Vanishing point: where is HIV at this year’s G8 summit?

For conspiracy theorists, G8 summits can provide much fodder. Anarchists and advocates traditionally march up and down outside G8 meetings demanding attention for this or that issue, believing summits represent the very worst of global capitalism.

And perhaps they have a point – given the economic events of the last five years, even the most hardened optimist would be tempted to agree that though Karl Marx may have been wrong about communism (it doesn’t work after all), he was probably right about capitalism (one class will control capital and wealth; and then there is everyone else). For many, that class is alive, kicking, and manifest in the G8.

As this year’s summit kicks off on 17 June, three main priorities are being discussed: trade (there should be more of it), tax (people who owe it should pay), and transparency (governments should be held more to account). But where are global poverty, malnutrition and health on the agenda?

Eight years on from Gleneagles

This year’s G8 summit is hosted by UK Prime Minister David Cameron in Lough Erne, Northern Ireland and is the first time the G8 returns to UK soil since the Gleneagles summit in 2005. At that event the UK was seen by many as a world player in addressing poverty reduction and shifting the eyes of powerful nations onto diseases related to poverty, including HIV, malaria and TB.

Eight years is a long time in politics and world affairs and given the current economic crisis it’s unsurprising this year’s meeting has a different slant, focusing on economic management.
That said, an important pre-summit meeting on malnutrition was held on 8 June, where a large number of world leaders (not just the G8), charities, and large donors signed an agreement to help beat hunger and malnutrition.

The Global Nutrition for Growth Compact commits to taking urgent action to end the “scourge of undernutrition [sic] in our lifetime.” It has a number of specific targets for 2020 to reduce malnutrition, including reaching 500 million pregnant women and children under two with effective nutritional interventions.

This, of course, is a worthy and ambitious declaration, but why has HIV vanished from summit statements released so far? This is such a change from 2005, where a commitment to universal HIV treatment access by 2010 was hailed as historic. In 2013 we still don’t have universal access, but there has been rapid expansion of people living with HIV receiving the treatment they need and now is not the time to take the foot of the pedal.

HIV and nutrition

So, if nutrition is one of the issues under discussion this year, how is it relevant to HIV? Well, HIV and nutrition are closely connected in a number of ways, demonstrated in a range of studies. People lacking access to food are less likely to benefit from antiretroviral therapy, and given that one effect of HIV is to reduce body weight, this is of course exacerbated by malnutrition.

Taking medication without food can be extremely painful, and a common reason for people not being able to stick to their antiretroviral therapy is poor nutritional access, as found in studies from Swaziland (Armitage, Hodgson, et al, 2011).

In addition, studies from Botswana and Swaziland show if there is dire need for food, there is an associated increase in risky behaviour and not using condoms (Weiser, Leiter, et al, 2007). For example, sex workers are more likely to engage in unsafe sex because clients generally pay more and this will provide more money for food for themselves and other members of the family (Willis, Hodgson, et al, 2013). In India, improved nutritional support correlates with significant improvement on the quality of life of people living with HIV (Alliance India, 2007) and this, and many other examples, confirm that improved access to nutrition is as important as access to treatment.

Crazy money

But it’s all about money, of course. In the UK, Stephen Hester, who parachuted in to head the RBS bank in 2008 following its near collapse, has just resigned. It cost the then Labour government £45 billion to rescue RBS. Hester, regarded by many as a competent administrator, will get £1.46 million as a pay off. He apparently reduced the size of the bank’s balance sheet by £1 trillion during his tenure.

These are crazy numbers, and as those on the right of Cameron’s Conservative party moan about the ‘large’ amount of money the UK gives in foreign aid, perhaps we should be relieved that the UK, and other members of the G8, are involved at all in commitments to reduce global malnutrition.

But we mustn’t let HIV slip off the agenda any further. We should ensure UK commitments to the Global Fund to Fight AIDS, Tuberculosis and Malaria – made at the 2005 summit – continue. Elton John, writing in a Guardian blog on 7 June, said: “The UK can make sure the Global Fund has enough money to turn the tide of history. Now is the moment to put serious money behind that hope: doubling its last contribution, putting in £1bn over the next 3 years, will boost the Global Fund’s ability to achieve its goals and persuade others to do the right thing too.”

John makes his point well: if such a contribution is made we won’t need to worry about HIV not being on the table when the UK chairs the G8 in 2021.