"We have failed," says AIDS Spokesperson

IN THE wake of the surge in HIV infections, disagreements have broken out in the AIDS sector on what has gone wrong and how to put it right.

Respected AIDS expert Dr Jonathan Anderson of the Carlton Clinic has written to Bronwyn Pike, Victorian Health Minister, suggesting a shake-up of the Victorian Aids Council that would see VicHealth take over some the VAC’s key functions.

While acknowledging the excellent work done by VAC in the past, he says, “Much of the education and prevention budget is spent on program staff and administration, rather than direct campaigns.”

And he also says a review two years ago, which identified changes that need to be made, has still not been implemented. And he said the problem isn’t just a lack of funds.

“If they can’t get additional funding from government they need to work out whether they can go ahead . . . within existing budgets. They were told two and half years ago that there were some programs that needed to be pared back, some could stand on their own or were being provided elsewhere, and some needed to be expanded to face the new changed environment.”

“Have they made those hard decisions?” he asked, “ I believe that if we waste money that is much worse than not having money in the first place.”

He suggests the VAC be split into a services and support community health agency, and a separate community representation agency, while their health education and promotion work should be taken over by VicHealth.

“What I’m saying is that I think we have an opportunity here in Victoria. We just happen to have Vic Health, which just happens to be one of the world’s best, if not the best, health promotion agency, so my suggestion is a constructive one.”

He dismissed objections that health education and promotion should be done by groups within the gay community.

“Certainly the programs need to be delivered by your peers at the local level, but that doesn’t stop the actual agency that’s commissioning the work and co-ordinating the whole program not being among the peers,” he said.

“If you look at the VicHealth website they’re doing tons of programs, and if they’re doing one for Somali women, for example, they’re funding Somali women to run programs.”

He said that VicHealth was a well funded body running very efficient and effective programs. And he pointed to the increasing acceptance of gays and lesbians in the mainstream in other areas, saying, why not in health promotion too?

“It’s changing nowadays . . we are more accepted in the wider world, we don’t necessarily need to rely on the gay community for everything. Which is why I argue that we should start to claim our part in the mainstream in terms of health promotion, too. Why aren’t we using the best mainstream health promotion agency in the world? Why don’t we?”

Sources within the HIV positive community said all the organisations involved had to face the fact that, “Whether we like it or not, we’ve failed. If our brief is to minimise infections in this state, we’ve failed. Now we have to say, what have we done wrong (?) and we must look for new ways to tackle the problem.

Mike Kennedy, CEO of the Victorian AIDS Council, said, “I don’t think we can talk about this in terms of success or failure. It’s not a useful way to have this discussion.”

Dr Anderson said the problem was that an organisation that tries to do everything may be unable to focus on the key things that need to be done. The VAC has been trying to be a jack of all trades he said, and when you do that, you lose focus.

But he was at pains to stress, “This is not about the VAC. This is about people not getting HIV/AIDS. If we look at the rates of unprotected sex, we don’t see any drop or flattening of the rates…if anything, it’s increasing. That’s the figure that matters. Let’s try and work out whether we can spend the scarce resources that are available in the best way to maximise health. That’s all I really care about.”