General Assembly Plenary
Twenty-sixth Special Session
2nd and 3rd Meetings (PM & Night)
SPECIAL SESSION IS OPPORTUNITY FOR GREAT LEAP FORWARD IN GLOBAL BATTLE
AGAINST HIV/AIDS, ASSEMBLY IS TOLD
Speakers from Many Nations Describe Multi-faceted
Efforts To Combat Scourge Said to Threaten Future of Mankind
The declaration of commitment to be endorsed on Wednesday was an opportunity to make a “quantum leap forward”, the special session of the General Assembly on HIV/AIDS was told this afternoon.
As the Assembly continued its general debate in two meetings, this afternoon and evening, the Minister for International Cooperation of Canada said it was now up to each and every participant to take ownership of the declaration and do what was necessary to end the epidemic, which was a major obstacle to the international development targets. “Every possible effort must be taken to make sure that every single person infected or affected by HIV/AIDS has access to the most comprehensive care, treatment and support available; that the rights of all individuals and groups are protected and respected everywhere, particularly those most vulnerable to HIV, such as women and girls, men who have sex with men, intravenous drug users and sex workers", she said.
Many high-level speakers in the debate shared their national experiences in the fight against HIV/AIDS, stressing the importance of education, awareness-raising and information in preventing the spread of the disease. In view of the gravity of the situation, they also emphasized the need to attribute priority status to anti-AIDS efforts at the national, regional and global levels. Also underlined were such issues as prevention; access to treatment; partnership between various players involved; and the need to allocate adequate resources to the national AIDS programmes.
"We have had enough of the discriminatory stigmatizing attitude of the rich towards the poor and the inequality which propagates the virus", the Minister of Health and Child Welfare of Zimbabwe said. The danger of that attitude was that the have-nots and the haves would become the HIV’s and the HIV-nots around the world. "Although we may not have clocks or roads in Africa, we do know the time, and time is ticking away inexorably for some of our states", he added. He knew that anti-retrovirals were only a part of the solution to the problem, but while they were denied to Africa, the message of prevention was inadequately supported.
Speaking on behalf of the European Union and associated States, the Minister for Health and Social Affairs of Sweden said that prevention and treatment were
complementary pillars of the expanded response to AIDS, and care and support were inextricably linked to effective prevention. Further effective research for cheaper and more effective treatment to combat the symptoms of the disease was necessary. The world also had to increase its efforts to develop effective and safe vaccines and microbicides.
Success of any HIV/AIDS programme would depend on genuine consideration for specific national circumstances and respect for particular norms and values of concerned societies, the Deputy Minister of Health and Medical Education of Iran said. The fact that irresponsible sexual behaviour had been among the key factors in the spread of the disease could not be brushed aside. The issues and concepts under discussion involved long-established fundamental ethical principles and values and could not be subjected to a post-modern "laissez-faire, laissez-passer" mentality. As far as sexual relations were concerned, the imperative of moral choice, the centrality of family as the basic unit of society and responsible individual conduct were indispensable to a healthy state of relations.
Also speaking at the two meetings were the Presidents of Mali and Guinea Bissau; the Prime Ministers of Lesotho, Burkina Faso and Barbados; and the Vice-President of Burundi, as well as Ministers and high government officials from the Netherlands, Thailand, Costa Rica, Chile, Australia, Romania, China, Honduras, Colombia, Papua New Guinea, Nicaragua, Trinidad and Tobago, Guatemala, Mauritius, Tonga, Belarus, Armenia, France, Suriname, Zambia, Spain, Belgium, Mexico, Tunisia, Dominican Republic, Germany, Angola, Italy and Switzerland. The representatives of Kuwait and Jordan also addressed the Assembly.
The Assembly will continue its general debate at 9 a.m. tomorrow, 26 June.
The General Assembly met this afternoon to continue its special session on HIV/AIDS. (For background, see Press Release AIDS/22 issued on 21 June.)
PAKALITHA B. MOSISILI, Prime Minister of Lesotho: Lesotho has declared HIV/AIDS a national disaster; the Lesotho Aids Programme Coordinating Authority has been established to oversee the national response. Our efforts are slowly beginning to bear fruit. The level of knowledge and awareness about HIV/AIDS is now estimated at 95 per cent. Drugs are provided for the treatment of opportunistic infections and a decision will soon be reached on the availability and accessibility of anti-retroviral therapy. We need support, however, for strengthening our infrastructure, for access to drugs and for human resource capacity.
It is a basic human right of both the infected and the affected to have access to quality care and support. We are focusing on removing the stigma attached to the disease and removing the gender disparities that negatively impact on the capacity of women and girls to take control of their sexual health. The rapid increase in the number of orphans has prompted us to direct efforts at ensuring the protection and maintenance of their access to health, education, food and shelter.
For the achievement of those objectives, availability of resources is key. The Government has already decreed that every government sector should allocate a minimum of 2 per cent of its budget to AIDS control activities. We should all be aware that any anticipated changes in the status of HIV/AIDS will not be realized if the constraints and underlying factors – such as poverty, food availability and access, stigma, infrastructure, human resource capacity and drug availability -- are not addressed. We urge the donor community to support country efforts in addressing these issues in a coordinated manner.
ALPHA OUMAR KONARE, President of Mali: The United Nations is meeting as the acting conscience of the international community against HIV/AIDS. The future of Africa is decisive for international peace and stability. Mankind can be assured of no future without Africa. AIDS is a case in point. There can be no combat against AIDS that does not include Africa.
Faced with this serious threat, we must consider past action and proceed to a realistic analysis. The United Nations must point the way to be followed and inspire the efforts that must be taken, while ensuring the full participation of the States involved. The universality of the challenge means all are involved in the epidemic.
Universal general interest obliges us to reject a system that benefits only the wealthy. We must adopt the concept of the public global good. The epidemic in sub-Saharan Africa is at the root of a crisis that affects longevity and national revenue. Africa is in a situation of total emergency -- the tragic triptych of AIDS, malaria and tuberculosis is devastating. Furthermore, the commitment to combat AIDS means that countries in conflict should lay down their arms.
African heads of State have confirmed their commitment to combat this scourge. In Mali a plethora of efforts have been made to fight the disease. Both the Government and the civil society are playing high-priority roles in local efforts. Action on the sub-regional level should be emphasized. The special session must link words to actions, and provide the means to fight against HIV/AIDS throughout the world. No State must be left to confront the disease alone. We must form an international coalition against it.
MATHIAS SINAMENYE, Vice-President of Burundi: The fight against HIV/AIDS has become a fight for survival for our peoples. AIDS kills the people who are most productive as well as young citizens. It limits the possibilities for development now and in the future. It jeopardizes all efforts to reduce poverty. In Burundi, the rate of sero-positive people is now 15 per cent in the urban zone and 7.5 per cent in the rural zone. AIDS has become the most frequent cause of death for adults. The community must cope with an increase in social burdens. The Government has established a national, multi-sectoral strategic plan to combat AIDS.
Preventive action has been stressed. The Government has accelerated the mobilization of the population, with the support of religious leaders and other private actors. In order to improve access to treatment, the Government has established a national fund and has eliminated taxes on medicines. It has agreed price reductions on anti-retroviral measures. The availability of those medicines in generic form is the only possibility. We hope the issue of the production of those medicines will be favorably resolved. Burundi has mobilized means to seek assistance in the fight against AIDS.
All of these actions will be fruitless if war and insecurity persist, because warfare in our region is contributing to the spread of AIDS. After years of war, the establishment of a ceasefire is a condition for implementing the peace agreement. Since the signing of the agreement, rebels have stepped up their attacks. Governments in the region and the international community must consider current acts of violence by rebel groups as a violation of the peace agreement, and they must be ready to take action, including sanctions. The international community must do everything possible to demand that rebel groups return to the peace process.
ELS BORST-EILERS, Deputy Prime Minister of the Netherlands: The epidemic is spreading like wildfire around the world. It is a fact that people living in poverty run a greater risk of infection. AIDS has a momentous impact on development as well as on the life of individuals. Investing in development is crucial to the fight. Solutions for the crisis should be based on respect for human rights, and gender equality is a fundamental aspect of reducing the vulnerability of women and girls. Non-discrimination is essential to avoiding social stigma.
Infected people should have access to work and be able to travel. Promotion and protection of human rights are inherent to reducing vulnerability. All this demands the leadership of all of us. Political commitment is key. We have to create openness on the issue.
Prevention and health-care system improvement are the cornerstones of the fight against HIV/AIDS. We have substantially supported the work of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Population Fund (UNFPA). Treatment, access to medication and adequate resources are also important. We are one of the biggest donors to the international AIDS vaccine initiative. Developing countries should always be in a position to produce or have access to medicines that they can afford.
More money is essential. The question is whether a global fund is the best way to raise the money. Existing programmes that have proven their worth have not received adequate funding and should not be forgotten. The founding fathers of the fund should put their money where their mouth is. More clarity on the administration of the fund is also essential. Duplication or competition with existing funds should be avoided. Once such concerns have been fully addressed, the Netherlands Government will be prepared to make a substantial commitment.
PITAK INTRAWITYANUNT, Deputy Prime Minister of Thailand: HIV/AIDS is a silent global menace which threatens not only development and human security, but also international security. The crisis not only needs national action, but also regional and global cooperation. Responsibility must be shared in managing worldwide economic and social development as well as threats to international security, as called for in the United Nations Millennium Declaration. Leaders of members of the Association of South-East Asian Nations (ASEAN) will convene a special summit meeting on HIV/AIDS in November.
Thailand is recognized as one of the most successful countries in AIDS prevention and awareness programmes. The record shows that the epidemic can be contained and brought under control. Thailand is prepared not only to share these experiences but also to provide the appropriate technical assistance to other developing countries, in the spirit of South-South cooperation. Thailand was the first Asian country to break the silence and come out of denial. HIV/AIDS needs to be tackled from the perspective both of prevention and treatment. There must be a holistic approach which addresses human, social, economic and cultural aspects of the HIV/AIDS problem.
Thailand urges drug-producing countries, regional and international organizations and civil society, in particular pharmaceutical companies, to be actively involved in research and development of HIV/AIDS vaccines and drugs, and to make them more widely accessible and affordable to all who need them in developing countries. All efforts require not only political commitment, but also financial resources. Each of the 29 richest people in the world has more in assets than the 7 to 10 billion dollars needed annually for AIDS/HIV resources. If the developed countries and the private sector, including these wealthy individuals, were to pitch in for the global struggle against HIV/AIDS, the required amount is not at all a high figure. It is certainly within our reach.
ROGELIO PARDO, Minister of Public Health of Costa Rica: While the social and human effects of AIDS are immeasurable, its economic impact is acutely clear. The epidemic will dramatically reduce global economic growth. By 2010, the economic losses will amount, just in Africa, to an estimated $22 billion.
The epidemic in Costa Rica has shown a gradual growth. Sexual transmission is the most frequent cause. The disease is more prevalent among homosexuals, who account for 44.6 per cent of the cases, followed by heterosexuals (23.8 per cent) and bisexuals (15.9 per cent). Infection of hemophiliacs and through blood transfusions appears to have stopped, amounting to only 3.4 per cent of the cases. The Government of Costa Rica has designed a new national strategic plan for the period 2001-2004, emphasizing prevention, social communication and education, and information addressed to the vulnerable groups.
Costa Rica supports the draft declaration of commitments, to be adopted at the end of this session. It reflects our main interests and priorities. There is a need to strengthen leadership in the fight against HIV/AIDS, in order to build up the national and international plans of financing. Attention must be given to prevention, especially that of sexual and mother-to-child transmission. As a steadfast advocate of human rights, Costa Rica supports all initiatives directed at eradicating discrimination or segregation of people with HIV or AIDS. Costa Rica endorses efforts to promote research, particularly the study of the habits and behaviour of population groups at higher risk and vulnerability.
LARS ENGQVIST, Minister for Health and Social Affairs of Sweden (on behalf of the European Union, Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Romania, Slovakia, Slovenia, Cyprus, Malta and Turkey): We must take effective measures to ensure that people everywhere, particularly young people, know how to protect themselves from being infected. Groups particularly vulnerable, such as men who have sex with men, prostitutes and injecting drug users, must be specially targeted by prevention efforts. Unequal power relations between women and men must be redressed. Every woman and girl had the right to say "no" to unwanted sex.
Prevention and treatment are complementary pillars of the expanded response to AIDS, and care and support are inextricably linked to effective prevention. Further effective research for cheaper and more effective treatment to combat the symptoms of the disease is necessary. The world also has to increase its efforts to develop effective and safe vaccines and microbicides.
Poor people are the most vulnerable to HIV/AIDS. Therefore, to prevent the spread of the disease we must reduce poverty. To this end, the European Union last month adopted a programme for accelerated action on HIV/AIDS, malaria and tuberculosis -- addressing prevention, care and support. The multiple challenges facing the international community cannot be faced without new, additional and sustained resources. We therefore welcome the proposals presented by the Secretary-General and several donor countries to establish a global HIV/AIDS and health fund. Together with the international community, the Union commits itself to strengthen the efforts to combat these major threats to life and development, and to contribute significantly to the fund once agreement has been reached on its establishment.
MICHELLE BACHELET, Minister of Health of Chile: My Government considers the establishment of a global trust fund for HIV/AIDS a substantive advance in the fight to diminish the economic disparities in the response to HIV that exist between the industrialized countries and the developing world. The commitment of the Rio Group of countries expresses the sensitivity of the American continent to the problem.
For Chile, full respect for the rights of people living with HIV is not only a duty, but also fulfils the ethical imperatives of a democratic society. In Chile, the epidemic has been primarily one of sexual transmission between homosexual men. Results of studies have served as a basis for strategies for prevention and care, with the active participation of State institutions and civil society, especially organizations of people living with HIV/AIDS and vulnerable people, as well as church and other humanitarian organizations.
Aware of State responsibilities to people living with AIDS, the Government of Chile has drastically increased its budget in the matter. It has stimulated awareness education, strengthened social actions and provided care. Chile has also participated in the technical group of cooperation to fight AIDS in Latin America and the Caribbean.
MICHAEL WOOLRIDGE, Minister for Health and Aged Care of Australia: The proposed draft declaration of the special session has the potential to show that the world community is serious about tackling the causes of HIV/AIDS, preventing its spread and caring for those who live with the virus.
Australia has had remarkable success in reducing new levels of infection, based on two key principles: to build and sustain a political consensus supported by all elements of our political system and endorsed by the Australian community at large, and a willingness for the Government to engage and work with those most vulnerable to the virus. Australia is disappointed that it now appears that these groups -- men who have sex with men, sex workers, injecting drug users, institutional and prison populations and indigenous people -- will not be explicitly named in the declaration of commitment.
Promoting prevention as part of a comprehensive integrated response, which includes all aspects of treatment, care and support, is of primary importance. Efforts to build stronger health system infrastructures and to improve access to HIV/AIDS treatments will have maximum effectiveness when part of an integrated community response. There must be a robust partnership between a wide range of groups, with the full involvement of communities through, among others, civil society organizations, including people living with HIV/AIDS. This has been the Australian experience. Partnership in decision-making, policy development and programme implementation helps to ensure that efforts to combat the disease are effective and sustainable.
While by no means under-estimating the immensity of the problems of Africa and other regions of the world, it is also important to address the impact of the HIV/AIDS pandemic in the Asia-Pacific region. In July 2000, Australia announced a new A$200 million Global HIV/AIDS Initiative as a major expansion of our assistance for international work on HIV/AIDS. As part of its regional efforts to this end, Australia is inviting ministers from 38 countries across the Asia-Pacific to a meeting in October this year. Other regions should consider similar initiatives, to build on the momentum from the Assembly’s special session.
DANIELA BARTOS, Minister of Health and Family of Romania: We all now recognize that HIV/AIDS is no longer a problem of people living with AIDS. It is a major problem of public health. The Government of Romania has declared HIV/AIDS as the country’s main public health problem. As the epidemic and its impact have expanded, the number of committed partners in the national response has grown to include numerous ministries, local and international non-governmental organizations, the private sector, the media, and the international donor community.
The focus of the country's strategy is on prevention of infection among youth and vulnerable groups and on the social, legal, ethical and human rights aspects of the disease. Priority attention is given to improving health and social services, supporting people infected with the disease and strengthening epidemiological systems to monitor developments over time.
Since the beginning of the epidemic, Romania has been increasing the budget allocated to the national HIV/AIDS programme -- up to $20 million this year. The Government is committed to maintaining the same budget, or even increasing it in real terms, within the next four years. This was not easy for a country in transition with severe budgetary restrictions and numerous other public health and social emergencies. Despite the challenges, we decided to introduce universal coverage with treatment and care, including anti-retrovirals for the people living with HIV/AIDS. We are gratified that our priorities and concerns are well reflected in the declaration, which will be adopted by the special session.
ZHANG WENKANG, Minister of Health of China: We deeply appreciate the efforts of the United Nations for the prevention and control of HIV/AIDS at the global level, particularly in the coordination and strengthening of the activities of the relevant international organizations. The Secretary-General has correctly analysed and accurately assessed the prevalence of the disease at the global level.
HIV/AIDS has become a global crisis and global efforts are needed to combat it. My Government gives priority to the prevention and control of the disease. In 1996, the “Regime of Coordination for the Control of STDs and HIV/AIDS” was established at the central Government level, and other initiatives have followed. Funding from the Government has increased seven-fold (from RMB 15 million yuan to the present RMB 100 million yuan. In the form of national bonds, RMB 950 million yuan has been used for further improvement of services of blood banks. The prevention and control of the disease is steadily progressing under the leadership of the Government at all levels.
The rapid spreading of HIV/AIDS is attributable to poverty. At the same time, it is a major contributing factor to worsen poverty. Only through a better job in prevention can the broad mass of people be freed from the threat of the disease, with its impact on socio-economic development minimized. Treatment is another critical issue; barriers to effective and affordable medicines must be resolved. International cooperation should be further strengthened for the mobilization of resources to render aid and support to developing countries in their fight against the disease.
ROBERTO FLORES BERMUDEZ, Minister for Foreign Relations of Honduras: We are aware of the social, political and economic implications of HIV/AIDS on our societies and our countries. Treatment requires greater access to medical services and cheaper medicines within a comprehensive health care system. Governments can carry out successful programmes involving all sectors of society. We need to convince all involved to act together at national and international levels in an organized and sustained manner. It is particularly important to learn about the successful experiences of other countries and regions.
At the end of the 1980s, the HIV/AIDS section of our national health department was created. A few years later, the Government had adopted its first strategic national plan of action to address HIV/AIDS, which the people of Honduras identified as a national problem. In 1989, a special law on HIV/AIDS was adopted and the Government was in the process of elaborating its second strategic national plan. Honduras has an extensive monitoring network as well as a large number of physicians working directly on the disease.
The epidemic had been less extensive in our country than had been predicted two years ago. However, despite these efforts, it continues to spread. The limitations on our national resources are such that we need the assistance of other nations.
MARIA MINNA, Minister for International Cooperation of Canada: We are here for the nearly 40 million people living with HIV/AIDS worldwide, for the 15,000 people that were infected with HIV today, and the 15,000 more who will be infected tomorrow and every day after that.
This pandemic is a major obstacle to our international development target to reduce by half the proportion of people living in extreme poverty by 2015. It also foils our efforts to reduce infant and child mortality rates by two thirds by that year. Every possible effort must be made to ensure that every single person infected or affected by HIV/AIDS has access to the most comprehensive care, treatment and support available; and that the rights of all individuals and groups are protected and respected everywhere, particularly those most vulnerable to HIV -- such as women and girls, men who have sex with men, intravenous drug users and sex workers.
This means an intensified commitment at the international, national and community levels, and this means involving civil society and people living with the disease in every aspect of our efforts. This session marks the turning-point in our struggle against this terrible disease. Prevention works, and must be the mainstay of our response. Comprehensive approaches work, and prevention must be fully integrated with care, support and treatment for all those infected and affected.
Canada has a leading-edge strategy on HIV/AIDS, which is meeting our own unique challenges, while also linking our efforts with those at the international level. Canada is quadrupling its development assistance funding for HIV/AIDS, and has today committed over $73 million for HIV/AIDS programming in Africa, the Caribbean, Asia and Eastern Europe. Canada has been instrumental in shaping the global fund on AIDS and health, and will support it financially. We are committed to making it operational by the end of the year. The declaration of commitment to be endorsed on Wednesday is an opportunity to make a “quantum leap” forward.
TOMMY TOMSCOLL, Minister for Health of Papua New Guinea: The epidemic’s trend in my country has indicated that many Papua New Guineans are infected with the virus; many do not know that they have the virus; and many more will continue to get infected, due to the complexities of factors that will facilitate the spread of the epidemic. The diversity of the country both in terms of culture and geographical terrain makes communication with the rural communities difficult. This is further compounded by the limitations of the low literacy rate and the presence of over 800 different languages.
My Government has enacted the National AIDS Council Act in December 1997. The structures of the National AIDS Council have been designed so that there are clear mechanisms for policy development and clear lines of communications with local authorities to plan and implement the comprehensive multi-sectoral response. About 10 to 15 thousand people will fall ill from the disease in the next few years, the majority of which will be the productive and economically important citizens for our society. Major challenges facing us are the existing uncontrolled sexually transmitted infections, the growing problem of tuberculosis, providing basic antenatal care to women throughout the country and the issue of security and violence.
We must review many criteria set by global agencies which often exclude Papua New Guinea unnecessarily from getting the support required to improve social and economic development. The United Nations system is urged to clearly define its role through the UNAIDS mechanism at country level. Access to treatment is an important challenge. To date, the Government does not provide anti-retroviral drugs. We acknowledge that it is our moral and ethical responsibility to do so. However, our financial situation prohibits the provision of those drugs to those living with the virus. We therefore welcome the establishment of the HIV/AIDS trust fund and sincerely hope that we can receive support from this fund to stem the tide of HIV/AIDS in Papua New Guinea.
MARIANGELES ARGUELLO, Minister of Health of Nicaragua: Nicaragua is a small Central American country in the process of development. It has a population of 5 million and a weak economic capacity which makes it difficult for the Government to meet all the needs of its people. It is also frequently the victim of natural disasters. All of this makes international assistance of paramount importance to our country. We registered the first HIV/AIDS case in 1987. Until recently, 688 cases of HIV have been registered, of which 320 have developed into AIDS and 174 of those have died. For the time being, Nicaragua was one of the least affected in our region but there is a trend towards increase.
In the last five years, the number of infected has practically doubled. That is why, more than ever, it is necessary to reinforce an education, prevention and awareness-raising campaign. Nicaragua requires the support of other nations and partners to prevent and reduce the economic and social impact of HIV/AIDS in our country. We have a national strategic plan to fight sexually transmitted diseases and AIDS, which we are planning to implement between 2001 and 2005. The necessary investment to cover the most immediate needs for prevention, detection and treatment amounts to $20 million.
One of our main achievements has been the adoption of a law on the protection and defence of human rights in connection with HIV/AIDS. We have also officially established the National Commission on HIV/AIDS, which is comprised of various government institutions and representatives of civil society, as well as people suffering from HIV/AIDS. Another advancement has been the law on safety of blood transfusions, which requires all health-care sectors to detect the HIV virus prior to any procedure.
One concern has been our ability to provide comprehensive health care to infected patients, especially considering the limited funds for necessary medicines. The price of anti-retroviral drugs is still beyond our reach, even though it has decreased recently. I note that Taiwan, which has been very active in the area of addressing HIV/AIDS, cannot actively participate in the numerous programmes in the United Nations system because it has yet to be re-admitted into the Organization as a full Member.
HAMZA RAFEEQ, Minister of Health of Trinidad and Tobago: HIV/AIDS rates in the Caribbean are the highest in the world outside sub-Saharan Africa, and AIDS is the leading cause of death in the 15-44 age group. Current national plans and actions are not sufficient to deal with the disease. There is an urgent need for greater international assistance and support and involvement of all sectors, such as non-governmental organizations, civil society and the private sector. With the most economically active and productive population groups being the most affected by the epidemic, severe social and economic repercussions are inevitable.
In Trinidad and Tobago, the epidemic curve is on the rise. The number of females infected is greater than that of males in the age group 15-24. The percentage of HIV-infected women has increased from 0 per cent in 1983 to 45 per cent in 1999. Eighty-two per cent of all reported HIV-infected women are within the age group 15-45 years, which highlights the risk of mothers passing on the infection to their babies. A macroeconomic study on the impact of HIV on key variables indicate that if the current rate of increase continues, by the year 2005, my country will experience a reduction in gross domestic product of 4.2 per cent, in savings of 10.3 per cent and in investment of 15.6 per cent.
Many programmes through information and education are aimed at prevention and targeted at the vulnerable in the population. A national policy on reduction of mother-to-child transmission has been implemented, and a new policy on HIV/AIDS in the workplace to protect the rights of infected persons will soon be introduced. Trinidad and Tobago will be hosting the tenth international conference for people living with HIV/AIDS in October. We are also participating in phase II of the HIV/AIDS vaccine trials. With regard to accessing special funding arrangements, the Caribbean’s premier financial institution, the Caribbean Development Bank, must be seen as an important stakeholder. The criteria for accessing funds should not be burdensome and bureaucratic and countries most in need should benefit.
TIMOTHY J. STAMPS, Minister of Health and Child Welfare of Zimbabwe: Zimbabwe is predicted to achieve zero population growth by the end of 2002, because of national family-planning initiatives, emigration and escalating death rates. All of the factors have been affected by the HIV/AIDS epidemic, not merely because of its contribution to death rates, but also as a result of the efforts of awareness on reproductive activity. We are very conscious of the ethnic discrimination against black Africans. How else does one explain the exponential growth of HIV in our region as compared to other countries where the disease surfaced earlier?
As a nation, we have achieved two successes which we continue to prioritize: a sustainable, safe national blood transfusion service, and the highest coverage in the world of reliable condoms (18 per male per annum since 1994). In addition, we have created sound taxation which last year raised over $30 million and is managed by an autonomous national AIDS council. Though we may not have clocks or roads in Africa, we do know the time, and time is ticking away inexorably for some of our states. We know that anti-retrovirals are only a part of the solution to the problem, but while they are denied us, the message of prevention is inadequately supported.
The world should recognize that we have taken the bold initiative to repossess our land to ensure that families have access to food and economic security, thereby combating the risks of exposure to HIV resulting from commercial sex for survival. We have had enough of the discriminatory stigmatizing attitude of the rich towards the poor and the inequality which propagates the virus. The danger of this attitude is that the have-nots and the haves will become the HIV’s and the HIV-nots around the world. We pledge support to the global fund for HIV and health and intend to earmark $1 million, explicitly as seed money for the creation of a budget line to identify, treat and eliminate reproductive tract cancers which are HIV related. This area has been neglected and affects our most vulnerable people: the young women of Africa.
MARIO RENE BOLANOS DUARTE, Minister of Health and Social Welfare of Guatemala: Guatemala is characterized by contrasts and ethnic diversity, with a population that is multicultural, multi-ethnic and multilingual. It is estimated that the population groups most exposed to HIV transmission are mainly in the urban areas. The first known case in Guatemala was in 1984, and by 30 April of this year, 4,010 cases had been reported. It is estimated that 50 per cent of cases go unreported. The Government's determination to combat HIV/AIDS has been reflected in the health code which assigns to the Public Health Ministry responsibility for evaluating and supervising actions aimed at controlling sexually transmitted disease, including HIV/AIDS, with the participation of various sectors.
A general law was passed declaring the disease to be a social problem of "national urgency", for which $640,000 has been budgeted. Actions have been initiated to provide care to persons living with HIV/AIDS. This effort seeks to reduce the socio-economic impact of the health problem on the Guatemalan population and promote the integration and complementarity of financial contributions.
A new HIV/AIDS epidemiological analysis commission is charged with determining the magnitude and significance of the problem, in order to orient the decision-making process. Another commission has been set up to establish strategies to improve access to better quality and lower-priced anti-retroviral drugs. We will also step up the search for joint solutions with the sectoral institutions, including the Social Security Institute, in order to make those drugs more accessible. While Guatemala will assume its responsibilities under the declaration from the special session, it is necessary to revise and implement the strategies and plans for national and multi-sectoral financing, in order to face up to the stigma, silence and denial of the gender and age aspects of the HIV/AIDS problem.
ASHOCK JUGNAUTH, Minister of Health and Quality of Life of Mauritius: We are here because we all share a profound concern for the sheer scale of the human impact of the HIV/AIDS pandemic. But this is of little value, unless it is coupled with a well-tuned capacity for taking practical steps to provide support for those affected, and to arrest the spread of the disease. Among the purposes of the special session is to reach agreement on the most cost-effective ways to reverse the spiraling rates of the HIV infection; on the best means for the clinical and personal care of patients with HIV/AIDS; on the best means of supporting those with HIV/AIDS; and on meeting the very tragic needs of those orphaned by AIDS. I firmly believe that the declaration of commitment towards which we are working will strengthen bonds among nations, communities and all partners.
Health-care costs for HIV-infected persons and AIDS patients are tremendous, putting a heavy burden on governments in Africa. Despite considerable efforts made by the Southern African Development Community (SADC), HIV infections and morbidity caused by AIDS continue to increase at an alarming rate, with a drastic impact on the region's socio-economic development. Addressing the HIV/AIDS pandemic last year, the SADC heads of State warned that there can be no meaningful development in the region as long as the problem is not addressed on an emergency basis. I am pleased to note that the pledges of African heads of State and government, made at the Abuja special summit in April, have been included in the draft declaration of commitment. I am also pleased to inform you that that Indian Ocean Commission has included HIV/AIDS on its agenda as a priority.
In my country, much emphasis has been placed on educational activities, which constitute the backbone of the national HIV control programme. These activities aim at promoting safer sex behaviour among the population and among high-risk groups. As regards mother-to-child infection, a programme for the prevention of HIV transmission has been initiated since 1998. The low prevalence of HIV/AIDS cases registered in Mauritius can be attributed to the prevention programmes and other factors, including free education, access to medical care and poverty alleviation. We need to ensure that this low prevalence does not create complacency in the population. The Government of Mauritius is further proposing to set up an inter-ministerial committee on HIV/AIDS to be chaired by the Prime Minister or Deputy Prime Minister and the Minister of Finance.
VILIAMI TANGI, Minister for Health of Tonga: It is of grave concern that HIV/AIDS prevalence is higher among women and young girls than any other group. There is clearly a need to develop measures to increase the capacity of women and young girls to protect themselves from the risk of infection. This might principally be done through prevention education and the provision of reproductive health services.
Living with a potentially fatal condition produces great stress and strain. Those people have special problems and needs that must be addressed. These needs not only include health care and treatment but also extend to social and spiritual support. People living with HIV/AIDS have a right to confidentiality and must not be subjected to discrimination, whether in the family, the workplace or the community. To address this, we must raise community awareness of the special needs of people living with the disease by strengthening, where possible, existing health-care and support services and ensuring that quality counseling is available to all those involved.
Basic national health and social infrastructures are essential for the effective delivery of preventative and care services. Our national health system is currently overstretched as it is. Therefore, it is vital that our national health system should be improved and strengthened in order to cope with the demands of HIV/AIDS. This would include the existence of a safe blood supply system that provides protection to donors, recipients and health-care workers.
As we have seen over the past two decades, HIV/AIDS is not just a health problem. Its widespread social and economic impact is potentially devastating in a small community such as ours, with just over 100,000 people spread over some 170 islands. It is therefore essential to coordinate the activities of the many different relevant agencies in order to attain the best and most effective response possible.
VALERY FILONOV, Deputy Minister of Health Care of Belarus: It is extremely worrisome that the spread of HIV/AIDS has recently expanded to the population as a whole in Belarus, making imperative the consolidation of efforts of the State and civil society in combating the pandemic. For that reason, the National Programme of HIV/AIDS Prevention was adopted, with an inter-agency council designated to coordinate activities of various ministries, institutions and community-based groups.
The relevant agencies and organizations have focused on prevention. At the current stage, the Government can help all those in need. However, should the number of those infected grow rapidly, there will be serious need for international assistance. We attribute great importance to the establishment of global and regional mechanisms for provision of HIV/AIDS-related drugs to complement domestic measures and strategies. Where possible, the domestic pharmaceutical capacities of countries should be developed. In Belarus, an antiviral drug named “Zamitsit” has successfully been synthesized and tested.
At the global level, system-wide United Nations coordination is extremely important, including active support of the activities of UNAIDS and its multilateral and bilateral partners. Particularly important is a high level of cooperation between my Government and related United Nations agencies, including the country team in Minsk. Consolidation of the efforts of States at the regional and subregional levels is especially promising.
DAVID BERSH, Deputy Minister of Health of Colombia: The number of HIV/AIDS cases worldwide will soon be higher than the number of fatalities during the Second World War. It is hard to know what the future holds. For the moment, there is no vaccine for HIV and no cure for AIDS. We know how many cultural difficulties there are when it comes to prevention.
In Colombia, AIDS cases have tripled in just two years, and we do not know the incidence of AIDS among the most vulnerable groups, such as those involved in conflict. Our policy is clearly set out in our national strategic plan. The main objectives of this plan are to consolidate inter-sectoral coordination, promote social participation, mobilize private-sector involvement, devise programmes to assist the most vulnerable populations and strengthen the public-health monitoring system. Our policy is clear-cut and open. We are prepared to make any adjustments to it as a result of the outcome of this session.
What is missing, in Colombia and the rest of the world, is possession of the required economic resources, which can be found through international assistance as well as from better streamlining of current activities and programmes. If the costs of anti-retroviral drugs were cut in half, we would save enough money to treat twice as many AIDS patients.
HAIK DARBINIAN, Deputy Minister of Health Care of Armenia: The true scale of the spread of HIV/AIDS in Armenia is many times the number of people who are officially registered, so the problem is already very serious in the country. The most promising way to counter the disease includes coordination of actors on all levels, widespread use of the media, and preventive programmes among vulnerable people.
While the Government of Armenia is allocating large resources, it hopes the coordination of international resources will be increased. A lack of financial resources is one of the greatest obstacles in reversing the spread of HIV/AIDS in Armenia.
A national strategic plan aims to mobilize resources on many levels, both public and private. It will also be the basis of prevention programmes to be adopted in the near future. Armenia supports the declaration of commitment by Member States at the special session, hoping that will become the blueprint for full-scale international cooperation on the problem.
MOHAMMAD ABULHASAN, Chairman of the Delegation of Kuwait: We hope the Secretary-General's proposed fund will indeed play a pioneering role in combating the HIV/AIDS pandemic. The greatest challenge in the world today is sustainable
development, which cannot succeed unless various factors are addressed. Among these factors are health and peace and security. Diseases also threaten stability and know no borders. HIV/AIDS is one of the greatest challenges to development, and everywhere in the world people have suffered from its effects. The special session must therefore elicit a world commitment for well-targeted international and national measures.
One guiding principle will be to provide preventive and therapeutic measures as well as research. Certain practices also need to be banned, particularly the ones discussed earlier today.
While Kuwait only has 100 HIV/AIDS cases, it has nonetheless created a commission to address the disease and adopted programmes to protect its population. Education has also alerted students to the dangers of the disease. Kuwait believes that all countries, and in particular the African nations, are called upon to provide the necessary assistance to combat the pandemic. Let us join efforts to contain this disease and adopt a document from this session that will limit its spread.
PRINCE ZEID RA’AD ZEID AL-HUSSEIN (Jordan): There is no doubt that we are confronting a pandemic without precedent, which has resulted in millions of cases of HIV/AIDS. We are facing a catastrophe which is having devastating effects on many countries and damaging efforts for development. This disease had also resulted in the resurgence of other diseases, making it difficult for health-care systems to cope.
Jordan, in addition to having strict controls of blood transfusions, is also offering information and awareness-raising programmes for the most vulnerable groups. It is also providing sterilization, as well as medical and psychological care for HIV-positive patients. Although Jordan has the lowest level of HIV/AIDS in the world, we are fully aware that factors that exist in our country could cause an increase in infection if a strategy to fight the pandemic is not found.
The Government has created a special centre to fight AIDS and provide counseling for AIDS prevention. It is also providing free care to patients in order to ease their suffering and improve their standard of living. Protection of the human rights of those infected is very important. Humane treatment must be provided and confidentiality must be respected.
The PRESIDENT stated that the second meeting of the special session was concluded. He called the Assembly to order for the third meeting.
When the debate resumed, PARAMANGA ERREST YONLI, Prime Minister of Burkina Faso: The words and intentions regarding the fight against AIDS, expressed at the Millennium Summit, have unfortunately not been followed up by concrete action. Efforts have been undertaken in Burkina Faso, where the Government has established various bodies to combat the spread of HIV/AIDS on many levels, including prevention, awareness, and care for sufferers. The national multisectoral plan organized, with the United Nations Development Programme (UNDP), a funders’ round table along with a conference in Ougadougou. Negotiations with pharmaceutical firms have made it possible to reduce the price of drugs. The National Committee has been transformed into a council directly connected to the President of Burkina Faso.
Burkina Faso would like to thank other partners in these efforts including China, and also Taiwan. I look forward to the redefinition of the international role in the fight against HIV/AIDS, including educational, health, and economic aid. All AIDS sufferers must have access to drugs and other care in a global union of compassion and solidarity. Debt cancellation is also needed to combat HIV/AIDS, as is the global fund. The gap, between North and South, of drugs and care availability, must be reduced. This should be a minimum indicator of international solidarity. In addition, efforts for public awareness are not enough; fighting aids is irrevocably linked with development and poverty reduction. Burkina Faso completely supports the declaration of commitment resulting from the special session, and hopes it brings about many of those necessary developments.
OWEN ARTHUR, Prime Minister of Barbados: Epidemics have been known to devastate nations and regions, but the present HIV/AIDS pandemic could make all previous epidemics look trifling by comparison. This is not just a health crisis, it is an economic and social threat that could lead to a planetary catastrophe of unprecedented proportions. It has the potential to reverse the social and economic achievements of the last half century, and engender a state of global insecurity in which governments fall and societies crumble.
The special session is timely, and hopefully it is not too late. The Caribbean has the highest number of reported AIDS cases in the Americas. Its rate of HIV infection is second only to that of sub-Saharan Africa. Even more ominous is the fact that HIV/AIDS is the leading cause of death among young people in the Caribbean.
Except during the era of genocide and slavery, the Caribbean never lost large numbers of its youth to wars or natural disasters. We are in danger now of losing to HIV/AIDS one of the most educated and creative generations in Caribbean history. This tragedy would put the promise of sustainable development in the twenty-first century beyond our reach. We should not have any delusions. HIV/AIDS is not a Caribbean nor African nor developing world problem. It is a world problem that reflects our common but fragile humanity. Even those countries with the lowest rates of infection and the highest rates of survival cannot quarantine themselves from this global pandemic without resorting to the most nightmarish of totalitarian measures. There must be a way forward that relates to the universality of this common threat. We need a global emergency response that will support regional and national programmes.
The Caribbean has already taken steps to fight the disease. A pan-Caribbean partnership against HIV/AIDS was launched in Barbados in February. It is a broad coalition of stakeholders, including people living with AIDS, aimed at providing a multi-sectoral approach to the fight. Nationally, Barbados has designed its own comprehensive programme for the management, treatment and care of people infected by HIV/AIDS. My Government has pledged just under $100 million over the next five years and is currently negotiating a $15 million loan from the World Bank to help fund the national programme. This matter is sufficiently important to warrant the extraordinary step of a petition to the World Bank, from whose loan programme we graduated in 1999, to re-admit us to borrowing to support the initiative. All of our national and regional efforts in the fight against HIV/AIDS require massive financial support from the international community,
KUMBA YALA, President of Guinea-Bissau: This session reflects our unswerving commitments to our common ideals and objectives. Its goal is to recall commitments already taken by global leaders and to ensure the mobilization of the necessary resources. The HIV/AIDS epidemic is indeed one of the main challenges to the survival and development of mankind. It impacts global society at all imaginable levels and has provoked an urgent situation which imperils our development.
The Organization of African Unity (OAU) Summit in April highlighted the need to allocate a considerable portion of national budgets -- at least 15 per cent -- to fighting this epidemic. However, it is clear that for countries whose means are limited, such as mine, it is necessary to have international solidarity to allow them to participate in that common struggle. Poverty and underdevelopment constitute fertile ground for the epidemic, which is also exacerbated by internal conflict.
Guinea-Bissau has one of the highest rates of HIV/AIDS in the world. Between 8 and 10 per cent of the adult population is affected. Our country is not able to obtain anti-retroviral medication. It is indispensable to intervene in a coordinated manner at national, regional and international levels to stem the propagation of this epidemic. All of our common health infrastructures need to be strengthened so that effective prevention and treatment can be provided. Proper sex education, the use of condoms, access to public health-care institutions and effective medication are all necessary in the fight against HIV/AIDS.
CHARLES JOSSELIN, Minister for Cooperation and la Francophonie of France: This session will result in a victory if it acknowledges that it is essential to join prevention with access to treatment, including anti-retroviral drugs. France has been in the vanguard of this effort. We must, in addition, provide support for the care systems that have been so severely battered and disorganized by the pandemic. A hospital therapeutic solidarity initiative, twinning European hospitals with others in countries that want to participate -- especially those in Africa -- has been proposed. In addition, the price of drugs and reagents must be further lowered. Also, prevention and treatment must be developed everywhere, including in communities and the workplace. Equitable access to all must be ensured.
Even though France already devotes over 100 million francs in bilateral assistance to the fight against AIDS, Prime Minister Lionel Jospin has recently announced that 10 per cent of the poorest countries’ cancelled debt will be allotted to combating AIDS. France will also make a contribution amounting to 150 million Euros over three years to the global AIDS and health fund proposed by the Secretary-General. We wish this fund to finance preventive action and access to treatment, and that part of official development assistance resources be earmarked for anti-AIDS work in the form of grants.
Despite the panoply of treatments available for the disease, these techniques are not suitable for application to the vast numbers of sufferers in need. For that reason, France is proposing an international meeting on the theme “From commitment to action” in Dakar at the end of this year. The aim of the meeting will be to reach policy agreement on the methods to be used to best help the millions of afflicted. Lastly, I wish to stress the rights of certain vulnerable groups, including women and children, homosexuals, prostitutes and migrants, which are still ignored. From a public health standpoint, it is inadmissible today not to admit this reality.
MOHAMAD RAKIEB KHUDABUX, Minister of Health of Suriname: At present, HIV rates in the general population of my country are relatively low, creating a window of opportunity for positive action. Prompt actions taken now are highly effective both economically and in terms of human security. We know that the virus spreads rapidly once it takes hold of the general population, and in this regard, infection levels of over 20 per cent have been recorded among the country's vulnerable groups. Furthermore, AIDS was the second leading cause of death for males, and the third leading cause for females in the age group 15-44 in 1997 through 1999. It is also growing rapidly among youth, especially adolescent girls.
Current trends indicate that behavioural change is not occurring at a rate which shows a decrease in HIV/AIDS incidence. This, however, is not unique to Suriname, as with few exceptions, an upwards trend of new infections continues to be reported globally. In order to build up momentum for HIV/AIDS prevention and control, my country has recently embarked upon the development of a five-year national HIV/AIDS strategic plan (2003-2007) which will be a truly participatory, consultative process with the input of all sectors of society. This initiative, driven from within and supported financially and technically by – among others -- UNAIDS, the Pan-American Health Organization and the World Health Organization (WHO), with Japanese and Dutch non-governmental organization support, will secure a broad-based national response which will not be solely dependent on the Ministry of Health and ad-hoc financial inputs.
Human and financial resource mobilization will sustain the efforts to meet the short- and long-term goals to be set in this national plan, which will include the greater involvement of persons living with and affected by HIV/AIDS. Through capacity-building, with technical backstopping from local and external support, the latter strategy will be one of the cornerstones of a successful HIV/AIDS programme in Suriname. We look forward to increased regional and international assistance in order to sustain and strengthen our momentum for and expanded response to the pandemic.
LEVISON MUMBA, Minister of Health of Zambia: The HIV/AIDS pandemic is threatening the whole African community, so this special session is timely. It poses a challenge to everyone to assess our achievements, learn from our failures, and chart a new course, based on renewed and viable partnerships which emphasize collective leadership to this problem.
In Zambia, the pandemic is the greatest humanitarian crisis we are facing, causing a profound reversal of the development gains made over the past 30 years. We have thus moved towards mainstreaming HIV/AIDS into all our policies and programmes. The national community has also responded to the crisis by developing various initiatives and infrastructure aimed at mitigating the impact of the scourge on the family and society.
Effective partnerships have emerged between the Government and civil society and the responses are now bearing fruit. Zambia has begun to record a downward trend in rates of HIV/AIDS prevalence since 1993, in both rural and urban areas.
We applaud principles which govern the global health fund, and appeal to our rich friends to match words with deeds, and remove subjective criteria aimed at influencing future initiatives. In order for the fund to achieve its intended purpose, it should be established with additional resources and avoid the establishment of parallel systems. The establishment of the fund is an opportunity to make a difference by demonstrating commitment to dealing with the problem of HIV/AIDS. Zambia will therefore make a modest contribution to it, as a sign of our dedication to this global effort. We remain convinced that the special session will result in an unprecedented galvanization of global commitment and action to combat the pandemic.
CELIA VILLALOBOS, Minster of Health and Consumer Protection of Spain: In the European Union, the HIV/AIDS epidemic has been controlled up to a point through preventive, educational and treatment measures. To date in Europe, and Spain in particular, AIDS is more a chronic disease than a social and human threat.
In sub-Saharan African countries, however, this epidemic threatens all societies. At the same time in Latin America and the Caribbean, a region for which Spain has a special sensitivity, it is also spreading in an alarming way. Prevention is a key element. The promotion of a favourable social environment by stimulating healthy changes in risky behaviour, advocating the use of condoms, ensuring the availability of safe blood and avoiding maternal foetal transmission are decisive elements of this strategy.
Damage-reduction programmes, especially among intravenous drug users have had great success in preventing new cases. In Spain we have considerable experience in this area, since the delay in starting the damage-reduction programmes caused a rapid spread of the epidemic that was not controlled until these programmes were implemented. The strategy of this programme involves a powerful assistance network for drug addicts. Universal access to prevention and to the integrated care of patients with HIV/AIDS is abysmally unequal in different parts of the world. The strengthening of local capacities to have access to essential medicine and anti-retrovirals and the implementation of differential pricing are mechanisms that will help in the distribution and correct use of these medicines.
We are willing to collaborate in the development and implementation of a world health fund in the fight against AIDS. Yet neither the signing of a statement of undertakings nor the creation of the fund are an end in themselves but rather a beginning. Millions of lives depend on us and our response must be urgent. I would also like to refer to the fourteenth international conference on AIDS which will take place in Barcelona, Spain, in July 2002, and to call for ample participation in it. The theme of this conference, "Knowledge, undertaking and action", faithfully covers the principles of this international campaign.
GIANDOMENICO MAGLIANO, Director General for Development Cooperation, Ministry of Foreign Affairs of Italy: The HIV/AIDS epidemic is a worldwide health crisis no one could have imagined 20 years ago. 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 lasting, sustainable promotion of human health for all. The promotion of fairness in the distribution of, and access to, health care is one of the guidelines of Italian health cooperation policy. 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.
In the framework of its international responsibilities, Italy has proposed a strategy to address the most urgent problems stemming this situation, based on the following pillars. In the context of debt cancellation, Italy has decided to cancel 100 per cent of the debt of the poorest countries. Also, it 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. In addition, 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.
The forthcoming G-8 Summit in Genoa will assure the launching of the global health fund. The Italian Government will then announce its substantial contribution to the fund.
JULIO FRENK, Minister for Health of Mexico: The answer to the HIV/AIDS epidemic requires a comprehensive and balanced focus that includes prevention, care, treatment and support. In prevention, safe blood transfusions must be guaranteed to all and universal access to strategies that allow for a decreased in perinatal transmission must be made available. In Mexico, both kinds of infection have been decreased by more than 50 per cent. In our region, AIDS is also closely related to sexuality; wide-ranging solutions that recognize socio-cultural aspects, and include promotional strategies, are needed. For the young, sexual education and clear information on preventive measures, including condoms, are also needed.
The necessary infrastructure and resources to offer testing, counselling and quality medical care – including drugs -- is also essential. Mexico currently offers comprehensive care through specialized medical services including coverage with free anti-retroviral treatment to 85 per cent of patients with AIDS. Respect and protection for people affected by the disease are also supported in Mexico.
The AIDS epidemic in Mexico is concentrated in men having sex with other men, commercial sex workers and intravenous drug users. There is still an opportunity to avoid an epidemic among the general population. In this case, preventive efforts should and will be focused on the most affected groups, with the collaboration of civil society organizations, which must be allowed to participate at many levels. In addition, multi-sectoral, regional and international cooperation is key to the global answer for the pandemic. Mexico confirms its support for the global leadership of UNAIDS and its unified strategic plan, as well as the creation of a global AIDS and health fund.
HEDI M’HENNI, Minister of Social Affairs and Interim Minister of Public Health of Tunisia: Tunisia supports the noble goals and orientations in the draft declaration submitted to this session for approval, as they are in line with our priorities of human rights and the eradication of poverty, illiteracy and disease. To address HIV/AIDS, we have initiated a national program and have reinforced our efforts in the areas of information, awareness-raising, communication and epidemic monitoring, as well as in the areas of medical, psychological and social care for patients and their families. Partnership has been important, notably with components of civil society.
Ensuring safe blood transfusion, laboratory testing, and free health care for AIDS patients -- including expensive three-drug therapy -- have all been factors in a strategy that had kept cases relatively low at the national level.
At the international level, Tunisia has participated in commitments and events related to HIV/AIDS. With our belief that fighting poverty worldwide is a priority in any health or social programme, we have called for the world solidarity fund. Tunisia also supports the declaration submitted for approval by the special session and welcomes the global fund initiative. We hope that the fund's organizational structure will facilitate access of nations to funding to initiate programs aimed at addressing the disease and obtaining retroviral therapies at affordable costs.
JOSE RODRIGUEZ SOLDEVILA, Secretary of State for Public Health and Social Assistance of the Dominican Republic: AIDS in my country affects about 2 per cent of the population. The Government has established a national commission to address the problems presented by the epidemic, with participation of civil society and other partners. The high rate of poverty contributes to the problem, as well as early sexual initiation, lack of education and the subjugation of women. The vulnerable groups include the jail population and Haitian migrant workers.
The economies of both the Dominican Republic and Haiti increasingly depend on tourism and migration, which contribute to the transmission of the disease. We must reinvent the culturally appropriate forms of combating the disease; a concept of solidarity should replace the practice of blaming others. AIDS should receive priority in national plans, with respect for cultural differences and human rights.
Prevention, especially as far as high-risk groups are involved, has an important place in my country’s national efforts. Many challenges remain, including the promotion and defence of the human rights of people living with AIDS, managing of financial resources, the high cost of medicines and sexual education. On these issues we need to cooperate with the international community. To ensure access to anti-retroviral drugs at reasonable costs, it is also important to reject the position of major pharmaceutical companies. Let us create a world fund to provide solutions to the epidemic.
ULLA SCHMIDT, Federal Minister for Health of Germany: In the battle against HIV/AIDS, in international policy, the world is embarking on a new quality of partnership. This only became possible when it was generally realized that the disease was not just a public health problem, but one which spans development and economic and even security policy. The setting up of a global health fund to provide swift, targeted and efficient resources for necessary and meaningful measures in the most affected countries and regions will thus meet a very real need. I hope the setting up of a single fund will take place soon and adequately address existing problems. Germany will support it. But while this fund can contribute to solving problems, it is certainly not the solution.
Governments must also commit themselves to the fight against HIV/AIDS and assume the leadership role in their countries. This implies bringing the problems to the public and calling them by name. It also includes breaking the taboo associated with homosexuality, and dealing with the rights of women and girls as fundamental human rights, including the right to sexual self-determination. In this context, I am shocked that HIV-infected men have intercourse with very young girls -- virgins -- because they believe they can cure the disease by doing so. Prevention is only possible through comprehensive open public information, education and targeted strategies that lead to behavioural changes. Prevention also remains -- in the absence of an effective vaccine -- the best strategy against HIV/AIDS
The basic prerequisite for efficient prevention is solidarity with those affected as a humanitarian imperative. The current special session is the result and the climax of the political discussions on the epidemic. The global turning point has been recognized. We know what should be done and now the time has come to take global action. Let us take on this task together and pursue the common goal of ultimately eradicating HIV/AIDS from the globe.
JOAO BERNARDO DE MIRANDA, Minister for External Relations of Angola: The impact of HIV/AIDS has been catastrophic, above all, in Africa. Owing to the weakness of their economies, African countries are not in a position to face alone the challenges presented by the disease. The United Nations and the international community must continue to dedicate special attention to the African continent, and in particular to the areas of prevention and treatment. At the same time, there is a necessity to implement adequate national policies where civil society, non-governmental organizations, the church and the private sector as social partners of the State, can play active roles.
In Angola, the fight against AIDS constitutes one of our principal priorities. It is estimated that currently there are 160,000 persons infected. The Government's national strategic plan, to which it has allocated $33 million, is aimed at prevention of HIV/AIDS transmission, above all in the most vulnerable groups, and at reducing the negative impact of the disease on families, communities and the country. The results of the campaign against AIDS would have been more effective, however, if there were no continuation of the terrorist acts by armed groups led by Jonas Savimbi. Mr. Savimbi has the onus of responsibility to declare without delay a unilateral ceasefire, disarm and cooperate with the United Nations in restarting the processes of the Lusaka Protocol. The political, economic and social stabilization that would take place with the return of refugees and the resettling of displaced populations will permit the Government to effectively carry out the campaign against HIV/AIDS and other diseases, including malaria and tuberculosis.
The fight against HIV/AIDS will have to be won through concerted efforts by the international community. For this reason, Angola welcomed with satisfaction the initiative creating the global fund for the fight against HIV/AIDS, and we appeal to the international community to contribute to that fund. At the same time, we reiterate our support for the results of the Abuja summit. We are convinced that the special session will help the international community find the most effective paths to halt the propagation of the AIDS scourge.
ALI-AKBAR SAYYARI, Deputy Minister of Health and Medical Education of Iran: The spread of HIV/AIDS cannot be addressed in a vacuum. The moral aspect involved in and around the why and how of it all, and the established fact that irresponsible sexual behaviour has been among the key factors in the spread of the disease, cannot and should not be brushed aside. The infected individuals deserve human empathy and effective, accessible and affordable care and treatment. The question, however, is whether the international community can bring itself to the point of addressing the real causes of the pandemic and coming up with what it takes to combat it.
This brings me to the crux of the divide in the course of the negotiations on the draft declaration. The issues and concepts under discussion involve long-established fundamental ethical principles and values and cannot be subjected to a post-modern “laissez-faire, laissez-passer” mentality. Insofar as sexual relations are concerned, the imperative of moral choice, the centrality of family as the basic unit of society and responsible individual conduct are indispensable to a healthy state of relations. While remaining faithful to our Islamic values and cultural dispositions, we have nevertheless exercised a high degree of flexibility in order to arrive at a common negotiated platform of action.
Despite the low prevalence situation in Iran, a national committee to combat HIV/AIDS was set up, based on multisectoral collaboration and premised on prevention. Main activities are: providing patients and community with information; serological and behavioural surveillance; voluntary testing and counselling; blood safety; and HIV care. We believe that the success of any programme, at national, regional and international levels, depends on genuine consideration for specific national situations and circumstances, and respect for particular norms and values of concerned societies. In this context, the pivotal role of family and religious community leaders needs to be underlined. Urgent international assistance, with particular focus on Africa, can hardly be over-emphasized.
EDDY BOUTMANS, State Secretary for International Cooperation of Belgium: The epidemic of AIDS has assumed tragic proportions, and its developmental and economic consequences are enormous. Although there is no simple solution, poverty in a broad sense should be recognized as the engine of the epidemic. The plan of action of the European Commission reflects that in its framework for poverty eradication. We should be ready to reconsider the international socio-economic relations to allow the poorest countries to break out of the circle of poverty.
The awareness of the gravity of the situation has increased considerably in recent years, and the struggle against AIDS is a priority on the agenda of many international meetings. However, there is a danger of financing questionable priorities and high-profile measures. The situation calls for a multiplicity of actions, which should include prevention and treatment. Education continues to be an important area. HIV/AIDS-positive people should participate in the prevention efforts, and participation of those concerned should be a criterion in testing the effectiveness of programmes. Among others, the vulnerable groups include men having sex with men, HIV/AIDS-positive women with children, prison populations and sexual workers. The partnership among various players is not just another superstructure, but a commitment to work with different partners.
The price of anti-retroviral drugs should be addressed by the international community. The treatment of people with HIV/AIDS demands satisfactory functioning of the health infrastructure. The management of the proposed global fund should include actors from the public sector. It should be part of the global strategy on health, and it should reinforce the existing capacities. It should function flexibly and effectively, improving access to drugs. All this requires wisdom, which the cause fully merits. Money is just one aspect of combating AIDS. The role of people is of equal value. It is solidarity and ability to work together that will allow us to meet the challenge.
RUTH DREIFFUSS, Federal Councillor, Minister of Health, Social Affairs, Education and Science and Culture of Switzerland: For the Swiss Government, the battle against HIV/AIDS begins with ensuring a proper coordination at the national level allowing it to collaborate with other civil society actors. A programme to fight HIV/AIDS must dispose of adequate and long-term financial means and its
principal axis must be prevention. Preventive strategies must place an emphasis on vulnerable groups, in particular youth, young girls, intravenous drug users, men who have sex with men, migrants and people involved in prostitution.
Care, treatment and support -– along with prevention -- constitute inseparable elements for an effective response. We must persevere in our efforts to reduce the cost of medication. One can neither minimize the gravity of the problem of resistance to the virus, which may develop with use of the wrong medication, nor justify inaction by hiding behind such a fear. In many developing countries, assuming responsibility for a large number of people affected by the disease requires a reinforcement of health-care systems.
As far as specific projects are concerned, priority should be given to preventing transmission from mother to child, and we must increase our efforts in research and development of a vaccine against HIV/AIDS. Less fortunate countries will need considerably increased resources in the battle. In response to the emergency, the Swiss Government will double its multilateral contribution for HIV/AIDS-related issues in 2001, and again in 2002.
* *** *