In his introductory remarks, the Chairman said that the challenge facing the international community was how to mobilize a level of resources commensurate with the magnitude of the HIV/AIDS crisis. It was a task that required partnerships between governments, civil society. the private sector, bilateral and international agencies, foundations and community groups.
World Bank President. Mr. James Wolfensohn, highlighted for discussion the following issues, which were contained in the background paper prepared for the round table:
. Each developing country needs to lead its own effort against HIV/AIDS.
All external partners need to work together under the country's leadership
and within the rubric of the country strategy;
. Developing countries need to increase their national investments in HIV/AIDS;
. Official, philanthropic and private contributors need to multiply and speed disbursement of their financial and technical commitments to HIV/AIDS. Partnerships also need to expand to include more businesses and foundations;
. Civil society should be centrally involved in global cooperation and funding;
. Conclusion of negotiations on the global fund.
UNDP Administrator. Mr. Malloch Brown, said that the figure of $9.2 billion for the proposed global fund represented a realistic and sober assessment of the projected cost of an effective global campaign against HIV/AIDS. Between a third and a half of that sum needed to come from domestic sources, which meant a major shift in the spending priorities of governments of AIDS-affected countries. The private sector with its marketing skills, outreach and economic resources had an important role to play as did civil society and foundations like the Bill and Melinda Gates Foundation. Ultimately, how ever, the fight had to be led by national decision-makers at the country level, since each country had a different set of priorities and its own special characteristics.
In the general discussion that ensued. there was a broad consensus that political commitment at the highest level was of crucial importance. In that connection, several speakers welcomed the Abuja Declaration as a tangible expression of the commitment of African leaders to the tight against HIV/AIDS. The view was expressed that less affected countries. which were generally the more affluent countries, had a moral obligation to contribute to the alleviation of the human suffering caused by the epidemic: It was also suggested that a dynamic not a static approach to the problem was needed, since the situation was constantly evolving. Other speakers stressed the need to focus on Vulnerable social !groups. Including the poor. women, children and orphans, and to take advantage of the: best practices and lessons learned in those countries, like Brazil and Thailand, which had succeeded in reducing the incidence of the epidemic. On the question of the link between poverty and HIV/AIDS, the representative of Botswana suggested that his country might be studied to determine why its rate of infection was so high, even though Botswana was not a poor country.
On the subject of national leadership and the integration of HIV/AIDS into national development plans, emphasis was placed on the importance of strong prevention programmes. It was noted, however. that the countries of Sub-Saharan Africa, in particular, which were hard lilt by the twin scourges of poverty and HIV/AIDS, had little capacity to respond to the challenges they faced. Funds were needed for the implementation of programmes and the strengthening of health institutions and delivery systems. A spirited appeal was made by the representative of the African Council of AIDS Service Organizations for disbursement procedures to be streamlined and made more transparent and for donors to listen to local community groups when they articulated their needs on the ground. Participants generally agreed that both national authorities and their partners needed to do more to integrate HIV/AIDS into national development plans and poverty reduction strategies, to build capacity to address HIV/AIDS in all sectors, and to strengthen health systems and infrastructure.
On the need for developing countries to increase their national investments in HIV/AIDS. a number of speakers pointed to the difficult choices faced by resource-constrained developing countries. The representative of Dominica, for example, noted that the cost of caring for an HIV-infected person was equal to the cost of educating 10 young persons for productive roles in the society. It was nevertheless recognized that, despite the difficulties, governments must translate their political commitment into budgetary commitments. The role of external assistance, however, including through debt relief, continued to be of crucial importance.
On the question of expansion of partnerships to include more businesses, philanthropic and private contributors and foundations, the representative of the Bill and Melinda Gates Foundation urged grant makers the world over to make HIV/AIDS a priority and to address the immediate emergency. However, they also had a responsibility to think in the longer term. If along-term approach to prevention and research had been adopted 20 years previously, perhaps an HIV/AIDS vaccine would have already been found and meetings like the current special session would not have been necessary.
It was generally agreed that civil society had played a pivotal role in all countries that had had success against HIV/AIDS and that every effort should be made to take advantage of the comparative advantages offered by the various civil actors. That participation should be broad-based and include persons living with HIV/AIDS and representing the voices of women, men, adults and youth. At the country level, civil society should have a direct role in AIDS governing bodies, and those bodies should channel a significant share of HIV/AIDS resources directly to the community level and to civil society organizations.
A good part of the discussion focussed on the conclusion of negotiations on the global fund. Some speakers called for technical studies to be conducted and relevant data
collected as inputs for a global master plan. Others questioned how the figure of $9.2 billion had been arrived at. The representative of France favoured the creation of a fund which, though not a United Nations fund, would have broad involvement of United Nations specialized agencies. Other participants felt that, because of its broad experience, UNAIDS should be the lead management agency of the fund, while yet others felt that it should be managed by an intergovernmental body of the General Assembly. The fund should be participatory. transparent and equitable in its rules and operation and should not be used to impose the norms and values of one society on another. Many speakers stressed that the fund's resources should be additional to the resources currently allocated to HIV/AIDS and that a large portion of those resources should be in the form of grants rather than loans. A number of participants pointed out that in addition to the proposed fund, developed countries should grant greater access to their markets for the products of developing countries to enable them to assume a greater share of the responsibility for the fight against HIV/AIDS. All participants agreed that it was essential to conclude the negotiations on the global fund as soon as possible and if possible by the end of 2001.
In concluding remarks, Mr. Malloch Brown reminded participants that trust in developing country stakeholders was pivotal to the success of the proposed fund. Without that trust, an oversight bureaucracy would develop that would doom the global fund to failure.