And then, much to the horror of all those present, he went on in the same insulting manner: “When the western world was living in jungles, we were leading a civilised life.”

But these remarks were not made out of the blue – they were his attempt at a rebuttal of the rapporteur general Jeff O’ Malley’s remarks about the absence of condoms at a conference meant to highlight ways to curb HIV and AIDS. “Where were the condoms? Don’t congress participants have sex?” Malley’s comment was completely misconstrued by the health minister, many here said.

Perhaps he had no clue that there was a higher percentage of men who have sex with men, drug users and sex workers than ever before among the 2,426 participants at the ICAAP, which ran from Aug. 19 to 23.

He also probably didn’t know that when AIDS experts were brainstorming about how to scale up prevention of HIV and AIDS at this week’s conference, among the main messages they discussed was a push for the decriminalisation of the sexual behaviour of MSM, transgenders and commercial sex workers, giving them rights to healthcare facilities, and their acceptance in the social and cultural milieu to curb stigma and discrimination.

Prof. A H Sheriffdeen, co-chair of the 8th ICAAP, reiterated in his closing remarks that while the ‘waves of change’ – the theme of the congress -- could lead to a decrease and finally reversal of the infection, there was a likelihood of it also bringing in complacency.

“It may also result in the diversion of resources to other sectors and regions,” he warned. He reminded leaders to think out of the box and see HIV and AIDS as a development issue that needs focused strategies for prevention.

In various sessions, participants at the congress discussed issues such as a not-so- encouraging coverage of universal access targets, insufficient coverage of rural areas, the inseparability of treatment and prevention, and the importance of early diagnosis and prevention opportunities as well as referrals.

At the same time, the discussions and workshops also pointed to barriers that included mostly state-sponsored stigma and discrimination, the prevalence of stigma in healthcare settings, and the lack of trained healthcare workers.

“While the most commonly cited barrier to impact is stigma, where are the concrete, resourced solutions at scale? Are these included in costed national plans?” asked participant Mandeep Dhaliwal, while presenting a summary of the discussions around the need to scale up interventions in the pandemic.

While scaling up interventions remain a paramount challenge, Taiwan’s example shows that at times, small scale-ups can prove to be successful if coverage is high and quality achieved with key populations. Much can be achieved even when there are resource constraints like in Cambodia, if government decides to pitch in.

However, scaling up HIV interventions should move away from just meaning the influencing of policy, and include an increase in community participation, reaching out to more people, an expansion of geographic focus and intensity of activities, and an improvement in the quality of services.

The closing ceremony had speakers delivering a critique summarising the various tracks of the congress, ranging from scaling up to universal access, the role of civil society, community and political leadership, epidemiology, and the involvement of youth.

O’Malley also said that while the activists and critics were pointing fingers at the government for their being in denial or complac