MONTREAL ― The International AIDS Society (IAS) has pledged that it “will not go back to business as usual” after hundreds of delegates to its International AIDS Society (IAS) Conference 2022, held in Montreal from July 29 to August 3, faced delays or denials of entry visas into Canada.
“The conference will draw from the lessons from AIDS 2022 and reevaluate how we ensure that the International AIDS Conference remains an inclusive event, especially for the communities most affected by HIV,” said the IAS on its website. It stated, “Underlying the difficulty experienced by many attendees of AIDS 2022 to enter Canada lies a broader problem of global inequity and systemic racism that significantly impacts global health.”
Protesters and patient activists took to the stage during the conference’s opening ceremony, declaring, “No more AIDS conferences in racist countries,” after Canadian government representative Harjit Sajjan, who is international development minister, canceled a scheduled appearance at the ceremony. For weeks leading up to the conference, Sajjan’s Department of Immigration, Refugees and Citizenship Canada (IRCC) faced sharp criticism for its expensive and time-consuming visa application requirements, which sometimes require that applicants ― especially from Africa ― travel long distances to the nearest consulate.
The outgoing IAS president and AIDS 2022 international co-chair, Adeeba Kamarulzaman, MD, told attendees she was “deeply upset” by the situation, which even prevented some IAS staff and leadership from entering Canada. “Even for me, I had to submit my bank statement and 10 years’ travel history,” the dean of the Faculty of Medicine and professor of medicine and infectious diseases at the University of Malaya, in Kuala Lumpur, Malaysia, told Medscape. “Perhaps this is the time for Canada to rethink that.”
Sharing the Blame
Criticism has also been leveled at the IAS itself for choosing high-income host countries such as Canada that have stiff entry requirements for delegates from low- and middle-income countries. Kamarulzaman said that it wouldn’t be practical for lower-income countries to host future conferences. Nevertheless, “we are committed to ensuring participation of people from lower-income countries, even if we host it in a high-income country,” she insisted.
The International AIDS Conference is the biggest conference hosted by IAS. This year, more than 12,300 people from 161 countries attended — 2200 of them virtually — making size a big barrier for lower-income countries to host, she said. “There are a limited number of venues that are large enough.”
Funding is another big barrier, she acknowledged. “A lower- or middle-income country might not be able to support us. For example, we offered 1600 scholarship places for this conference, and Canada gave us a not insignificant sum to support that.” IAS has experienced several financially difficult years, she added. “We’re only now in a good space to really consider kind of taking a hit ― if you like ― from having a conference, where it’s going to be a big haul on the budget.”
Delays, Denials, No Response
Norman Chong, MD, a colleague of Kamarulzaman and a researcher at the University of Malaya’s Center of Excellence for Research in AIDS, was among those whose visa problems forced him to attend the meeting virtually. He said about six of his fellow IAS Young Leaders faced the same trouble. “We are all from low- and middle-income countries,” he told Medscape. “It is an understatement to say we are deeply disappointed and angry, because this translates as not just an egregious denial of access but, at best, a lackluster leadership commitment and accountability from a high-income country to the collective HIV response. In my case, my visa application was met with pin-drop silence even after multiple follow-ups with members and licensed agents of IRCC. I was informed after my submission that it would take approximately 44 days for the outcome of my application to reflect, but to date, it is ‘still in process’ on my application page — and it surely has well surpassed the 44-day window period. One of my peers in the youth leadership program was denied visa twice and has given up trying altogether.”
One of the major concerns of IAS is the “really not very pleasant reasons” for visa rejections, added Kamarulzaman, “such as, ‘We don’t believe you’re going to return to your home country.’ ” Chong confirmed that this as well as “insufficient funds” were among the reasons given to his colleagues.
Chong is grateful that he had virtual access to the conference, but he said the thing he missed most was networking. “I leveraged my Twitter and LinkedIn accounts by posting live updates and my reflections from the sessions I attended. I also chatted with other IAS Young Leaders and Changemakers virtually. It would definitely feel more meaningful if these connections were made organically,” he said. And being halfway across the world presented other problems. “I attended the conference from 8:00 PM to 5:00 AM whilst still maintaining my daytime routine. I literally camped in my study room from the early preconference days until the last conference day with microsleeps and coffee in between to keep me going.”
The host city for the next International AIDS Conference has not yet been chosen. The conference is held every 2 years, said Kamarulzaman. The other two big conferences held by IAS are IAS 2023, which will be held in Brisbane, Australia, and HIVR4P 2023, which will be held in Lima, Peru. Locations of smaller IAS meetings might present fewer barriers for attendees, she said. “In 2022, four in-person meetings are being planned: in Tanzania on 12–13 October, in Chile on 27 October, in Indonesia on 9–10 November, and in Latvia, also on 9–10 November.”
International AIDS Society (IAS) Conference 2022.
Kate Johnson is a Montreal-based freelance medical journalist who has been writing for more than 30 years about all areas of medicine.
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