Distinguished Guests,

When I wake up in the morning, usually very early to catch a plane or get to a meeting with my
staff, I feel very privileged and blessed. The world often feels full of opportunity. From my bed
in my apartment outside Geneva, Switzerland, I can see the Alps and the lake. I feel the fresh,
clean mountain air fill my lungs. My first thought is often How will I ever get everything done
today that has to be done, then I think about the responsibility and the influence I have as
head of the International AIDS Society, representing over 10,000 researchers, doctors, nurses
and other health and community professionals from 173 countries around the world. On their
behalf, on your behalf I have a responsibility to make a difference.
After that first breath of fresh air, I usually crave a cigarette. As I light up the first cigarette of
the day, I think that I must stop smoking again, something I do as often as I can every year. I
think about how nicotine patches and nicotine chewing gum, as substitution therapy, have
helped me so often to stay off cigarettes. That it is not so much the nicotine itself that harms
my health, but the smoke and other dangerous carcinogens in the cigarettes. I thank God and
myself that I was never unfortunate enough to become addicted to heroin, or cocaine or other
drugs. And I think of the friends and colleagues I have known who were not so fortunate, who
died lonely and grim deaths due to drug addiction. And I think of the others, those who were
able to stop their addictions, usually with help from other people, often with help from
medicines, like methadone and buprenorphine, substitutes that helped them first to reduce
the harm they did to themselves when they injected drugs, and then to get on with their lives,
be productive and contribute to society.
Next, I look beside me in bed at my magnificent husband, himself a senior figure in the
international response to HIV. I think about how much I love him, how with each passing year
our love seems to grow. I feel privileged to love and be loved by such a man. I think about our
wedding years ago, surrounded by family and friends from around the world, wishing us well
and celebrating our love. I think what a difference it has made to our lives that our love for
one another is recognized by the state. I think that the governments and the people of
Canada, and Spain, and the Netherlands and Belgium, by recognizing gay marriage, have
given lesbians and gay men a strong signal that we are valued, we are as important as
everyone else, we are normal.
I remember incidents when my sense of hope and privilege has been shaken in this regard.
The time 15 years ago when my boyfriend at the time and I, holding hands on holiday in Paris,
were beaten by skinheads on the main platform of the Gare de LEst train station, while all the
passersby watched, but ignored our pleas for help. I still have the scar from the metal-toed
boot that split my forehead open. But then I remember the old French woman, perhaps 80
years old, who sprayed mace on the thugs that were beating us up. Afterwards, while
everyone else ran away, the old woman stayed to help us, offering us tissues to clean up the
blood.
I think about the many times people have shouted abuse at me and my husband in Geneva,
in Toronto, in Sydney, Australia. But then I think that these times are fewer and further
between than they were earlier in our lives. Perhaps we are less threatening as we get older,

(CRAIG MCCLURE - PLENARY PRESENTATION AT EECAAC, MOSCOW, 2ND MAY 2008)

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perhaps in some countries people really are becoming more appreciative of the extraordinary
diversity amongst human beings.
I look over again at my husband, and I feel privileged that science has given us new
opportunities together. When we first met twelve years ago, in 1996, Ian had a rapidly
declining CD4 count and over one million copies of virus. His HIV infection was quickly
destroying his immune system. It seemed inevitable that soon he would have AIDS. But 1996
was the beginning of a turning point in HIV medicine. Soon after we met, Ian began taking a
potent combination of antiretroviral drugs. His viral load dropped to undetectable levels, his
CD4 count began to increase. He has never had detectible HIV since and his CD4 counts and
other markers of his immune system functioning are now normal. He lives a full and healthy
life, and I am privileged to share that with him.
The difference between despair and hope, failure and success, deprivation and privilege in my
life has always come down to PEOPLE. When people respect and celebrate those that are
different rather than condemning them, when people reach out to support and create and
discover for others in need, when people collaborate rather than compete, when people share
their knowledge and skills rather than withhold them from others, these are the times that
problems are solved, new insights are found, the world is transformed.
The International AIDS Society is all about PEOPLE people working professionally in HIV
throughout the world. Our role is to bring them together through our conferences and
issue-specific meetings we organize, through our support of regional conferences, through
our education and advocacy work. One of our goals is for science and reason to prevail over
ideology in the response to HIV/AIDS. But scientific evidence often does not prevail on its own.
Lets take an example one that is close to the hearts of many in this room - the subject of
opioid substitution therapy. The World Health Organization, UNAIDS, the UN Office on Drugs
and Crime, and the International AIDS Society all agree it is an essential component of a
comprehensive strategy for addressing HIV with injecting drug users, that also includes needle
and syringe exchange, HIV testing and counseling, antiretroviral therapy, prevention and
treatment of other sexually transmitted infections, condom promotion and distribution,
information, education and communication with injecting drug users and their sexual partners,
hepatitis and tuberculosis diagnosis, prevention and treatment. Throughout the world,
methadone and buprenorphine therapy for opioid dependence has been shown to be
effective. Eleven countries in this region include substitution therapy as an essential part of
their HIV prevention, treatment, care and support services, including in Belarus, Ukraine,
Estonia, Moldova, Kyrgistan and Uzbekistan. And yet in Russia and a few other countries the
issue remains extremely polarized. Methadone is currently illegal in the Russian Federation,
and there seems to be no light at the end of the tunnel.
More data, more evidence, is not going to help. Only people, working together, can move
things forward. Narcologists, psychiatrists and infectious disease specialists, working together
with injecting drug users and their advocates and governments can overcome this impasse.
And health care professionals, who know the evidence, must lead the way in this partnership.
I look forward to lively debate and discussion at this conference on this topic. Community
groups, including communities most at risk of HIV infection and groups of people living with
HIV/AIDS have begun to form strong networks across the region. The International AIDS
Society aims to support researchers and health professionals to do the same.

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Researchers and health care professionals can be extremely strong advocates for change.
Working together with communities most affected, HIV professionals have the power of
science, of data, knowledge and experience tools that can influence government, the private
sector and civil society. People can and do change the world, for better or for worse.
I was privileged to be part of the planning of the 1st EECAAC, held two years ago on the
outskirts of the centre of Moscow. It was the first time that governments, researchers and
health professionals and community representatives from around the region got together to
plan an AIDS conference.
Today, despite substantial progress in terms of increased resources, both from within the
region from governments themselves, and from external support through the Global Fund
and other sources, there remains a fragmentation in the health sector. Health systems
continue to be in transition, from centralized Soviet-era systems to de-centralized systems that
are attempting to meet the challenge of the new realities of the region. Enormous wealth has
been generated in many parts of this region through the changes that have taken place in the
past twenty years. But many are left out of this progress. The marginalized communities of
the region the very communities most vulnerable to HIV infection women and girls, men
who have sex with men, injecting drug users, sex workers, migrants and prisoners have been
largely left out of this economic and social transformation, and changing health systems and
the people that work within them are often unwilling or unable to help them. The incredible
diverse people that live in this region are waking up to that reality.
It may be that, just as the overwhelming majority over 80% - of people living with HIV in this
region are under 30 years of age, so too the response to HIV will need to be driven by young
people. At the International AIDS Society our goal is to support the strengthening of networks
of health professionals and scientists in the region. Young researchers and health care
professionals can show us the way. They hold the power to influence the future. Just as
young people are the most vulnerable to drug use, to sex trafficking, and to HIV infection,
young researchers, health care professionals and young people in the communities most
affected must find the solutions to end this epidemic. And we must support them, help bring
them together, listen to their new ideas, and ultimately hand over the reins of power to them.
I am indeed privileged. Privileged to be here with all of you with people who are working to
make a difference in the HIV epidemic in Eastern Europe and Central Asia. Privileged to
support you in any way that I can. Privileged to be one unique person working with the
incredible diversity of unique people that is this movement that will one day end stigma and
discrimination, one day ensure universal access to HIV prevention, treatment, care and
support, and one day end the AIDS pandemic once and for all.

Thank you.

(CRAIG MCCLURE - PLENARY PRESENTATION AT EECAAC, MOSCOW, 2ND MAY 2008)

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