Why empty chairs at AIDS 2022 have Canada under fire

The cube-shaped white chairs, arranged in a line onstage, were empty.

David Gillespie, a researcher at Cardiff University, had shown up to the panel in Montreal expecting to hear experts discuss the stigma that having HIV still carries in health-care settings.

That was not what he got.

Instead, he recounted in an email, an organizer came out to explain that there had been a change of plans — the panellists had all been unable to enter the country.

Feeling “shock and disappointment,” he snapped a picture of the empty chairs and fired off a tweet that has since been shared almost 1,000 times, including by prominent researchers.

Most were wondering a version of the same thing: Canada was playing host to AIDS 2022, the world’s largest conference devoted to an illness affecting almost 40 million people around the world, so why was it so hard for researchers from the Global South to participate?

According to organizers, roughly 12,300 people were set to participate in the conference, 2,200 of them virtually. They weren’t sure how many had faced visa problems, but everyone from the federal government to several global HIV organizations had implied the issue was widespread.

In response to a question from media this week, Federal Health Minister Jean-Yves Duclos called it a “human tragedy” that so many people had been unable to attend, adding that “a conference of this size, nature and value needs more people in the conference than were able to come.”

“This is not only a source of anger, of frustration but also a source of inefficiency.”

The conference had an ambitious agenda to “define future research agendas” and “chart a new consensus on overcoming the HIV epidemic,” according to its website. But all week, panel chairs and presentation booths had sat empty, unoccupied by experts unable to make the trip to Montreal.

Winnie Byanyima, the executive director of the Joint United Nations Programme on HIV/AIDS — UNAIDS for short — blasted the problem in a news release Tuesday, saying that the organization was “deeply saddened” by how many people from Africa, Asia and Latin America had been unable to secure a visa.

Many critics have pointed out that the visa issues were particularly upsetting given the disproportionate burden AIDS puts on certain regions, including Africa.

“The host country of the next global AIDS conference, two years from now, must be one that guarantees that this will not be repeated and that those most affected by HIV can be fully at this important table,” she wrote.

In an email, Aidan Strickland, a spokesperson for Immigration, Refugees and Citizenship Canada, said the department understood the “disappointment” from some applicants who had not received visas in time, adding that it had worked with the event organizers and prioritized visas for delegates.

“Immigration, Refugees and Citizenship Canada (IRCC) took every measure available to expedite as much as possible the processing of applications and facilitate travel for this event,” Strickland wrote.

“In fact, IRCC processed over 93% of applications received before the start of the conference.”

However, Gideon Christian, a law professor at the University of Calgary, said it’s long been hard for scholars from the Global South to get visas to come to Canada, and this isn’t the first time an international conference has struggled to welcome experts from Africa, in particular.

Residents of many countries do not require a visa to come to Canada, but most of the visa-exempt nations are in the global North, such as Europe.

According to organizers, roughly 12,300 people were set to participate in the Montreal conference, 2,200 of them virtually.

For those that do require a visa, it’s not always clear why they get rejected, said Christian, who is also the president of the African Scholars Initiative, which aims to attract more experts to Canada. He said he’s seen people from Africa wait up to a year for a decision.

He also argues that requirements that applicants prove that they’re economically independent and won’t stay in Canada after an event are overly broad and can be used to discriminate against experts who aren’t white or from the West.

He pointed to an artificial intelligence conference also hosted in Montreal back in 2018, in which many people slated to speak at a workshop on being Black in AI were denied visas. He questioned why accomplished experts, of all people, are being kept out.

“Experts with Google in Africa will not be hanging around in Canada after the event,” he said. “What is he going to be doing? Flipping burgers at McDonald’s?”

Christian said it’s important that Canada continue to host these conferences, as a service to the global community, but that discriminatory practices be dealt with.

“I am a scholar who works on issues affecting the Black population,” he said. “I don’t see any reason why I cannot host Black-focused events in Canada, except that if I’m inviting Black scholars from Africa, the IRCC may not let them in. It’s like living in a house where you can’t have your friends over because your landlord won’t open the gate for them.”

Gillespie, who tweeted the photo of the empty panel chairs, was one of hundreds of experts who did make it to Montreal this week. As a senior research fellow at Cardiff University, he studies the use of pre-exposure prophylaxis — basically medication that works to stop the spread of HIV — among those who get it through Wales’s National Health Service.

All week, he said, events had been missing participants, but the panel where nobody had made it was frustrating.

“It seemed to reflect a tragic sort of irony that the topic that they were planning to travel to talk about (structural stigma) seemed to prevent their access,” he said in an email.

In a direct message, Dr. Madhu Pai, the Canada Research Chair in global health and epidemiology based at McGill University, said he was “sad and disappointed” as the event drew to a close.

He pointed to a recent piece he wrote in Forbes, about how “extraordinarily unequal” global health can be.

Wealthy western countries not only benefit from more resources and access to medicines — such as the COVID-19 vaccines, as an example — but they dominate in research and academics, while the first-hand experience of those in the Global South is often discounted.

All of this came to a head here, he said, in which experts from parts of the world with some of the highest HIV case counts were left out of the conversation entirely.

“This is a cautionary tale for everyone in global health,” he said. “We must organize global health events only in places where people with lived experience are not only welcomed and valued, but also get a chance to lead the agenda.”

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