Mr. President, Excellencies, Ladies and Gentlemen,

Let me begin by saying that Italy fully endorses the statement made by Sweden on behalf of the European Union.
More than twenty years ago, the goal was set to achieve "Health for All by the year 2000." The promotion of basic health care, approved in Alma Ata, was indicated as the best strategy for reaching this goal.

Full implementation of this strategy, as an integral part of the health-care system and the development process as a whole, should have led to a deep transformation of health-care systems and a substantial change in priorities. Instead a different approach was taken: rather than a systemic change in services, the choice was made to orient health-care more toward combating specific illnesses. This may have led to better control over major diseases but not to a true structural change in the way health-care is provided. We have to admit that we are still far from achieving our goal.

Today we are facing a worldwide health crisis that no one could have imagined twenty years ago: the outbreak of a new plague, the HIV/AIDS epidemic. The inadequacy of health-care systems as a whole and, above all, the failure to tackle the underlying social issues, have contributed to the spread of the disease. To this we must add two major factors, armed conflicts and poverty, and particularly one of the most tragic expressions of poverty: the lack of education.

Rather than "health for all," today we have more than 880 million people who are being denied access to basic health-care. At the opening of the twenty-first century, we have a unique opportunity: the common awareness that the international community has a responsibility not to miss this goal once again. The tragic toll in victims of HIV/AIDS, especially among the poorest and most afflicted, demands a l obal response. I insist on the term "global" because the globalization process must be interpreted and governed, above all within a perspective of sharing the needs of the poorest populations and assisting them, and not just in affirming the interests and policies of the most favored countries.

The experience of the past two decades has taught us that without a structural improvement in health-care systems, together with projects aimed at improving living conditions, there is no hope for a lasting, sustainable promotion of human health for all. In its health cooperation activities, Italy has taken a systemic approach to health-care development. Within this context, illnesses such as HIV/AIDS, malaria and tuberculosis which are recognized as absolute priorities- are nevertheless specific problems that should be addressed through an efficient and effective health care system accessible to all. Transmissible diseases should be controlled by getting the national and local healthcare systems of each country to adopt sustainable, integrated strategies. In other words, the resources mobilized for specific illnesses should be used to improve and expand health-care systems as a whole.

 In this framework, Italy recognizes the importance of assuring, at the level of single countries, a process of broad sector-by-sector planning in which public and private partners work together to carefully identify and promote priorities and needs as well as internal and external resources. We feel that a similar process should be enacted at every level, assuring strong coordination between bilateral and multilateral donors as well as between UN agencies.

The promotion of fairness in the distribution of and access to health-care is one of the guidelines of Italian health cooperation policy. To this I would add prevention, community involvement, appropriate technology, inter-sectorial participation, and the involvement of local resources that are traditional elements of our cooperation, which is inspired by the principles of ownership and partnership.

In this connection, Italy promotes every possible option for improving the availability and reliability of drugs. This includes lowering prices and supporting local manufacture of drugs-especially anti-retroviral treatments-in order to make the careful distribution of such medicines more effective in the poorest countries. The Italian Government supports and encourages more research, particularly promoting the testing of preventive and therapeutic vaccines through cooperation and technological transfer programmes with scientific institutes and NGOs from developing countries.

The Italian initiative currently underway to fight HIV/AIDS in Africa follows the above principles and guidelines. It is being implemented in 16 African countries and is fully complementary with the national programmes of each country. For this initiative Italy has thus far earmarked more than € 30 million, 20 million of which have already been disbursed. The funds are channeled through bilateral and multilateral arrangements (namely UNAIDS, WHO, UNDP), but also through national programmes to fight HIV/AIDS that unite the Italian scientific community with its co-parts in developing countries. The involvement of both Italian and local NGOs is also foreseen.

HIV/AIDS is a clear challenge to the entire international community. The numbers speak for themselves. The figures cover up extreme situations that require an urgent, decisive and long-term commitment from those who have the means to do something, be they governments, private parties, organizations from civil society, regional or international bodies. A l obal response to a global crisis: action that requires close coordination among all the stakeholders.

In the framework of its international responsibilities, Italy has proposed a strategy to address the most urgent problems stemming from this situation, concerning first and foremost health, but also education, food security, the technological gap, and access to markets.

 This strategy is based on four pillars:
- In the framework of debt cancellation, Italy has decided to go beyond the commitments of the HIPC initiative, and cancel 100 % of the debt of the poorest countries;
- Italy proposes that the markets of industrialized countries be opened to the exports of the poorest countries and that tariff and non-tariff barriers to trade be eliminated. We are also committed to helping these countries build a productive capacity that allows them to export and to take advantage of the growth of the international economy;
- Italy is hoping that the private sector can play a new role, and is fostering the creation of the right conditions to help the poorest countries attract private investments and facilitate technology transfer;
- Finally, we suggest that cooperation focus more on the development of human potential in the poor countries by supporting their efforts in the fields of health and education.

One of the tools for concretizing these strategies is the creation of a "Global Health and HIV/AIDS Fund," to be managed in an innovative way through the active participation of all the major stakeholders. In welcoming the political message sent by this UNGASS, the Genoa Summit will assure the launching of this Fund when it announces the contributions of the G-8 countries. In Genoa the Italian Government will announce its substantial contribution to the Fund.

The Fund will create the opportunity to establish a special new partnership between the public and private sectors and to conduct a coordinated fight against the disastrous effects of the HIV/AIDS pandemic and other communicable diseases.
In our view, the Fund should be used in a transparent and consistent manner, based on precise project proposals by the afflicted countries. Such proposals should adopt an integrated approach that activates additional resources, with an emphasis on prevention, namely training activities and vaccines development, and on treatment, namely drugs and therapeutic vaccines, in order to achieve sustainable results. These projects should be tailor-made to the context of the area, with a view to countering the various co-factors of the pandemic.

The idea of the Fund was born from a wide-ranging, complex dialogue following the G-8 Summit in Okinawa. It is not an end in itself, but rather aims to provide an opportunity to create a common framework that, in relation to concrete proposals, will develop a dialogue between governments and the representatives of civil society on issues, such as health, that are of enormous importance to millions of people in the world.

We are certain that the Fund will cement a special relationship, in a moment of acute need, between rich and poor countries. Strong political leadership will play a decisive role in identifying the challenges of the epidemic and in order to prevent the particularities that sometimes inspire the positions of countries and peoples from obstructing the fight against the disease.

The AIDS tragedy, especially in the African countries and other afflicted countries, forces us to reflect on the need to address this challenge in a radical new way and retrain the goals of our cooperation efforts. In this framework, we warmly salute the commitment made by the African leaders in the Abuja Declaration of April 27, 2001, and all the efforts being made at the regional level in other afflicted areas.

We must not forget that poverty, underdevelopment and illiteracy are factors that contribute significantly to the spread of HIV/AIDS. Therefore the only possibility for success, the only way to reverse the dangerous tendencies that threaten the gains thus far made, is to follow coherent development policies and foster respect for human rights-a respect that is crucial to lowering vulnerability to AIDS.

It is the historic task of this Special Session to meet the global challenge of HIV/AIDS with a global strategy. It is the moral duty of the international community to face up to its responsibilities collectively.

Thank you, Mr. President.