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Rachael Le Mesurier's seven years of change: Part one

Wed 8 Dec 2010 In: HIV View at Wayback View at NDHA

Rachael Le Mesurier bowed out officially last week after seven years at the helm of the New Zealand AIDS Foundation. Before she resigned spoke to her in-depth about her thoughts on the history of the Foundation and her seven years as Executive Director as part of our series on the 25 years of the NZAF. Tony Hughes covered off the early history of the NZAF so well in an earlier pair of features, that this piece will concentrate on Le Mesurier's tenure from 2003-2010. The situation in 2003 Tony Hughes has a theory that there are three stages of the 25 year history of the NZAF - the first being no HIV treatments and a death sentence. The second was the availability of anti-retrovirals, when globally, those working in HIV/AIDS slightly took their eye off the ball due to their relief at finally having something that saved lives. "People were burnt out. People were exhausted. People lost lovers and friends weekly," Le Mesurier says of this phase of the NZAF's history, in the years before she came onboard. "In 1991 over 90 men died," she says. "That's more than one a week in New Zealand ... It was deeply, deeply traumatising. So when that second phase hit and it was wonderful, people didn't have to die, we didn't really understand, because it hadn't happened before, what impact it might actually have on the mission and prevention." It was in the "third phase", a phase full of fresh questions, that Le Mesurier came onboard. She was excited about the role, saying there was a good team of people at the NZAF, but plenty to do. The jumps in infections over the previous two years was provoking the most concern. "They'd begun to think, oh shit, it's two years in a row and it's quite a jump. What's going on?" She says. "We'd always been aware of what was happening overseas, but what had happened overseas historically was that we were always two years behind ... we weren't two years behind this time. And that's because the drugs happened at the same time. So we all got it at the same, give or take six months." Le Mesurier says when she arrived at her new office there was a level of understandable anxiety about what was going on. "In 2003 we had what was beginning to be quite rightly a resurgence of the epidemic. So we were like 'what the hell's going on?' first and foremost. Secondly there were no volunteers. I arrived and said 'how many volunteers are there?' and they said 'there's two'. Then we had very few members – we had 50 members and 40-odd were staff. So with very few members there were problems around our trust deed. " Things had been relatively quiet for the NZAF from 1999 and it had very little media profile. There was no social networking, the boom in online dating was yet to happen – and Le Mesurier says the NZAF was not very engaged. At the same time the cost of health services was high, with many of the Foundation's counsellors operating independently without auditing or standards or consistency (something Le Mesurier points out was pretty standard for 2003). She says the website was pretty basic. "There wasn't much messaging going through it and we were really in the realm of making posters – but great posters some of them. As an organisation we were really just emerging from a slightly more complicated community group. We didn't have many written systems, whether it was recruitment – we had a reputation for just appointing our friends. There wasn't anything really transparent around that. A lot of that was really important to me." Le Mesurier says her predecessor Kevin Hague had 'rattled a few cages' and got more money out of the Government and the first HIV/AIDS Action Plan had come out. "But we really didn't know what it meant to be professional. We really didn't have a sense of some of those things. Performance reviews - we weren't doing them. We didn't have a collective, those sorts of things." Creating change Rachael at her farewell function Le Mesurier says there has been amazing progress on all six of the Foundation's strategic goals over her seven years, even the first which was to reduce the number of new diagnoses to 50 percent of those diagnosed in 2003. "We didn't get there. No-one in the world did. But what I am so excited about is now I can say I think there is a trend – a plateau – a new one. Higher - but we know why now. In fact nowhere in the world have they been able to keep it at levels in 1995 and 1996. But I actually think we've had an amazing achievement in this country. It's still new, it's still early yet, but it's exciting to think that possibly, more than possibly, we've found a way to successfully try and keep it at a new plateau." Le Mesurier says there has not been a drop-off in condom usage. She says condom use is like seatbelts – you never get 100 percent. "Gay men have carried on using condoms. A portion of them always, a tiny wee small portion are less than always using them. "For those guys who, maybe they didn't use condoms six times a year, in 1992 they were less likely to come across someone with HIV who was well and fit and sexually active than they are now. In fact there's probably a six times increase of a probability. "So in their six times they didn't use condoms they're far more likely to be coming across someone with HIV that they did 25 years ago. That's the difference. Not the condom use, but the increased probability that their sexual partner has got HIV –knowing or not knowing. "That's been the difference that we've realised, simple epidemic prevalence, which is the number of people living with HIV, because the drugs work, there are more and more people alive - which is hallelujah." Le Mesurier is proud of catching up with Australia on drug access, saying seven years ago we were six drugs behind and people were dying because they could not get what they needed. "Matt White died. Our staff member died because he couldn't get the drugs early enough. So what I'm pleased about is we are right on par right now. We don't have the types of battles that we had in the first four years of my being here, where we were constantly harassing -now PHARMAC comes to us for advice." "I'm proud of rapid testing, so proud of what the Positive Health group have done. I'm really proud of Get It On! I'm really proud of taking on social marketing, I'm really proud we've got a comms unit." "We come back to the people. It's our members, our volunteers, our trust board. It's phenomenal that we did need to change in 2003 and it has. And I'm really proud of that. I can't take the credit for any of those things on my own, any of them. I'm proud that it happened while I've been here." The sixth strategic goal was to never stand still, too keep changing when it was needed "and I think we have," she says. "I think we were a little bit late getting online. I think we were a little bit late getting to understand the social networking. But I think now we're at the front end of it. We're at the breaking end rather than a little bit dragging." Part two, looking at community criticism and the people who had an impact on Le Mesurier's tenure will follow tomorrow.     Jacqui Stanford - 8th December 2010

Credit: Jacqui Stanford

First published: Wednesday, 8th December 2010 - 5:27pm

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