Executive Director 
Peter Piot

 at the 
World Summit on Sustainable Development,

Johannesburg, South Africa
30 August 2002

Mr President, Distinguished Delegates,

AIDS is the shadow that hangs over all the deliberations at this summit. If we continue to allow AIDS to drain human resources at an increasing rate, sustainable development will be impossible. Quite simply, if you don't survive, you cannot develop.

The sobering reality is that in the countries most affected by the AIDS epidemic we are at the beginning of a human resource crisis which will only get worse unless infected people are treated and prevention efforts are decisively scaled-up. This crisis will not only significantly undermine progress towards sustainable development, but it will even `undevelop' some the worst affected countries.

By the most basic measure of development - life expectancy - AIDS has already erased fifty years of progress in the worst affected countries. Across sub-Saharan Africa as a whole, life expectancy today is 47 years - without AIDS is would have been 62 years. Africa is not alone in feeling this impact. For example, in Haiti, 6 years have been wiped off life expectancy as a result of AIDS, and in Cambodia 4 years.

The impact of AIDS is fundamentally a human impact. Teachers, farmers, miners, doctors, and administrators are all being lost in large numbers to AIDS. AIDS is stripping away the human resources and capacities on which the future of sustainable development depends.

Nowhere is the interconnectedness of development, population, environment, health, trade and stability better illustrated than in AIDS.

Let me take just 2 examples.

First, young people. Half all new infections are in people under 25 years old. In many of the world's poorest countries, the first half of this century will see a major bulge in the youth population. Theirs is the generation which stands to be devastated by AIDS. Some will die prematurely, but a much larger number will see their lives destabilised. Millions of children will be deprived of adult care and guidance. An AIDS-ravaged generation of youth constitutes not only a human tragedy, but a basic threat to communal security. In such a context, societies themselves become unsustainable.

Second, rural life. AIDS undermines food security as food reserves, livestock and land are sold to pay health costs. Impoverishment rapidly follows the appearance of AIDS. The loss of agricultural skills means the food impact of AIDS will resound for generations. As urbanization continues, rural areas threaten to become unsustainable repositories of the very young, the very old and the sick. And AIDS exacerbates food crises, such as the one currently emerging in southern Africa.

Some of the world's poorest countries have demonstrated that these outcomes can be avoided - but only with a full-scale response to AIDS. Comprehensive implementation of existing, proven prevention strategies by 2005 would avert 29 million new HIV infections this decade. Similarly, HIV treatment has slashed AIDS mortality in high-income countries, as well as in less wealthy settings like Brazil. But in low and middle income countries across the world, this treatment currently reaches fewer than 300,000 of the 6 million people whose lives it would save.

Global consensus has been achieved on the keys to success against AIDS. Succeeding against AIDS is integral to the achievement of the Millennium Development Goals, and by the same token, the goals of progress in education and women's empowerment are the vital building blocks to combat AIDS.

Only by joining forces can we muster the strength to overcome this epidemic. For that reason, UNAIDS is a joint programme that brings together the strength of eight UN system agencies in a common focus on AIDS. In leading the global fight against AIDS, UNAIDS is committed to a partnership that maximises the available resources - multilaterally and from governments, civil society and business.

Investing in AIDS is good investment, but we are still far from the funding needed reverse the spread of HIV, treat the infected and support the orphans left behind. UNAIDS estimates that AIDS spending in low and middle income countries needs to rise to $10 billion dollars per year, three times its current level.

Finding these resources is our collective challenge.

If the world is to stand any chance of meeting its aspirations for sustainable development, then our action agenda must include a full-scale attack on AIDS.

It has four indispensable components.

First, serious resource commitments to fully fund the AIDS prevention and treatment programmes everywhere that are needed to meet the targets agreed in the Declaration of Commitment on AIDS adopted by the UN General Assembly and again endorsed in this Summit's proposed action plan.

Second, the leadership from both governments and communities that is required to break the silence around AIDS and develop the capacity to respond.

Third, the integration of action on AIDS into the core of development practice across sectors, in government and civil society.
Fourth, a major commitment to redress the human resource crisis provoked by AIDS, a commitment that runs from increased prevention and accessible treatment, to investment in new models of development that re-build human capacity from the community up.

Ladies and Gentlemen, the choice is clear.

Turn our backs on the epidemic and, in the worst affected countries, development will continue its rapid slide into `undevelopment'. But act purposefully and in partnership, and the impact of AIDS can be turned back.

Thank you.