SECURITY COUNCIL, ADOPTING 'HISTORIC' RESOLUTION 1308 (2000) ON HIV/AIDS, CALLS FOR PRE-DEPLOYMENT TESTING, COUNSELLING FOR PEACEKEEPING PERSONNEL20000717
The Security Council today urged Member States to consider voluntary HIV/AIDS testing and counselling for troops to be deployed in peacekeeping operations.
Unanimously adopting United States-sponsored resolution 1308 (2000), the first ever by the Council on a health issue, it expressed concern at the potentially damaging impact of HIV/AIDS on the health of international peacekeeping personnel, including support personnel.
It asked the Secretary-General to take further steps to provide training for peacekeeping personnel on the prevention of the spread of HIV/AIDS and to continue the further development of pre-deployment orientation and ongoing training on those questions for all peacekeeping personnel.
The Council recognized the efforts of those Member States which have acknowledged the problem of HIV/AIDS and have developed national programmes. It encouraged others that had not already done so to develop, in cooperation with the international community and the Joint United Nations Programme on HIV/AIDS (UNAIDS), effective long-term strategies for HIV/AIDS education, prevention, voluntary and confidential testing and counselling, and treatment of personnel as an important part of their preparation for their participation in peacekeeping operations. The Council also encouraged international cooperation in support of those efforts.
By other provisions of the text, the Council encouraged UNAIDS to continue to strengthen its cooperation with interested Member States to further develop its country profiles in order to reflect best practices and countries' policies on HIV/AIDS prevention, education testing, counselling and treatment.
Statements were made by the representatives of the United States, Namibia, Argentina, Tunisia, United Kingdom, Canada, Malaysia, Ukraine, Mali, Netherlands, Bangladesh, Jamaica, France, Zimbabwe, Indonesia, Malawi and Uganda.
Dr. Peter Piot, Executive Director of UNAIDS, made a statement and also responded to comments by delegations.
The meeting, which began at 11:45 a.m., was adjourned at 2:40 p.m.Council Work Programme
The Security Council met this morning to consider its responsibility in the maintenance of international peace and security: HIV/AIDS and international peacekeeping operations. It has before it a draft resolution contained in document S/2000/696.
Before the Council is a 5 July letter from the Secretary-General transmitting a note from the Joint United Nations Programme on HIV/AIDS (UNAIDS), summarizing action taken since the Council's 10 January meeting on the impact of AIDS on peace and security in Africa.
The note states that concrete steps had been taken and that further progress was under way. An unprecedented system of regular information sharing via electronic information bulletins and Web sites was now operational. One of the most comprehensive initiatives -- the country-response monitoring project -- scheduled to take shape this month, would enable easy access through the World Wide Web to the latest summary information on the epidemic in specific countries.
The information would include regular updates on the UNAIDS programme and on the financial support of various international partners and national responses to the epidemic. The objectives of the strategy are to enhance both the dissemination of information and the systematic collection of data from countries.
According to the note, discussions had been held with the Department of Peacekeeping Operations and the Civil Military Alliance, a UNAIDS collaborating centre. It focused on ways in which conflict and humanitarian situations sometimes brought about an elevated risk of HIV transmission for refugees and host communities, as well as for United Nations and non-governmental organization personnel. The goal was to promote responsible and safe behaviour among staff providing humanitarian aid and peacekeeping troops. It was also to ensure that they were fully aware of preventive measures.
Specific follow-up actions included expanding the pool of training expertise and the development of a United Nations medical policy on HIV/AIDS for personnel associated with United Nations missions.
The note states that the Framework for Action of the International Partnership against AIDS in Africa was now complete and comprised a set of principles, goals and targets that had been agreed upon by all five constituencies of the Partnership. The Partnership brought together, under the leadership of African governments, the United Nations system, donor governments, the private sector and the community sector. The Framework for Action provided the basis for moving the endeavour forward.
Some progress had also been made at the country level, according to the note. In Malawi, a round-table meeting was organized to mobilize funds for implementing the national HIV/AIDS strategic framework. In Burkina Faso and Ghana, special funds had been created to respond to the HIV/AIDS epidemic. In Ethiopia, mechanisms for channelling resources to rural communities, such as including an HIV/AIDS component within the Social Rehabilitation Fund, had been identified. Comprehensive sector plans in health and education had been completed in Mozambique, while in the United Republic of Tanzania, a national body to coordinate multi-sectoral response to HIV/AIDS had been completed.
PETER PIOT, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said he had come directly from the International Aids Conference in Durban, South Africa, where more than 10,000 people from all over the world gathered to break the silence around AIDS. It was the first such conference in the South, and it generated unprecedented attention for the AIDS problem in developing countries, particularly in Africa. The meeting was opened by South African President Mbeki and closed by former South African President Nelson Mandela, who stated that the challenge is to move from rhetoric to action, and action at an unprecedented intensity and scale. There is a need for us to focus on what we know works.
He believed that the conference came at a turning point in the epidemic. Its underlying message was one of hope. What was to be done was known. Prevention worked. It was possible to improve treatment and care offered to people living with the virus. Access to treatment was the main theme of the conference. Communities throughout the world were fighting back, working together to develop their own responses and to embrace, rather than reject, those directly affected by AIDS.
He said AIDS was now at the top of the agenda of the United Nations system, as illustrated by the debate and resolutions of the Administrative Committee on Coordination (ACC), at the governing bodies of numerous agencies and programmes, at the World Bank/International Monetary Fund (IMF) Development Committee, and as highlighted by the Secretary-Generals report to the Millennium Assembly.
Clearing-house efforts on HIV/AIDS in Africa within the United Nations had been intensified, he said. One of the most comprehensive initiatives in that regard was the Country Response Monitoring Project, which would be launched this month. That effort, in collaboration with relevant government departments, and supported by UNAIDS, the United States Agency for International Development (USAID), the Department for International Development of the United Kingdom and the Swedish International Development Agency, would enable easy access through the World Wide Web to the latest summary information on the epidemic in specific countries. That information would include regular updates on the Programme and on the financial support of various international partners to national responses to the epidemic.
As a follow-up to discussions in the Security Council, an Inter-Agency Standing Committee working group endorsed an action plan last May, which emphasized the importance of incorporating HIV/AIDS also into humanitarian action. It addressed, inter alia, the role of the uniformed services and peacekeeping forces in the prevention and spread of HIV; the epidemics potential to contribute to social instability and emergency situations; and the need to ensure minimum standards of prevention and care before, during and immediately after conflicts or disasters occurred.
To implement the proposed actions, which the Inter-Agency Standing Committee working group had tasked the UNAIDS secretariat to spearhead, a humanitarian coordination unit had been established by the secretariat last June. A number of countries had been identified for the first phase of the effort, the majority in Africa, but also including countries in Asia, Latin America and Europe.
He said the emphasis of the draft resolution before the Council on the uniformed services, including peacekeeping troops, was significant. During the last several months, the UNAIDS secretariat had sharpened its own focus on training and prevention measures among uniformed services. Their strategy included, as the resolution suggested, increased collaboration among national uniformed organizations, as well as the integration of their activities into broader national responses.
To maximize the effectiveness of voluntary testing and counselling, they should be offered as one element in a comprehensive range of HIV prevention and support services. The results of voluntary testing should be confidential, provided in a non-stigmatized environment, and should include pre-test counselling, informed consent and post-test counselling. The UNAIDS co-sponsors and secretariat were willing to work with governments to ensure that the voluntary testing recommended in the resolution not only respected the human rights of individuals, but also achieved the goal towards which it was directed: to protect both the peacekeeping troops and the communities in which they operated.
He said beating back the epidemic in Africa alone would cost $3 billion.
MARTIN ANDJABA (Namibia) said that while many countries heavily affected by the HIV/AIDS pandemic had acknowledged its impact and had demonstrated the necessary political commitment for the prevention of the disease, prevention alone -- given the large number of people already infected -- was not enough. Due to lack of resources and of access to HIV drugs, not much progress had been made in the treatment of the disease. Therefore, governments could not do much for the people already affected by the disease -- those that were left to die without hope of treatment.
He said that the gains made in sustainable development would be lost if a remedy to the spread and devastating consequences of AIDS was not found. It was, therefore, essential that populations in developing countries be given access to effective AIDS drugs that would help prolong their lives. Those drugs should be provided at affordable prices.
He went on to encourage countries and organizations that had provided resources to fight HIV/AIDS to continue and to call on others to emulate their actions. In that regard, he welcomed the announcement by the World Bank that it would soon present a multisectoral AIDS Programme for Africa to its board of directors. That initiative would no doubt facilitate the efforts of governments in implementing their strategies. He also welcomed the launching of the UNAIDS Initiative of the International Partnership in Africa.
He noted the progress made on key issues relating to AIDS at the thirteenth international AIDS Conference in Durban, South Africa. His delegation was hopeful that coordinated efforts of that type would continue. It was important that access to care had emerged as a key issue at the conference, with access to anti- retroviral therapy being central to such care.
He recognized that the issue of HIV/AIDS did not fall directly under the purview of the Security Council, but said that in maintaining international peace and security, the Council would contribute in a major way to minimize the impact of the disease in conflict areas. The Council would also assist governments in devoting more resources to tackling social and economic problems. He also welcomed the efforts of the Department for Peacekeeping Operations to ensure that peacekeeping personnel were well informed about AIDS prevention and about the implications of risk behaviour.
LUIS CAPPAGLI (Argentina) said peacekeeping operations had become a vital means for the Security Council to exercise its role in the maintenance of international peace and security. Peacekeeping missions represented the main tool for that purpose, involving significant contributions from a number of countries, including his own. It was essential that risks to peacekeeping personnel should be minimized, and one more step towards that end was the draft resolution before the Council, which Argentina supported.
AIDS was not the sole problem facing peacekeeping personnel, he said. It could have been avoided if better training had been provided to such personnel. He reaffirmed the relationship between that grave problem and the concept of human security, whose recognition Argentina had previously advocated. Only concerted efforts by all relevant actors would make it possible to forestall the threat posed by AIDS to international peace and security.
SAID BEN MUSTAPHA (Tunisia) praised the President for convening the meeting, and also commended Dr. Peter Piot for his briefing on the Durban HIV/AIDS conference. He recalled that the Security Council had comprehensively taken up the question of HIV/AIDS under the United States presidency of the Council last January. He paid tribute to the General Assembly and the Economic and Social Council for their lead role in the fight against the epidemic. He noted the inclusion of an item on AIDS in the provisional agenda of the forthcoming session of the General Assembly, intended to consider all aspects of the epidemic. The Councils consideration of the epidemic so soon after the Durban meeting underlined the need to take up the meetings recommendations. The international community was duty-bound to respond. International solidarity was needed. Time was short. The efforts of the international community must be intensified.
He said scientific research into HIV/AIDS must be encouraged, and the results made available to all countries. All mankind had the right to share in the benefits of the scientific results. It was unacceptable that some might be denied that right because they came from poor countries. Treatment and drugs should be available at affordable prices, he said. He paid tribute to France for its practical proposals, particularly concerning the creation of an international solidarity fund, and its plans to organize a conference of all interested parties, including drug manufacturers and pharmaceutical companies.
Peacekeeping forces could play an international role in raising awareness about the epidemic, he said. They must be prepared and equipped to shoulder the responsibilities entrusted to them. He expressed support for the United States- sponsored draft before the Council. The United States initiative, he said, was "historic".
Sir JEREMY GREENSTOCK (United Kingdom) said that reducing the rate of new HIV infections by 25 per cent by the year 2010 was a realistic and achievable goal. But, as the Secretary-General made clear in his report to the Millennium Assembly, it would require international action to be better coordinated and intensified.
He said it was vital to see HIV/AIDS as more than just a public health issue. It was a global crisis which, by creating environments in which political and ethnic tensions could worsen, would contribute to the proliferation of armed conflict. It was now starting to be recognized that security conditions had a direct impact on the spread of AIDS. For that reason, the Security Council must focus on AIDS as part of its responsibility for maintaining international peace and security.
The resolution focused on links between the spread of HIV/AIDS and peacekeeping, he said. That was not to denigrate peacekeepers as agents of the virus, but the Council must always recognize that they did not operate in isolation from the local community. The resolution, therefore, rightly highlighted the importance of peacekeepers from all countries being made aware of the risks, both to themselves and to others, of HIV/AIDS.
He said the Security Council did not have the primary responsibility in tackling the pandemic. All delegations must work together in the General Assembly and the Economic and Social Council to make a difference. The United Kingdom looked forward to playing a leading role.
ANDRÁS VÁMOS-GOLDMAN (Canada) said there was no question that the AIDS pandemic had reached proportions that posed a clear threat to stability and development. AIDS was not just an issue of concern for Africa. No region of the world could afford to be complacent. In Canada, new and alarming rates of HIV infection were showing up in major cities. Fortunately, there were some bright spots on the AIDS horizon. Canada welcomed the update provided by UNAIDS on its work in support of national efforts, as well as its broader activities to intensify cooperation within the United Nations system in the fight against AIDS. Canada urged all countries which had not established effective strategies to deal with AIDS to do so, because national governments carried the ultimate responsibility for ensuring the well-being of their populations. The international community could assist, but it could not act in absence of national efforts.
In June, Canada launched an aggressive action plan outlining its proposed contribution to several clear and attainable international goals, including reducing the level of infections in the 15-to-24-age group of 25 per cent in the most affected countries by 2005, he said. Canada would also spend $120 million over the next three years, as compared to the $22 million spent in 1999.
Given the sheer enormity of the AIDS pandemic and the need for urgent action on a global scale, it was appropriate that the Council should speak on the AIDS issue, he said. The devastating impact of AIDS on people, families and whole societies could not but conspire against efforts to build security within and between families. The Security Council could be most effective in contributing to the fight against AIDS, most notably in Africa, through stepped-up efforts at conflict prevention and resolution. It was clear that populations fleeing conflict areas were more likely to be vulnerable to all manner of disease, including AIDS, and to suffer more as a result of difficult, if not impossible, access to medical treatment. Ridding affected regions of conflict was the best way to enable them to dedicate resources to the fight against AIDS, and to ensure that international support for that fight was most productive. World peace depended not only on securing borders, but on securing people against threats to their human security. The AIDS epidemic posed a fundamental challenge to human security and above all, to our humanity. The fight against AIDS must be integrated into efforts to build world peace.
HASMY AGAM (Malaysia) said that as more United Nations peacekeepers were deployed in conflict areas, some of which were afflicted by the AIDS virus, there was the imperative need to protect them from being infected from the virus and to ensure that they did not spread the disease themselves. That could only be done through proper orientation and training before the deployment of peacekeepers to mission areas, so as to raise their awareness of the potential risks of being infected. A stringent regime of regular medical checks and necessary treatment in operation areas were also necessary. AIDS-related programmes must be made an integral and mandatory part of the orientation and training of peacekeepers before their departure to mission areas.
The indiscriminate spread of AIDS in afflicted areas involved rebel groups and national armies, as well as peacekeepers and humanitarian workers, he said. Increased coordination and cooperation on HIV/AIDS matters between and among the United Nations and other international agencies was necessary. Peacekeepers and international workers must be made to realize that the HIV/AIDS virus was just as deadly as the traditional enemies they usually encountered.
The Durban Conference on AIDS focused on the important but sensitive issue of cheap and accessible drugs. To meet even the most basic care and prevention needs, there had been numerous calls for dramatically increased spending on combating the HIV/AIDS virus. It was not surprising that the single most contentious issue of the Durban Conference centred on access to care and treatment. Of particular importance was the role of community mobilization in changing the actions of the pharmaceutical sector, and the need to create an international political and legal consensus to support differential pricing.
VALERI P. KUCHYNSKI (Ukraine) said that HIV/AIDS was an epidemic of global proportions, with enormous human and social ramifications that went far beyond the province of health alone. HIV/AIDS constituted a global emergency, threatening stability, exacerbating inequalities and undermining sustainable development. AIDS had become a disease of poverty, ignorance and gender discrimination, with the greatest effect on poor children and women. The most disturbing facet of the disease was that 95 per cent of all HIV-infected people lived in developing countries. Estimates showed that in the forthcoming decade no sector would be spared the ravaging effects of the epidemic, including trade and economic development, health care, education, employment, social and other sectors. AIDS would continue to be a challenge for years to come and would require comprehensive, multisectoral responses involving a broad range of actors. Failure to meet it effectively would put at risk all other aspects of international development during the next decade.
It was encouraging that increased attention to the problem of AIDS had started to bring about the first practical results, he said. Ukraine welcomed the recent decision by a number of pharmaceutical companies to begin the process of cutting the price of AIDS drugs for States affected by the disease. Such measures, however, were only one of the factors in what should become a much broader and more urgent effort. Only the concerted and coordinated efforts of the international community could successfully address the problem of HIV/AIDS. It was high time for the United Nations to elaborate a comprehensive agenda for action against the pandemic. While all relevant United Nations organs could contribute to the cause, it was the General Assembly that should play the central role in tackling he issue by proposing new strategies, methods, practical activities and specific measures to strengthen international cooperation. Ukraine believed that a special General Assembly session would be the most appropriate forum for that purpose.
MOCTAR OUANE (Mali) recalled that at the holding of the Council's debate on AIDS in Africa last January, the President of Mali, Alpha Omar Konaré, had said it would help break the silence about the epidemic. President Konaré had urged mobilization of the international community to wage a crusade against the epidemic. He called on the international community to intensify research on the disease, to increase prevention and to provide the necessary support for the millions of people affected by the disease, particularly the men, women and children of Africa.
Some Member States had placed the question on the agenda of the Economic and Social Council, which had devoted a special session to the issue last February. More recently, there had been the thirteenth annual international conference on AIDS, which had just ended in Durban, South Africa. He also welcomed the remarkable progress made by UNAIDS, as well as the statement made by the head of the agency, Dr. Peter Piot.
Mali supported the Plan of Action prepared by the Inter-agency Standing Committee of UNAIDS, which mainstreamed HIV/AIDS in humanitarian action and focused on the part played by military and peacekeeping forces in the prevention or propagation of HIV/AIDS. Mali also welcomed measures to intensify international cooperation among national organs in order to accelerate the adoption and implementation of HIV/AIDS prevention, testing, counselling and treatment of staff participating in international peacekeeping operations.
Mali encouraged the existing cooperation between UNAIDS, the World Health Organization (WHO), the United Nations Population Fund (UNFPA) and the Department of Peacekeeping Operations to reduce the risk of transmission of HIV/AIDS among refugees, host populations, as well as United Nations staff and members of humanitarian agencies in conflict situations.
Twenty years after the outbreak of the epidemic, he said the international community must not accept a situation in which the patients were in the South and the treatment in the North. Mali welcomed the recommendation of the Executive Council of the WHO, in which it called for improvement of access to prevention and treatment of HIV and associated illnesses by bringing about reliable systems of distribution and benefits and providing access to affordable medicine. That could be brought about, in particular, through the development of resolute policies relying on generic products, bulk purchases, negotiations with pharmaceutical companies and appropriate financing.
JOOP SCHEFFERS (Netherlands) said he would highlight some points that were characteristic of his country's approach to the international dimension of the AIDS crisis. The Netherlands had noted with appreciation that the pandemic was no longer seen as just a heath problem. The social consequences were severe, and the disease could adversely affect a country's potential for economic development. In fact, the disease might ultimately destroy the fabric of whole societies and aggravate the risk of instabilities. AIDS could, therefore, become the root cause of conflicts.
In that regard, he noted that soldiers and displaced citizens on the move were important sources of HIV dissemination. Those very circumstances also made the disease that much harder to track. Other reasons for the rapid spread of the disease included poverty, gender discrimination and lack of information. Girls were particularly ignored. Efforts to reach and teach girls were often hampered by poverty, local customs, violence or social and religious bias.
Given that "bleak and somber" background, he said that his delegation believed that the fight against AIDS should follow an approach that went beyond sectors or countries. He also believed that the General Assembly and the Economic and Social Council should continue to have a major role to play in that regard. Wherever or whenever the opportunity arose, his delegation would stress that political commitment, on both national and international levels, was equally essential.
The Dutch international AIDS policy was focused on prevention, care, non- discrimination and relief, as well as on the promotion of research, he said. Prevention and awareness ought to go hand in hand with relief and care for victims of the pandemic. In the end, however, only a vaccine could provide a lasting solution. In that context, the Netherlands had recently decided to make $20 million available for international AIDS vaccine initiatives aimed at supporting vaccine research and guaranteeing that they became available in developing countries. It had also increased its contribution to UNAIDS.
ANWARUL KARIM CHOWDHURY (Bangladesh) said that the HIV/AIDS pandemic was now increasingly recognized as more than a public health problem. Its nature and extent had made it a development problem for a vast majority of countries. HIV/AIDS had the potential to cause violence and social destabilization through the enormous toll it could take on the active members of a society. It also had a security dimension. Although HIV/AIDS had the greatest prevalence in Africa, no single continent or country was immune. In Asia, for example, new HIV infections had increased by 70 per cent between 1996 and 1998.
For a secure future, every effort must be made to halt the spread and impact of the pandemic, he said. The strategy to fight AIDS should be focused on a time- bound target for reducing HIV/AIDS. There was also need for better coordination and exchange of information between and among the bodies working on AIDS. There should be partnership between governments, international organizations and civil society, particularly the private sector. Pharmaceutical companies, in partnership with donor nations, could come up with affordable vaccines to prevent infection. Equally essential were knowledge and education. The stigma associated with open discussion of HIV/AIDS in many societies deprived the potential victims of useful knowledge needed for escaping infection. There should be a systematic approach for dissemination of knowledge, particularly among the young.
PAUL ROBERTSON, Minister for Foreign Affairs of Jamaica, said that the many reports on HIV/AIDS pointed to one undeniable fact: the AIDS pandemic had reached catastrophic proportions, not only in Africa but also worldwide. HIV/AIDS had had a devastating impact on many countries, threatening to wipe out economic and social gains hard won over the past decades, and compromising the future of many countries.
He said that the situations of conflict were fertile grounds for the spread of HIV/AIDS among affected population. The cycle of the epidemic seemingly had no end in sight, unless the world community acted in unison to end the scourge.
It would be morally wrong, he said, to ask young men and women to serve the cause of peace without acknowledging that HIV/AIDS also posed a real threat to their well-being. The world community must seek to prepare them for that emerging challenge. To the extent that the HIV/AIDS epidemic could affect the efficacy of peacekeeping operations, the Council had a responsibility to seek to address the challenges presented. His delegation, therefore, supported the inclusion of a provision in the draft resolution on efforts to sensitize peacekeeping personnel in the prevention and control of HIV/AIDS and other communicable diseases in all peacekeeping resolutions.
Jamaica had recognized that the issues of peace, security and development were multifaceted and must be tackled in a holistic manner. Those efforts required a multi-sectoral response by the international community and, with regard to the United Nations system, necessitated the involvement of all its organs and agencies. To do otherwise would be to deny the truly complicated inter- relationships that militated against sustainable peace and security in many regions of the world. He commended the Economic and Social Council, UNAIDS, the WHO, the United Nations Children's Fund (UNICEF) and other agencies for their work in formulating appropriate responses to the HIV/AIDS pandemic.
While researchers continued to seek a cure for AIDS and to develop vaccines, the international community must build on the experiences and lessons learnt and endeavour to find ways to ensure that advances in medications and treatment were made widely available. Jamaica, therefore, supported the holding of a special session of the General Assembly to address appropriate responses to the HIV/AIDS pandemic, he said.
PASCAL TEIXEIRA DA SILVA (France), speaking on behalf of the European Union, said that AIDS had special characteristics which had turned a basically human and medical catastrophe into one of the developing world's major causes of economic and social disintegration. The impact of the pandemic was particularly unacceptable in those countries where decades of effort and progress had been brought to naught. AIDS was a massive killer, causing 10 times more deaths last year than all the conflicts on the continent. As qualified workers had disappeared as a result of the spread of the virus, entire sectors of the population and society had been destabilized.
That destabilization had sadly exacerbated conflict situations. In turn, conflicts and the combatants themselves also contributed directly to the spread of HIV. It was, therefore, necessary to promote the mobilization and coordination of all international actors. "The efforts of all are a must", he said. In that regard, it was important to underscore the action undertaken by UNAIDS.
The 24.5 million persons infected with the AIDS virus in Africa presented the staggering possibility of that many imminent deaths, he said. Such levels of human catastrophe were unprecedented in recent history. Rapid solutions must be found. It was important, therefore, that the resolution currently before the Council should focus on the pandemic's impact on peacekeeping operations and the health and well-being of civilian and military personnel participating in those operations. The resolution demonstrated that the Council was endeavouring to protect the health of such personnel, as well as the health of the citizens in the countries in which they work. "No effort must be overlooked", he said, "in waging this difficult but necessary struggle against AIDS."
Speaking in his national capacity, he recalled two proposals France had introduced following the Security Council's special meeting on HIV/AIDS in January. First was the organization of an international meeting under the auspices of the United Nations on access to treatment for persons affected by AIDS in developing countries. Access to treatment had been at the core of the international AIDS conference in Durban, and the pledge of the international pharmaceutical industries to lower the cost of medication in developing countries - and, in some cases, even provide free distribution -- represented a major breakthrough which placed a new responsibility on governments.
He went on to say that since those pledges needed to be followed up by concerted action in the international community, France strongly favoured the convening of an international meeting, under the auspices of the United Nations, to organize cooperation and consolidation in that area. Such consolidation would bring together manufacturers, donor countries and non-governmental organizations and patients' associations.
The second of France's proposals was for UNAIDS to prepare a report on all bilateral and multilateral actions now being undertaken in the area of HIV/AIDS, to ensure consistency and geographical, medical and social coordination.
T.J.B. JOKONYA (Zimbabwe) said that considering the large-scale awareness campaigns and prevention programmes launched in many developing countries, the feeling that there might be an international conspiracy of silence about effective and fundable programmes initiated by governments in many of those countries was justifiable. How was it possible that since the anti-AIDS campaign began, the international community quoted efforts in only three countries at most? If that approach was meant to highlight the earliest success stories, it had outlived its purpose.
Sterling efforts in too many countries continued to go unnoticed and under- funded, with tragic consequences. Zimbabwe's national efforts had been greatly enhanced last year through the enactment of a clear National AIDS Policy, when Parliament had passed a statute establishing the National AIDS Council. At the same time, the fiscus had introduced an AIDS levy at the rate of 3 per cent on income and corporate tax to provide secure funding for the Council's activities. The Council had already begun to receive disbursements from the proceeds of the levy. He said it had taken too long for the international community to forge a partnership involving all stakeholders, including governments, the pharmaceutical industry and international institutions, working together to make HIV-related drugs more accessible to developing countries. It remained painfully clear that the profit motive continued to take precedence over humanity's medical well-being. Regrettably, of the $2 billion spent on seeking an AIDS treatment to date, only $250 million had been spent on creating vaccines.
HAZAIRIN POHAN (Indonesia) noted that the worst effects of the epidemic, particularly in developing countries, had further exacerbated prolonged civil conflicts that had obliterated decades of social and economic development, plunging life expectancy to the same low levels as those of the 1960s. However, while HIV/AIDS, prolonged civil conflicts and setbacks in development were interrelated, linking the epidemic to international peacekeeping raised serious questions, among them whether HIV/AIDS and peacekeeping were genuinely interrelated; which aspects of peacekeeping operations were related to HIV/AIDS; and if so, how they were interrelated.
As there was no clear picture of the connection between HIV/AIDS and international peacekeeping operations, Indonesia would rather approach the issue in a practical way, he said. Peacekeepers should receive orientation on the disease before their deployment. Indonesia supported the decision contained in the report of the Special Committee on Peacekeeping Operations to request the Department of Peacekeeping Operations to incorporate language in the "Guidelines for Military and CivPol Participation in Peacekeeping" to raise peacekeepers' awareness of the disease.
He said affordable pre-deployment immunization provided to peacekeepers would help mitigate the risks of being exposed to HIV/AIDS. It was important to include a medical unit in United Nations peacekeeping operations in countries where HIV was spreading, to provide regular medical check-ups to peacekeepers and other mission personnel. Indonesia also supported the development of HIV mapping in countries where peacekeepers would be deployed. There was a need for pre- deployment survey by the Department in partnership with relevant United Nations agencies in the field.
YUSUEF JUWAYEYI (Malawi) said that AIDS had had a devastating effect on Malawian society. In fact, if he could, he would change the language of the draft resolution currently before the Council to reflect the uniquely devastating impact the disease has already had on many societies. The tragic effects of the pandemic were not "about to occur": in many countries, they had already taken hold with tragic consequences.
The whole world awaited good news from the thirteenth International AIDS Conference held is Durban last week, he continued. That was particularly true for countries that had been most severely affected by the spread of the disease. The hope had been that the promising research strategies reported at the last national conferences would provide some positive results -- that a vaccine was being made ready, or even that a cure was imminent. Even if those expectations had constituted a "tall order", sub-Saharan Africa had been at least expecting to hear that the so-called "cocktail drugs" readily available in developed countries would be made available to the developing world at affordable prices. Sadly, he said, even that was not forthcoming from the Durban Conference. Returning to the situation in Malawi, he said that where the population had once been on the increase, recent studies had shown a precipitous decline. Thus, in a sense, AIDS had given the people of that country a death sentence. While low population growth in some developing countries would be welcomed if it had been due to informed family planning, unfortunately, that had not been the case in Malawi. It was important to note that his country was not alone in seeing decline in population growth due to AIDS. He quoted a recent article from The New York Times which stated that if the AIDS trend continued untended, South Africa could soon have a white majority. "This is serious business", he said.
He went on to say that it was clear that the strategies hitherto adopted by the international community to fight the spread of HIV/AIDS had failed. Therefore, it was important to note that while the resolution currently before the Council focused on the impact of HIV in conflict situations, the worst affected countries, including Botswana, South Africa and Zimbabwe, had, by and large, been stable for the last decade. In that regard then, it was not only violence and instability that contributed to the spread of AIDS. There had to be other reasons.
He went on to say that there must be something in the African culture that made it difficult to accept death from AIDS. Perhaps, it was now time to address the cultural aspects of the spread of the disease. Cultural experts, not medical experts, might be more capable of carrying out research and developing new strategies on how to stop the spread of the disease. By way of example, he said that in recent weeks, circumcision in males had been linked to a reduction in the spread of the disease. This was a cultural matter and not subject to public discussion, so 10 years of research had been ignored. It was clear that new strategies with cultural components now needed to be considered.
Finally, he said that Malawi, as a troop-contributing country had in the past and would continue to ensure that adequate civic education was given to all persons in the field.
M.M. SEMAKULA KIWANUKA (Uganda), referring to the recent Durban International Conference on AIDS, said there was a general consensus that AIDS was crushing Africa politically and economically. It was recognized that AIDS was a development and poverty issue. There was also a consensus that the AIDS bill was enormous, hence, the need for worldwide response.
Sharing Uganda's experiences in the fight against AIDS, he said there had been open and political commitment at the top of the country's political leadership. A multi-sectoral approach had been adopted, indicating that the epidemic was more than a health issue. Public education had played a key role in the fight against the disease. Free condomns had been distributed. Non- governmental organizations had also played a role through widespread programmes and activities. The net results were that the country had begun to see a positive change.
Nevertheless, Uganda had seen the productive part of its population affected. AIDS was a poverty issue, as only the well-off could afford the drugs. Poverty was a major constraint in the struggle against AIDS. In the preventive strategies being discussed, attention should be paid to the socio-political environment, as well as to culture.
He urged assistance to poor countries to enable them to carry out testing and undertake the preventive action called for in the draft resolution. He said Uganda had been engaged in awareness and education campaigns long before the Security Council and the United Nations thought about the issue.
Dr. PIOT, head of UNAIDS, speaking on comments and observations made by delegations, said access to health care was now inseparable from prevention. It was unthinkable not to care for those affected. Progress had been made in the treatment of HIV/AIDS in Africa. His agency had negotiated with the pharmaceutical industry on affordable drugs. A global approach to the problem of costs was required. Other alternatives were being explored, such as working with manufacturers of generic drugs. The UNAIDS had set up a contact group to disseminate information.
He supported the call by France for a conference on funding to fight the disease. He said the resolution was a historic one. It would be the first recognition by the international body of the link between human security and AIDS. It changed dramatically the kind of resource that could be deployed to tackle the problem. Moreover, the resolution would help community groups in the field. He concluded by saying that the Durban Conference had been truly a beacon of hope for him.
The Council then proceeded to vote on the draft, which it adopted unanimously.
The full text of the Council resolution, to be issued as resolution 1308 (2000), reads as follows:
"The Security Council,
"Deeply concerned by the extent of the HIV/AIDS pandemic worldwide, and by the severity of the crisis in Africa in particular,
"Recalling its meeting of 10 January 2000, on "The situation in Africa: the impact of AIDS on peace and security in Africa", taking note of the 5 July 2000 report from UNAIDS (S/2000/657) which summarizes follow-up actions taken to date; and recalling further the letter of its President dated 31 January 2000 addressed to the President of the General Assembly (S/2000/75),
"Emphasizing the important roles of the General Assembly and the Economic and Social Council in addressing HIV/AIDS,
"Stressing the need for coordinated efforts of all relevant United Nations organizations to address the HIV/AIDS pandemic in line with their respective mandates and to assist, wherever possible, in global efforts against the pandemic,
"Commending the efforts by UNAIDS to coordinate and intensify efforts to address HIV/AIDS in all appropriate forums,
"Recalling also the 28 February 2000 special meeting of the Economic and Social Council, held in partnership with the President of the Security Council, on the development aspects of the HIV/AIDS pandemic,
"Welcoming the decision by the General Assembly to include in the agenda of its fifty-fourth session an additional item of an urgent and important character entitled "Review of the problem of HIV/AIDS in all its aspects", and encouraging further action to address the problem of HIV/AIDS,
"Recognizing that the spread of HIV/AIDS can have a uniquely devastating impact on all sectors and levels of society,
"Reaffirming the importance of a coordinated international response to the HIV/AIDS pandemic, given its possible growing impact on social instability and emergency situations,
"Further recognizing that the HIV/AIDS pandemic is also exacerbated by conditions of violence and instability, which increase the risk of exposure to the disease through large movements of people, widespread uncertainty over conditions, and reduced access to medical care,
"Stressing that the HIV/AIDS pandemic, if unchecked, may pose a risk to stability and security,
"Recognizing the need to incorporate HIV/AIDS prevention awareness skills and advice in aspects of the United Nations Department of Peacekeeping Operations' training for peacekeeping personnel, and welcoming the 20 March 2000 report of the United Nations Special Committee on Peacekeeping Operations (A/54/839) which affirmed this need and the efforts already made by the United Nations Secretariat in this regard,
"Taking note of the call of the Secretary-General in his report to the Millennium Assembly (A/54/2000) for coordinated and intensified international action to reduce the HIV infection rates in persons 15 to 24 years of age by 25 per cent by the year 2010,
"Noting with satisfaction the 13th International AIDS Conference, held from 9 to 14 July 2000 in Durban, South Africa, which was the first conference of this type to be held in a developing country and which drew significant attention to the magnitude of the HIV/AIDS pandemic in sub-Saharan Africa, and further noting that this Conference was an important opportunity for leaders and scientists to discuss the epidemiology of HIV/AIDS and estimates of resources needed to address HIV/AIDS, as well as issues related to access to care, mother to child transmission, prevention, and development of vaccines,
"Bearing in mind the Council's primary responsibility for the maintenance of international peace and security,
"1. Expresses concern at the potential damaging impact of HIV/AIDS on the health of international peacekeeping personnel, including support personnel;
"2. Recognizes the efforts of those Member States which have acknowledged the problem of HIV/AIDS and, where applicable, have developed national programmes, and encourages all interested Member States which have not already done so to consider developing, in cooperation with the international community and UNAIDS, where appropriate, effective long-term strategies for HIV/AIDS education, prevention, voluntary and confidential testing and counselling, and treatment of their personnel, as an important part of their preparation for their participation in peacekeeping operations;
"3. Requests the Secretary-General to take further steps towards the provision of training for peacekeeping personnel on issues related to preventing the spread of HIV/AIDS and to continue the further development of pre-deployment orientation and ongoing training for all peacekeeping personnel on these issues;
"4. Encourages interested Member States to increase international cooperation among their relevant national bodies to assist with the creation and execution of policies for HIV/AIDS prevention, voluntary and confidential testing and counselling, and treatment for personnel to be deployed in international peacekeeping operations;
"5. Encourages, in this context, UNAIDS to continue to strengthen its cooperation with interested Member States to further develop its country profiles in order to reflect best practices and countries' policies on HIV/AIDS prevention education, testing, counselling and treatment;
"6. Expresses keen interest in additional discussion among relevant United Nations bodies, Member States, industry and other relevant organizations to make progress, inter alia, on the question of access to treatment and care, and on prevention."
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