Having just returned home from my second international AIDS conference, maybe I shouldn't be too critical: It is quite a feat to plan and successfully execute these conferences, and for advocates, they provide a space to gather to celebrate the success within the HIV and AIDS movement, highlight the struggles of the past, discuss the challenges of the present and chart the way forward. 

But how much closer did the conference bring us to realizing its theme, Universal Access Now?

Clearly, Universal Access Now reflects the success sexual and reproductive health and rights advocates have had in shaping the long-term global response to the pandemic.  Yet I still can't help but feel that we are still stuck in Toronto waiting for global funders and policymakers to deliver on this promise.

In Mexico, I heard the same rhetoric claiming that we have succeeded in providing vulnerable populations with access to prevention, treatment, care and support.   At the same time, recently released UNAIDS data shows that the rate of new infections in many countries continues to skyrocket.

My experience working with youth in the Caribbean, which has the second highest rate of new infections, has been challenging--there is a lot of talk about what to do and little action.  Developing a sustainable and effective response to the epidemic in the Caribbean, and the entire world, is even more urgent today given the fact that half of new infections occur in young people.

I have heard little from global AIDS leaders and funders about how we will stop new infections among young people, and little action towards ensuring that young people have access to comprehensive sexuality education, male and female condoms and the reproductive health services that can provide them with the tools they need to protect their health and realize their rights. 

So what do we do now? Will everyone go back to their organizations and do what they have always done? Or will we find a new way forward? 

The fact is that the work that truly meets the needs of the people who are affected and infected by HIV and AIDS is happening at the grassroots level. It is in the space where conference themes and panel sessions do not matter, a space where challenges remain and the work must still be done. This won't change even as we wait for universal action.