Focusing On The Positive

The most recent figures from the Secretariat of the Pacific Community (SPC) puts the HIV (including AIDS) infection rate in the region at 8,260, although this is widely acknowledged to be an underreported figure. Bopp recently spoke with Pacific Magazine on the future of the PIAF, including a mooted move to Suva, Fiji for "strategic" reasons.

Maire Bopp Dupont meets former South African President, Nelson Mandela at AIDS 2002 in Barcelona, Spain. Courtesy Pacific Islands AIDS Foundation

Pacific Magazine: What inspired you to set up the Pacific Islands AIDS Foundation?

Maire Bopp: After about five years of working a little bit at all levels on all islands in the Pacific, it was obvious there was still some kind of denial that we already have people infected by AIDS in the islands. We had a lot of programs in place but most of them were just running parallel, (there was) not much coordination of activities going on. We didn't really know who was doing what. And we also had a big dependence on external organizations that did not have HIV as a mainstream issue, and were not Pacific orientated. In 2000 the two big programs (an SPC program and UNAIDS) somehow closed down in Fiji, so we were left with nothing, no coordination, no offices, and it kind of freaked us out I must say, and everybody was just waiting for something. It got me thinking that we needed something born in the Pacific.

PM: How was the Foundation launched?

Bopp: We launched by delivering our first service, a $20,000 grant for people living with HIV in Fiji. Our second was a fundraising project with diplomats, politicians and high-level leaders in Fiji for those people living with HIV in Fiji. We hope to organize that every year.

PM: What are PIAF's main objectives?

Bopp: It comes under different headings. Positive health is to lobby regionally to convince governments that we have a responsibility to source drugs for people living with HIV, to find the funding to do so and to negotiate the best prices. Positive living is about building a more friendly environment for people living with HIV, and putting policies in place to avoid discrimination against them. It is also about reducing the economic burden on these people. With action and prevention, the idea is to encourage and train positive people to take part in campaigning, to work with schools and others publicly to educate the community about HIV prevention. And finally we want to work with other organizations on action and prevention, not to replace existing structures. We have as much as possible tried to fill the gaps, we don't have any shame in that.

PM: What changes have you seen in attitudes towards people living with HIV/AIDS since you started this work?

Bopp: There has definitely been a big improvement but the reality changes from one place to another and it really depends on the level of awareness and the educational policies. It ranges from an old fashioned attitude to a more progressive approach. We do notice that when there is not education people go back to their complacent attitudes.

The awareness at a government level, like the regional HIV plan to be endorsed at the Pacific Islands Forum in Samoa (next month) is one big change. And now a lot more positive people are willing to speak out. In Asia, they haven't got that far.

PM: Why do you think more people are willing to speak out? Are they following the example of people like you?

Bopp: I think that is part of it. I also think that most people confronted with HIV would like to do one thing, open up, talk about it, do something to ensure other people are protected. The challenge is to give them the opportunity to do this. With the Foundation we've provided some kind of platform for this to happen. Last December, we ran a training workshop for seven positive people about how to have the confidence to speak out, and to learn more about their condition. Four have decided that they should be able to do it (speak publicly as part of education and prevention programs).

PM: Where in the Pacific Islands region would you say prevention and education are working?

Bopp: Definitely the French territories have a good system in place. Of the others, Fiji, Kiribati, Samoa, Tuvalu and Cook Islands have shown commitment to doing something about it and are definitely on the right path. We find still one major problem is access to good quality condoms. Access to good quality condoms stops people from translating information to action. Through the Foundation we are planning the bulk purchasing of condoms. But I find it quite ironic that now we have to provide marketing studies to illustrate that that is what people want. I find it quite stupid and it is only working against us because it is delaying access to quality condoms.

PM: What about Papua New Guinea, where the number of people infected is so much higher?

Bopp: There has been a lot of work done in PNG but what is creating a lot of problems is the loss of law and order, which undermines any program put in place. The law and order situation makes it impossible to implement the program- because people can't circulate, people don't feel safe, there are gang rapes almost every day. It's quite sad. PNG probably tackled the epidemic a bit late too, which is causing the problems now. But I have hope in PNG when you see the courage and the bravery of those infected with the virus who just want to educate people and discuss their life and experiences for the benefit of others.

PM: What are the barriers to securing the best regional prices for HIV drugs?

Bopp: Restrictions under the WTO (World Trade Organization) are the biggest obstacle -- not being able to directly order products that are cheaper and better. That's why we initiated a program in Fiji to access drugs for 20 people who really needed it for six months in the hope that it would speed up the processes in Fiji to resolve legal issues with the WTO. I think we have solved 90 percent of the problem, but now we are trying to look at a country-by-country basis, as not everybody is a member of the WTO.

PM: You've had a very public journey since declaring your positive status. What doors has being HIV positive opened to you? Which ones have closed?

Bopp: I only look at what I have gained, the people I have come to know, the places I have come into contact with, the experiences. As for doors closed, nothing that has great meaning to me, that has made me regret. It is a constraint. There is a medical problem that requires attention, but what I have gained from it is far too great. Maybe it is something I had to do in this lifetime, and I only hope I am doing it well enough for people to benefit from it.