishermen in Thailand and one on mobile populations in Cambodia, Laos, Thailand and Vietnam -- suggest mainstream tricks like promoting condom use just aren't working for people who lack traditional support structures and health care and are vulnerable to economic and sexual exploitation.

"The way an epidemic spreads is through the movement of humans," says Promboon Panitchkpakdi, director of CARE Thailand. "We can't stop mobility, so we have to make it safe."

***

But how do you do that?

One answer is through policy - but you have to make it stick, says Sarah Kambou, head of the International Centre for Research on Women and an expert on migrants in western Africa.

"They have policies that protect migrant workers in West Africa," she tells me. "It's all written down. So it's the interpretation and the application of those policies, right down to the immigration officer on the border."

Kambou says more and more women are taking to the roads in the region, becoming infected and spreading the disease. They are typically traders from the coast who go to Lagos or Abidjan to buy cheap goods they can sell for a profit at home.

"But what happens is while they're traveling, they're trying to keep their operating costs as low as possible. So in order to negotiate with let's say the bus driver or the customs officer, they use sex as currency.

"Then you have another phenomenon. Because of globalization, girls in rural villages in Mali watch TV and see, say, a popular soap opera from South Africa which shows a very different kind of life style, and it creates in their minds need. So they'll run away from home."

TOBIAS HECKLED

Protestors heckle U.S. AIDS coordinator Randall Tobias during a speech, chanting "Bush lies, millions die" and carrying a giant cheque to the podium, made payable to "big pharma & right-wing extremists."

The scene is reminiscent of the disruption of a speech by U.S. Health Secretary Tommy Thompson at the last global AIDS conference in Barcelona two years ago. But unlike Thompson, Tobias is eventually able to finish his speech.

"What we're complaining about is the fact that the U.S. agenda is completely guided by ideology and by corporations when it comes to prevention and to treatment," says Akenji Ndumu, an African immigrant to the United States.

"For him to come to an AIDS conference and pretend to be fighting the worst epidemic mankind has ever known and to be on the forefront we think is a bit of a sham."

EASY PICKINGS

I take a stroll through an exhibition hall where drug companies have set up fancy booths with plush carpets, interactive displays and slick coffee areas. GlaxoSmithKline even has walls of cascading water.

People are lining up in astonishing numbers to get to these stalls. What are they after? Surely not literature on protease inhibitors?

Turns out it's the free bags, candy and toys the drug firms are dishing out. "To get the best freebies, you have to turn up early on Monday morning," an American activist says.

I do a quick survey. Bristol-Myers Squibb gives you shiny dolls. Ranbaxy shells out candy and fancy pens. Roche gives you a bike bag if you can answer swatty questions about HIV drugs (they help with the answers).

GlaxoSmithKline are the scrooges of the bunch. Don't they risk losing out on the crowds? "Possibly," a helpful attendant tells me, "but the people who come are serious."

***

Trouble over at the Gilead stall.

Activists angry at Gilead for conducting drug trials on prostitutes trash the space, splattering the display panel with red paint and leaving a heap of paint-stained brochures all over the carpet. One man throws a water bottle, hard, at the Gilead sign.

Most of the activists are prostitutes demanding a halt to trials of a preventative AIDS drug they say put prostitutes at unnecessary risk of infection. They disrupted a Gilead-sponsored symposium on Tuesday in similar manner.

The Gilead people don't look too concerned. Within an hour, the stall is scrubbed and back in business.

NON-VIOLENT PROTEST

I run into Mahatma Gandhi near the escalator. He's dressed in a loin cloth and painted silver from head to toe.

"Mahatma Gandhi, the father of our nation, the great India, is back to the world on the streets of Bangkok to fight against HIV/AIDS," he tells me. "He wants to draw the attention of world leaders to HIV/AIDS rather than to anti-terrorism, which is nothing but killing amongst ourselves."

Gandhi is actually Surya Prakash Makarla in costume, gearing up for a safe sex march in the heart of Bangkok's red light district. He does look remarkably like Gandhi.

But why all the silver? "How else will you see me?" he says.

ADDICTS' GROUP FETED

Honours for the Thai Drug Users' Network, which stood up for addicts' human rights during the government's recent "war on drugs", in which more than 2,000 users were killed.

The group gets the Award for Action on AIDS and Human Rights, awarded by Human Rights Watch and the Canadian HIV/AIDS Legal Network for its work bringing state abuses against addicts to global attention through peaceful protests.

"The network's courageous and peaceful work in the face of extreme violence exemplifies human rights heroism," says Joanne Csete, director of the HIV/AIDS Programme at Human Rights Watch.

NGO STANDARDS

Grass roots organizations meet to discuss a code of good practice for NGOs responding to HIV/AIDS, with a view to improving accountability and quality and fostering greater collaboration.

Fourteen NGOs -- including the International Federation of Red Cross and Red Crescent Societies, Action Aid and CARE USA -- are spearheading the initiative. Click here to see the Draft Code.

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