Background on Key Themes within the Declaration of Commitment on HIV/AIDS

This section of the paper profiles each of the ‘themes’ within the Declaration of Commitment on HIV/AIDS, and the targets related to them. The full Declaration is available at: http://www.un.org/ga/aids/docs/aress262.pdf

Leadership

In countries around the world, progress is being made to curb the epidemic. After over two decades of fighting AIDS, we know that more often than not, success stories come from countries with strong political will and involvement across all sectors. The governments of the Special Session recognized their own important role in leading their nations to design, plan, implement and evaluate programmes in order to develop their own comprehensive responses to AIDS.

Governments committed to:


1. On a national level, implement strategies across all sectors of society to fight AIDS. These plans should confront stigma, provide funding as possible, address human rights, and strengthen infrastructure to care, support and treat people living with HIV and AIDS.
2. On the local level or a region representing several countries, intensify cooperation among groups and encourage the development of regional plans to confront AIDS. This includes encouraging the UN Economic and Social Council to request regional commissions to support national efforts as they arise.
3. On the global level, link together the public and private sectors.

Prevention is the mainstay of any effective response to the global epidemic. Education campaigns, voluntary testing and counselling, health care services for people at risk of HIV or those living with HIV, and campaigns to counteract deadly stigma all contribute to comprehensive prevention programmes.

Governments committed to:


1. Reduce HIV infection rates among high-risk groups.
2. Implement awareness programmes in the workplace, among migrant and mobile workers (including health care services) and to implement universal precautions in health-care settings to prevent HIV transmission, such as in the blood supply.
3. By 2005, include in prevention programmes the goals of reducing stigma particularly in culturally sensitive countries, encourage responsible behaviour, expand access to male and female condoms, clean injection equipment and safe blood supplies, and voluntary and confidential counselling and testing.
4. By 2005, ensure that 90% (by 2010, 95%) of young people age 15-24 have the information and services they need to stay safe.
5. By 2005, reduce by 20% (and by 2010, 50%) the number of babies infected by HIV by giving pregnant women antenatal care (with a goal of reaching 80%), treatment for mother-to-child transmission, voluntary and confidential testing and counselling, treatment - including antiretroviral drugs - and breast-milk substitutes where needed.

People living with HIV and AIDS deserve the highest possible standard of physical and mental health. Access to affordable medication, within the context of international law, is fundamental to that right. Health systems within countries must be strengthened for care, treatment, support and prevention programmes to be effective.

Governments committed to:


1. Collaborate with the international community and all sectors within their countries to develop health care strategies that take into account access to medications for people living with HIV and AIDS. This includes working with pharmaceutical companies to promote innovation and the use of generic drugs, while abiding by international law.
2. By 2005, implement care plans that strengthen the capacity of communities, families and health care workers while improving supply systems, funding and referral systems for medical, palliative and psychosocial care.

Human rights violations – including sexual violence, stigma and denying young people and other vulnerable groups information about HIV and AIDS – have allowed HIV to spread more rapidly, undermining prevention efforts. A comprehensive response to the epidemic must include proactive measures to ensure human rights, reverse stigma, provide information and access to care, support and treatment where it is needed.

Governments committed to:


1. Enforce legislation and policies that stop discrimination against people living with HIV/AIDS and at-risk groups. Their rights include access to education, health care, inheritance, social services - including prevention, care and treatment, legal protection and confidentiality. This includes promoting the human rights of women and their empowerment, in particular.

While all people are affected by AIDS, those living in developing countries – particularly women and girls – bear the largest burden of the epidemic. A vicious cycle is created by poverty, underdevelopment and illiteracy, contributing to the spread of HIV while reversing hard-won development gains. Further, children orphaned and affected by AIDS need special assistance.

Governments committed to:


1. Implement programmes that address vulnerabilities including economic disadvantage, social exclusion, illiteracy, lack of information, discrimination and sexual exploitation. This will be done while recognizing the importance of family, culture and religion.
2. Reduce the vulnerability of high-risk groups, women and young people, with information and counselling.
3. Develop and implement strategies for creating supportive environments for orphans and children affected by AIDS, including access to education, counselling, health care, and protection from abuse of any sort. This includes urging donor governments to complement national programmes that support children.
4. Evaluate the social and economic impact of the epidemic and develop plans to address it at all levels, keeping poverty reduction at the forefront, particularly for women and the elderly. Also, develop policies within the workplace to protect the rights of people living with HIV.

Research and Development

AIDS still has no cure, making research and the development of new treatments and, ultimately, a vaccine, crucial to the global fight.

Governments committed to:


1. Increasing and accelerating research on HIV vaccines, including the development of research infrastructure such as laboratory capacity and improved data collection. This includes training researchers and health care providers, particularly in the hardest-hit countries.
2. Increase research to improve woman-controlled prevention methods and the means to prevent mother-to-child transmission.
3. Develop approaches to monitor treatments, including drug interactions, side effects, toxicity, etc.
4. Strengthen cooperation to exchange best practices and findings.

People destabilized by armed conflict, humanitarian emergencies and natural disasters – including refugees and internally displaced people – are at increased risk of HIV infection. Women and girls, in particular, are subject to increased sexual violence and loss of resources during conflict, making them more vulnerable to HIV.

Governments committed to:


1. Include HIV/AIDS awareness, prevention, care and treatment in responses to emergencies and international assistance programmes. This includes calling on supportive bodies assisting areas in conflict – such as the UN, nongovernmental organizations and other governments – to do the same.
2. Address the spread of HIV in the armed services and during conflict through awareness programmes, including ensuring that all personnel involved in peacekeeping operations are likewise trained in HIV prevention.

Resources

Limited resources are a significant obstacle to effectively controlling HIV infection rates across the developing world. Further, even if people living with AIDS have access to the medications they need to keep themselves and their families healthy, they can seldom afford to continue on a steady regimen of treatment. Currently, resources devoted to fighting AIDS are insufficient and debt has depleted many nations’ ability to combat the epidemic in their countries.

Governments committed to:


1. Ensuring that resources to fight AIDS globally are substantial, sustained and that they achieve the desired results. This includes more resources for UNAIDS and its partners, as well as the directing of more funds to national, regions and sub-regional commitments and organizations.
2. By 2005, reach an overall annual target of U.S. $7 – 10 billion spent on AIDS in low and middle-income countries and those countries experiencing or at risk of experiencing rapid expansion for prevention, care treatment, support and mitigation of the impact of HIV/AIDS.
3. Urge all developed countries to target 0.7% of their GNP for development assistance, while making AIDS a priority within that goal.
4. Implement the Heavily Indebted Poor Country (HIPC) Initiative, cancelling all bilateral official debts for participating countries to finance and implement poverty eradication programmes, including those that relate to AIDS.
5. Support the Global Fund to Fight AIDS, TB and Malaria to finance a rapid and expanded response to the AIDS pandemic, including the launch of a campaign to garner contributions from public and private sectors.

Through the Declaration of Commitment, the Governments recognized that they know what needs to be done to effectively combat AIDS globally and in their own countries. They must now fulfill their commitments, and set follow-up goals to ensure progress.

Governments committed to:


1. Conducting periodic reviews at the national level, to chart the progress of achieving the Declaration’s goals.
2. Regionally, encourage the exchange of information regarding progress on fulfilling Declaration promises and implement periodic reviews. Further, include HIV/AIDS on the agenda of regional meetings at the ministerial and Head-of-State level.
3. At the global level, devote at least one full day of the annual General Assembly session to review the Declaration’s progress, while ensuring that HIVAIDS is included on the agenda of all appropriate United Nations meetings. This includes supporting conferences, seminars and workshops in follow-up to the Declaration and in the spirit of partnership in the global fight against AIDS.