The 17th International Conference on AIDS and STIs in Africa (ICASA) took place this week in the beautiful setting of Cape Town, South Africa. In recent years, this biannual event has been a source of frustration for those looking to speak about people who use drugs – previous conference programmes have largely overlooked this population in favour of sexual transmission, mother-to-child transmission and antiretroviral therapy.

In many ways, the programme this year was much the same – yet we were able to have a number of fruitful discussions and events nonetheless. Through the global Community Action on Harm Reduction (CAHR) project, the International Drug Policy Consortium (IDPC) was able to attend the conference and worked on a number of sessions:

The conference was dominated by the news that the great Nelson Mandela had passed away on 5th December, with tributes flowing throughout the conference as well as poignant quotes from the man who has done so much for freedom, equality and HIV in Africa.

The conference was also memorable for the visibility of African communities of sex workers and men who have sex with men (MSM). Both these key populations had a strong, open, beautiful and powerful presence throughout the event – with exhibition areas, marches, music and dance, and presentations. This was really refreshing to see, particularly when a group of Nigerian activists interrupted the presentation from their Minister of Health to protest against the discrimination and abuse they face in their home country. The Minister was clearly shocked and utterly humiliated by the experience, which was an excellent example of opportunistic advocacy by a marginalised group.

Yet it was also very sad that the visibility and voice of people who use drugs at the conference was significantly weaker. Through a combination of funding constraints, refused visa applications and the lack of drug user networks in the region, Very Kunambi – the Vice-Chair of the Tanzanian Network of People who Use Drugs (TANPUD) – was the only drug user activist to formally present at the conference. We were told in all of the sessions above – by UNODC and others – that injecting drug use is happening in Africa, that it is a growing problem that cannot be ignored, and that repressive drug policies are impeding the HIV response for this population. It was also great to meet colleagues in South Africa who are running the only needle and syringe programme in the country (a small-scale MSM project in Cape Town), those who are looking to deliver a long overdue scale-up of these services (as well as methadone prescription), and some of the local drug users who were inspired by the Tanzanian networking experience and are keen to better mobilize their community as well.

 This year in Cape Town, there was much more focus on drug use and drug policy than at the 2011 event (in Addis Ababa, Ethiopia). For the next ICASA in Tunisia in 2015, we need to work even harder to put this issue firmly on the agenda. We should be demanding high profile, Plenary presentations on harm reduction and drug policy, a number of sessions to showcase the advances that are being made in Tanzania, Senegal and Kenya (the latter through the CAHR project), and a strong and impactful presence of people who use drugs at the event itself.