I’ve personally encountered how serious some of this opposition can be. I have worked together on HIV education efforts with a member of Act Up Paris who has developed close ties to LGBTQ communities in francophone west Africa.

Antiretroviral treatment and promising HIV vaccine research there have been met with suspicion and resistance that act as strong barriers to efforts to reduce circulation of the virus.

Medical experts from outside the region who go in with unrealistic expectations often find their efforts stymied by opposition they don’t have any experience with.

Working closely with people who understand legitimate suspicion of western medical involvement should be a core element of any initiative.