While the World Watched
AIDS 2006 mesmerized Toronto for a breathtaking week last August, attracting more than 22,000 attendees from around the globe. Held in the downtown Metro Toronto Convention Centre (MTCC), the conference took over the city, jamming downtown restaurants with hungry participants, and cramming the streets with attendees who took part in lively outdoor concerts, presentations, and information sessions.

The biannual gathering was first held in 1988 and is an unusual medical meeting where a quarter of attendees are health care workers, 20 percent are researchers and the rest are educators, policy administrators, advocates, and people living with HIV/AIDS.

"It's all about diversity and inclusiveness," explained Mats Ahnlund, the conference's director, who works with the event's  main organizer, the International AIDS Society (IAS), based in Geneva.

The gathering, which had a budget of U.S. $24 million, and a staff of 3,000 (plus 1,500 volunteers), provided an international, independent forum for the exchange of scientific knowledge and research. A primary goal was also to impact worldwide treatment and prevention programs, especially in poorer, developing nations. According to Ahnlund, about half of the attendees go for "personal and professional development" and half for the "networking opportunities."

Acting Up
Unlike other medical meetings, the AIDS conference has a strong grassroots component that is very much about community, consciousness-raising, advocacy, policy change, and providing opportunities for the disadvantaged. Along with its scientific, abstract-driven sessions (including biology and pathogenesis of HIV, clinical research, treatment and care, and epidemiology, prevention and prevention research), the conference offered a cultural program, a youth program, Global Village, outreach program, and opening and closing plenaries.

Peaceful protesting was also a key activity and the Web site (www.aids2006.org) noted, "Activism and advocacy contribute to advancing commitment, policy, and practice aimed at ending the epidemic. The right to participate at the IAC [International AIDS Conference] is fundamental to ensuring open dialogue between all stakeholders."

"We had hired some retired riding policemen as security and they were incredulous that the protesters are allowed in. Some protesters even get scholarships to attend. The security men were thinking of the G8, stone-throwing types. But our situation is different. We provide protesters with a copy machine, help them with their demonstration signs, and we even have a team of community activist liaison facilitators who keep the dialogue open, and provide advice and assistance to protesters in advance of, or during, the conference," said Ahnlund.

In Toronto, the protesters were calm and well behaved, but that hasn't always been the case. "At our meeting in Bangkok in 2004, they spray-painted booths and even dismantled some. In 2006, we introduced new rules and guidelines that were written by people living with HIV/AIDS. They cover everything from obeying the laws of the host country to verbal disruptions in sessions and are now printed on the backside of registration badges," explained Ahnlund, adding, "It's important to have an open dialogue with activists because, traditionally, they are the people who push decision makers and pharmaceutical companies to do things like lower drug prices."

Geeta Prashad, who was event coordinator for the MTCC during the conference, and is now vice president, customer service, was wary of the advocate policy at first. "We generally don't have protesters inside the building that are welcome," she said. "But, the IAS knew where the protesters would go; they even directed them to the places they'd get the most attention. Instead of making them leave, they were managed. There would be a bit of chanting and noise and then the protesters would march to the media center. It wasn't a huge issue." Random searches by security personnel for banned items such as firearms, spray paint, and noisemakers also ensured that attendees behaved in an orderly fashion.

A Dress Like No Other
One of the liveliest spots at the conference was the Global Village. Held in one of the MTCC halls, it was dedicated to a diverse mix of educational exhibitions. Attendees could see everything from Asian sex workers talking about the importance of using condoms, to women, children, and grandmothers speaking about living with HIV/AIDS. There were displays of frilly gowns made of condoms as well as drug exhibits with posters and banners set up by some of the world's largest pharmaceutical companies. The Global Village was organized for the first time in 2004 in Bangkok. In Toronto, the village included 160 different countries, was open from 8 a.m. to 8 p.m. daily, and according to Prashad, was the "cultural pulse" of the event. "People could meet others from Malawi, or Tibet, share ideas, and provide education for the public, since you could attend it even if you didn't register for the conference," explained Prashad, adding, "At other conferences you pick up candy at the booths. At this one it was a rainbow of colored condoms."

Planning for the Toronto meeting started three years in advance and a team from the IAS in Geneva came over to inspect the MTCC venue in 2004, immediately after the conference in Bangkok. "I did 10 site inspections with different groups from the IAS so everyone could see the parameters for their sessions. Some of the most important goals were to see the flow of traffic, how people were able to walk through the building, and to make sure that the rooms were an adequate size," explained Prashad. The total square footage used by the conference - including exhibit space, meeting rooms, and the prefunction space - was 798,500 square feet.

Planning for Health Issues
The health needs of the attendees were of particular concern at the planning stages. "We needed a lounge specifically for people living with HIV/AIDS to give them a chance to rest during the conference. And we needed an on-site medical center for them as well. We brought in a local HIV/AIDS doctor to supervise, as well as nurses, so as few people would have to go off site for treatment as possible." The room selected for the medical center was originally a media/press room with its own washrooms, and outfitted with six beds.

The lounge, designed by the local host committee, was close to elevators and escalators and in a quiet area of the convention center.

"It was a little oasis in the midst of all the bright lights. There was muted lighting, comfy furniture, and volunteers gave massages," noted Prashad.

Part of the organizational process was to educate MTCC staff about HIV/AIDS. "We had members of Toronto Public Health come in and answer questions. It was very positive," said Prashad.

The Rooms
The conference's medical research presentations were held in 24 rooms, including 11 rooms holding 100 people for skillsbuilding sessions, and 12 large session rooms where minimum capacity was 450. The convention center's John Bassett Theatre seated 1,330 and the largest general session room, where Gates and Clinton spoke, had capacity for 6,000.

"We used 20,000 chairs in total for the whole event," Prashad recollected, adding that 20 rooms were allocated as offices for the IAS, sponsors, K.I.T. Association and Conference Management (the Professional Conference Organiser [PCO]), as well as an infant feeding room and an interfaith prayer room. The nearby Rogers Centre sports stadium hosted the opening and closing ceremonies, with speeches by Clinton, Gates, and Gere, and performances by Alicia Keys and the Barenaked Ladies.

Food
Retail outlets set up stands with coffee, tea, and sandwiches outside the halls in the prefunction space.  At breakfast, a cereal bar was set up with a variety of cereals in bins, along with toppings and milk. "You could go either healthy with something like bran or nostalgic, with a bowl of Froot Loops. It was very successful," enthused Prashad. Hot food such as soup and pasta was available at lunch. "It was difficult to find space for the retailers, because we had such a full building, but luckily it was nice outside and people would go out to nearby restaurants to eat. We didn't have to provide for everyone."

Media Presence
More than 2,600 international media representatives attended the conference and the pressroom was a hall with a speaker's lounge and three press conference areas. CBC, the Canadian Broadcasting Corporation, was the host broadcaster and set up a fully equipped mobile broadcast unit for any of the attending TV journalists needing a news feed. Open 24 hours a day, it was provided at no cost to the conference and was valued by organizers at around U.S. $1 million.

During the conference, Prashad was in constant communication with 30 representatives from the IAS, PCO, and the local host. "There was a lot of talking going on and you had to always be on. But it was also a lot of fun. I learned that communication brings everybody in the mix, so there are no surprises along the way. I was the pivot person between the MTCC and the client. During internal meetings we'd make sure that everybody in the room understood what we were doing. We started our weekly production meetings six weeks in advance and listened to everyone's ideas, from security, to retail food, to cash, to banquets to AV, electrical, and contractors. Plus, we'd report on our meetings to the client. It really helped to keep us all on the same page."

Security
Registered attendees received Radio Frequency Identification (RFID) name tags embedded with identification information, while convention center staff wore special wristbands that allowed them into areas for setup and tear down. The organizing committee hired a local security company, and the high-profile guests provided theirown teams. "Bill Clinton had the FBI, who didn't speak to our security team at all. Bill Gates had his own security people and they were more collaborative," recalled Ahnlund.

Registration Glitch
The first day of the conference got off to a rocky start with long, snaking lines of people waiting to register. Ahnlund blamed the new RFID badges and postal service for the problem. K.I.T., which expedited distribution of the badges, "expected 60 percent of the people would get them in time and we were counting on that. But less than 5 percent got them and we learned later that only 7,000 were sent out. Also, the U.S. mail wouldn't let them through for security reasons since they are imbedded with a microchip."

After a crisis meeting on the opening afternoon, they beefed up the number of people on the registration counter and the problem was alleviated.

Success Measurement
To measure the success of AIDS 2006, an extensive monitoring and evaluation team asked questions that were specific to their goals. These included: What kind of new science was presented? Ahnlund noted that "Even if there was no huge breakthrough this year, the HIV research confirmed the early findings that male circumcision lowered incidence by 70 percent; what was the impact on policy and political commitment?

"There was $5 million committed to a global fund, plus we had a huge media impact. With big names like Gates and Clinton, HIV/AIDS was on the world's agenda and we became top-rated news around the globe that week."

Did disadvantaged people get enough access? "The conference paid for 2,500 people from developing countries to attend. These were local health care workers, people living with HIV/AIDS, advocates, and NGOs. Some had never been in a elevator before, and they were able to go home and follow up with what they had learned and people they had met," Ahnlund said.

AIDS 2006 was much more than a medical meeting. It delivered science to the world and put a spotlight on the problems of HIV/AIDS treatment and prevention in developing nations.

It was also a diversified, supportive global village that allowed attendees to network and find a sustainable community. Only with supreme organization and cooperation from all parties involved could such a gathering take place.

Contributing Editor Maureen Littlejohn is a freelance writer in Toronto.

AIDS 2006
The fashions ranged from white lab coats to candy-colored gowns made entirely of condoms, and the guest list included Norwegian royalty, Hollywood star Richard Gere, former U.S. President Bill Clinton and Microsoft gazillionaire-turned-philanthropist Bill Gates and his wife, Melinda. At first blush you might think this was a Malcolm Forbes-style celebratory extravaganza. But on closer examination, you would see one of the world's most unique medical meetings unfolding - where princes, magnates, politicians, and celebrities rubbed shoulders with top researchers, physicians, policy advisors, advocates, demonstrators, and patients.

"CHOOSING A HOST
Selecting a host venue is a tricky process for the AIDS conference organizers. Many countries, including the United States, Russia, and China, do not receive people living with HIV/AIDS and there are between 3,000 and 5,000 people affected by the virus who attend, said Ahnlund. Also, there must be enough hotel rooms and a large enough convention center to accommodate up to 30,000 people. (In the past, New Delhi was considered but didn't have enough hotel rooms.) High media impact is also a factor, as is the ability to change policy in the region. The next conference, in 2008, will be held in Mexico City.

To keep down costs, before they even tell a city it has the next meeting, Ahnlund confided that they send out "secret agents" to book rooms in advance before hoteliers have a chance to boost prices.

AIDS 2006 ORGANIZATION: A MULTI-LEVEL OPERATION
The International AIDS Society was "convener and custodian" of the AIDS 2006 conference, and it worked closely with the local Toronto host organization, as well as five co-organizers. These were: Global Network of People Living with HIV/AIDS; International Community of Women Living with HIV/AIDS; International Council of AIDS Service Organizations; Joint United Nations Programme on HIV/AIDS; and the Canadian AIDS Society.

"We provide the secretariat, which is the lead organizer of the conference. It's a collective effort," explained Mats Ahnlund, conference director, working with the International AIDS Society. Each component of the event had its own committee, including one for conference organizing, science programming, community programming, and leadership professionals, which dealt with political/governmental issues and was responsible for bringing in Bill Clinton to cover policy.

Ahnlund noted there would be a change in organization for the 2008 conference. The secretariat will take over the operational functions previously provided by the local host: "It means we will have more control, especially since the local host doesn't pick up any of the costs of the conference at the end. The secretariat does."