General Assembly Plenary
Twenty-sixth Special Session
8th & 9th Meetings (PM & Night)
WITH UNANIMOUS ADOPTION OF ‘BATTLE PLAN’ FOR FIGHT AGAINST HIV/AIDS,
ASSEMBLY CONCLUDES HISTORIC THREE-DAY SPECIAL SESSION
Deeply concerned that the HIV/AIDS epidemic constitutes a global emergency and one of the most formidable challenges to human life, the twenty-sixth special session of the General Assembly this evening committed itself to ensuring that the resources provided for the global response to HIV/AIDS are substantial, sustained and geared towards achieving results.
The Assembly took that action as it concluded its three-day special session on HIV/AIDS, which began on 25 June, by adopting without a vote a draft resolution submitted by its President, Harri Holkeri (Finland), containing a Declaration of Commitment on HIV/AIDS.
By that declaration, Heads of State and Government and representatives of Member States made a further commitment by 2005 -- through incremental steps -- to reach a target of an overall annual expenditure on the HIV/AIDS epidemic of between $7 and 10 billion in low- and middle-income countries, as well as those experiencing or at risk of rapid expansion of the epidemic. It also called for the implementation of measures to ensure that needed resources are made available, particularly from donor countries and also from national budgets, bearing in mind that resources of the most affected countries are seriously limited.
By other terms of the Declaration, the Assembly supported the establishment, on an urgent basis, of a Global HIV/AIDS and Health Fund to finance an urgent and expanded response to the epidemic based on an integrated approach to prevention, care, support and treatment. The Fund will also assist governments in their efforts to combat HIV/AIDS, with due priority given to the most affected countries. Contributions to the Fund will be mobilized from public and private sources, with a special appeal to donor countries, foundations and the business community, including pharmaceutical companies, philanthropists and wealthy individuals.
The Assembly also committed itself to launching, by 2002, a worldwide fundraising campaign -- conducted by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other partners --- aimed at the public and private sector, to contribute to the HIV/AIDS and health fund.
Addressing actions to be taken at the national level, the Assembly further committed itself to ensuring, by 2003, the development and implementation of multi-sectoral national strategies and financing plans for combating HIV/AIDS
that: address the epidemic in forthright terms; confront stigma, silence and
denial; address gender- and age-based dimensions of the epidemic; eliminate discrimination and marginalization; involve civil society, the business sector and people with HIV/AIDS, vulnerable groups, people at risk, women and young people.
The Declaration goes on to state that national strategies should be resourced wherever possible from national budgets without excluding other sources such as international cooperation; fully promote and protect all human rights and fundamental freedoms; integrate a gender perspective; and address risk, vulnerability, prevention, care, treatment and support; reduce the impact of the epidemic; and strengthen health, education and legal system capacity.
In addition, by 2003, the Declaration states that there is a commitment to integrate HIV/AIDS prevention, care and treatment and support as well as impact-mitigation priorities into the mainstream of development planning, including poverty reduction strategies, national budget allocations and sectoral development plans.
Addressing prevention -- described as the mainstay of the international community's response -- the Declaration states that by 2003, there is another commitment to establish time-bound national targets to achieve the internationally agreed goal of reducing, by 2005, HIV prevalence by 25 per cent among young men and women aged 15-24 in the most affected countries, and by 25 per cent globally by 2010.
On the issues of care, support and treatment, there is also a commitment to make every effort to progressively provide in a sustainable manner the highest attainable standard of treatment for HIV/AIDS. There is also a call for constructive cooperation to strengthen pharmaceutical policies and practices, including those applicable to generic drugs and intellectual property regimes, in order to promote further innovation, and the development of domestic industries consistent with international law.
There are also commitments to improve, by 2005, the effectiveness of supply systems, financing plans and referral mechanisms required to provide access to affordable medicines, including anti-retroviral drugs, diagnostics and related technologies, as well as quality medical, palliative and psycho-social care.
According to the Declaration the Assembly, again by 2005, committed itself to implementing measures to increase the capacities of women and adolescent girls to protect themselves from the risk of HIV infection, principally through the provision of healthcare services, including sexual and reproductive health, and through prevention education that promotes gender equality within a culturally gender-sensitive framework.
In his closing remarks, the President said that despite the alarming statistics and the real human suffering they represent, out of the lively discussions and deliberations during this historic three-day special session, the feeling had emerged that there was reason for hope. Speakers in both the plenary and the round tables had emphasized that clearly, a turning point had been reached. Now the international community must reach out to those who most needed that hope, or be judged responsible for not acting when it had the chance.
(page 1b follows)
He also said that the concrete targets and follow-up mechanisms contained in the Declaration represented the first global "battle plan" against AIDS. The beauty and significance of the Declaration was its pragmatic and straightforward approach, and the global commitment to scale up efforts in all critical areas. It would serve as a tool for specific strategies to turn the tide of the epidemic. The Declaration was also the global call for desperately needed resources. In that regard, he welcomed the establishment of a global fund to finance the fight against the disease, as well as the pledges already announced by a number of countries.
Prior to the adoption of the Declaration, statements were made by the two Co-Facilitators of the negotiations on the text, Penny Wensley (Australia), Ibra Deguène Ka (Senegal) and Chairs of the sessions Round Tables, Denzil Douglas, Prime Minister of Saint Kitts and Nevis, Grzegorz Opala, Minister of Health of Poland, Abdul Malik Kasi, Minister of Health of Pakistan, and Anna Abdallah, Minister of Health of the United Republic of Tanzania (speaking on behalf of the Chairman of the Fourth Round Table, Benjamin Mkapa, President of the Republic of Tanzania).
The special session ended with a moment of silent prayer.
The Prime Minister of Niger and the Vice-President of Palau made statements this afternoon.
In addition, Ministers and high officials from Jamaica, Brazil, Saint Vincent and the Grenadines, Tuvalu, and Samoa also made statements, as did the representatives of Grenada, and Albania.
Addresses were delivered by the Director-General of the International Labour Organization (ILO), the Executive Director of the United Nations Centre for Human Settlements (Habitat), United Nations Population Fund (UNFPA), the United Nations Development Fund for Women (UNIFEM), and the Administrator of the United Nations Development Programme (UNDP).
Representatives of the International Federation of Red Cross and Red Crescent Societies, European Community, Sovereign Military Order of Malta, International Organization for Migration, Inter-American Development Bank, Commonwealth Secretariat, and Pacific Islands Forum also spoke.
On behalf of civil society, the special session heard interventions by representatives of International Community of Women Living with HIV/AIDS, International Centre for Research on Women, Global Network of People Living with HIV/AIDS, Global Business Council on HIV/AIDS, World Council of Churches, International AIDS Society, International Council of AIDS Service Organizations, and the Community of Portuguese-Speaking Countries.
Statements after adoption of the Declaration were made by the representatives of Nepal, Mexico, France and the Observer for the Holy See.
(page 1c follows)
In his opening remarks to the session, Secretary-General Kofi Annan called for frank discussion and solidarity between the healthy and the sick, rich and poor, and above all between richer and poorer nations. Spending on the battle against AIDS in the developing world, he said, needed to rise roughly five times its present level. Developing countries were ready to provide their share, but they could not do it alone. That was why he had called for a Global AIDS and Health Fund of $7 to 10 billion to help the international community finance a comprehensive, coherent, coordinated strategy. Following that appeal by the Secretary-General, a number of Member States made pledges to the Fund during the ensuing session.
High officials of many of the most affected countries, as well as those active in the struggle against the epidemic, cautioned that contributions to the Fund should be made without resulting reductions in resources for development and poverty eradication. Many speakers also warned against the Fund being used to impose conditions on developing nations.
Other issues raised over the historic three-day meeting included access to affordable drugs and putting human lives before profit; the integral link between care, treatment and prevention; the importance of implementing multi-sectoral national strategies; the symbiotic relationship between poverty and the spread of HIV/AIDS; broad societal participation in initiatives to combat the disease, including those living with HIV/AIDS; the end to stigmatization, discrimination and the culture of silence; and the importance of mainstreaming gender and human rights issues in AIDS-related policies and programmes.
During the special session 12 Heads of State, including one King, 14 Heads of Government, five Vice-Presidents, one Deputy Prime Minister and over
100 Ministers and high government officials made addresses. A total of 179 Member States and three Observer States made statements. In addition a number of organizations of the United Nations system and non-governmental organizations also addressed the session.
In last year’s Millennium Declaration (General Assembly resolution 55/2), world leaders committed themselves to halting and beginning to reverse the spread of HIV/AIDS by 2015. The Assembly, in its resolution 55/13, decided to convene the special session, including four interactive round tables, in which HIV/AIDS in Africa was the crosscutting theme. The overall themes included HIV/AIDS prevention and care; HIV/AIDS and human rights; the social and economic impact of the epidemic and strengthening national capacities to combat the disease; and international funding and cooperation to address the epidemic’s challenges.
The General Assembly met this afternoon to conclude its twenty-sixth special session on the review of the problem of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in all its aspects. For background, see press release GA/9883, issued on 25 June.
HAMA AMADOU, Prime Minister of Niger: HIV/AIDS has mobilized the world and united it in solidarity. In Niger, according to our health services, only 1.4 per cent of the population is affected. However, that number is not reassuring, as 1.4 per cent is still too much, especially considering that the country is on a migratory crossroads. The campaign against AIDS must take into account Niger’s status as a corridor of transmission from South to North. This session must not be just a succession of speeches but also a realization of the collective responsibility of States. This means that in the Declaration of Commitment each country must contribute, bearing in mind that the war against AIDS cannot afford to pass up any resources. As it is said, “it is water from small brooks that feeds great rivers”.
The Global Fund is indispensable and Niger will support it with full conviction. However, we still need strong political commitment at the highest level in all countries. We also need full accessibility for all people to the available services, and anti-retroviral drugs must be made available to all those who need it. No State can overcome this illness without help from others. Hence, the strategy to combat the epidemic must be based on cooperation. The campaign against AIDS will be financially expensive -- but it was already costing too much in terms of human lives. At this point in time, surviving with AIDS means one has to be rich or live in a prosperous country. Without the hope of a possible cure, few people would submit to HIV/AIDS testing. Niger has decided to make a symbolic contribution of $50,000 to the fund.
SANDRA SUMANG PIERATOZZI, Vice-President and Minister of Health of Palau: As all of you know, my country is one of the newest members of the United Nations. Palau is not immune from the scourge of HIV/AIDS. While the figures for infection in our country seem low compared with other countries, the impact is enormous to us. Given our small population and its slow growth, Palau cannot afford to lose any more of its citizens. Like many remote islands, Palau has limited natural resources and relies heavily on outside sources. Our number one industry is tourism. While this industry brings in needed revenue, it also brings unwanted extra baggage that puts our people at risk. Our people’s travels abroad is another revolving door adding to this risk.
From our standpoint, the best way to effectively combat the pandemic is through massive public education on prevention through safe sex. This is especially critical among young people. Our efforts at public education are often hampered by cultural barriers and limited resources. In the last few months, a young HIV-infected mother gave birth to a healthy baby. The early testing has shown that the baby is HIV-free. The new mother is doing well, and her husband has also tested negative. Our hospital was able to follow closely the protocols, keeping the mother’s identity confidential. Proper procedures were followed for delivery. This is a milestone in our medical history, but there is no guarantee that it can be repeated successfully.
We seek to dispel the stigma and isolation associated with HIV/AIDS, so that those infected can come forth without fear of ostracism. This is particularly important where an informed public could avoid further spread of the disease. Also, women and girls bear a disproportionate share of the HIV burden. Women are central to prevention and treatment plans, as well as to finding sustainable solutions to the situation. I appeal to all to ensure gender equality in strategies to address HIV/AIDS.
JOHN JUNOR, Minister of Health of Jamaica: In the Caribbean, the region most seriously affected by HIV/AIDS after sub-Saharan Africa, AIDS has become a major threat to the most productive segment of the population, the 15-44 age group. Because of that, there is a strong chance that it will undermine the productive capacity of crucial sectors such as education, health, agriculture and business. In Jamaica, 1-2 per cent of the adult population is affected, with a high fatality rate which has orphaned an estimated 2,000 children.
In response, the Government has undertaken comprehensive measures to strengthen healthcare services and has intensified its prevention campaign, along with a programme to reduce mother-to-child transmission. We have also worked within Caribbean regional programmes. We have succeeded in maintaining a lower infection rate than predicted in early projections, but there is still urgent work to be done.
For that reason we welcome the proposed establishment of a global fund, and hope that it will not be subject to bureaucratic impediments. There are no alternatives to acting decisively to promote prevention, to ensure cheaper access to drugs and healthcare, and to respect the rights of those living with the disease.
JOSE SERRA, Minister of Health of Brazil: As far as prevention is concerned, a wide range of measures has proved successful, including: universal access to condoms; women’s empowerment; programmes relating to mother-to-child transmission; strategies directed to the most vulnerable, high-risk groups and the inclusion of issues related to HIV/AIDS in school curricula. In Brazil, these policies have yielded excellent results, allowing us to control the transmission rate. The number of people living with HIV/AIDS now amounts to less than half of what estimates used to predict.
Our integrated approach to prevention and treatment was essential in reaching this success. Because of our policy of ensuring free and universal treatment, the population feels encouraged to accept voluntary and confidential testing, improving notification of AIDS in earlier stages that otherwise would be hidden. Since 1996, when the efficacy of the anti-retroviral therapy was proved, every Brazilian living with HIV/AIDS has had free access to the therapy. Nowadays, almost 100,000 people are taking these drugs in Brazil. The death rate has fallen by approximately 50 per cent. Hospitalizations saw a 75 per cent drop. The epidemic has been stabilized and our public health services are much less overburdened.
The reason for the affordability of our policy is local production of drugs. Brazil produces eight generic versions of non-patented anti-retroviral drugs at low cost. Another essential factor in combating HIV/AIDS is strict respect for human rights.
DOUGLAS SLATER, Minister of Health and the Environment (St. Vincent and the Grenadines): St. Vincent and the Grenadines adds its voice to the chorus of nations calling for a collaborative approach to combating HIV/AIDS, a disease that is now dominating many national agendas as both a health and developmental issue. Increased poverty is among the many uniquely devastating effects of the spread of a disease which has reversed global development achievements and eroded the ability of governments to provide and maintain essential services. Reduced labour supply and productivity are also serious side effects of the spread of the virus. Indeed, the breadth of the HIV/AIDS pandemic continues to make a mockery of the well-intentioned objectives and recommendations of the Millennium Declaration.
It is well-known that the Caribbean region is second only to sub-Saharan Africa in HIV infection rate. While I won't repeat the statistics, the entire region faces a gloomy future if transmissions continue at their current pace.
St. Vincent and the Grenadines accounts for 50 per cent of new reported cases. The impact of the virus has been similar to that of other small developing countries: our scarce, invaluable human resources have been depleted as persons whose skills and expertise cannot be easily replaced have died. Our women of child-bearing age are most at risk. It is also thought that half of the new infections occur in young women under 25.
An ounce of prevention is worth a pound of cure, and we must continue to educate our populations with timely information so that they can engage in the best practices possible. In St. Vincent and the Grenadines we have confronted that issue head on by continuing our educational programmes involving non-governmental organizations (NGOs) as well as community-based and cultural organizations. Within our limited resources, our Government is currently proposing that treatment be provided to HIV/AIDS infected persons. But the cost of medicine must not jeopardize our efforts to reduce the spread of the disease.
In countries like ours, whose natural beauty makes it inviting for tourists, there is a tendency to avoid openly discussing serious health-related issues such as HIV for fear it would have a negative effect on our economies. But we believe that the opposite is necessary: we must exhibit a renewed vigour in informing our citizens and visitors to our shores of the danger of AIDS.
AMASONE KILEI, Minister of Health of Tuvalu, on behalf of the Pacific Islands Forum Group (Australia, Fiji, Federated States of Micronesia, Marshall Islands, Nauru, New Zealand, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Vanuatu and the observer delegation from the Cook Islands): As this is Tuvalu’s maiden statement since joining the United Nations last year, please allow me to reaffirm Tuvalu’s confidence in the Organization’s ability to safeguard the fundamental rights and survival of members of the international community, particularly the most vulnerable. The incidence of HIV/AIDS is still relatively low in the Pacific, but our countries face particular challenges in preventing the spread of the disease, such as accessibility problems and overstretched health and education systems.
We are among the many Pacific Island nations that have already taken steps to prevent the spread of HIV/AIDS. We realize the need to involve all sectors in that regard, along with the need for regional strategies. We believe that the presence of UNAIDS in the Pacific must be maintained, with its priorities reviewed. Prevention activities must be culturally sensitive, and need to take into account the diversity of vulnerable groups, with unflagging respect for women’s rights. Safe blood supplies present a particular challenge in our region because of its reliance on “walking blood banks”.
We welcome the Global Fund and express appreciation to those who contribute, and request that Pacific Island nations be assisted in their efforts to ensure that the current low rate of HIV transmission and infection is contained and ultimately eradicated. Time is of the essence. We have great expectations for the Declaration of Commitment in the struggle against this pandemic.
ABDULMEJID HUSSEIN (Ethiopia): In response to the AIDS epidemic, my Government, with its limited financial and trained human capacity, has taken several measures. Anti-AIDS campaigns were launched in various governmental ministries and other parastatals; the mass media has raised public awareness; and anti-AIDS camps have been established in schools. Also, a national HIV/AIDS policy was launched in 1998 with the overall objective of providing an enabling environment for the prevention and control of HIV/AIDS.
The HIV/AIDS pandemic is simply, without qualification, the greatest existing threat to humanity in general, and Africans in particular. Our point of departure in combating the disease must be an appreciation of the fact that while AIDS is a disease that infects and kills human beings, it is also a societal disaster. The crisis is crying out for political leadership with vision and compassion.
We have no choice other than to begin acting now. This special session is an important and laudable step towards ensuring that the anti-AIDS agenda is taken with due seriousness globally. Let us make sure that this is not a one-off event, and that the momentum generated at Abuja, Nigeria, last April is sustained. We must ensure that the youth and children of Africa and the world live in communities that are no longer plagued by AIDS.
LAMUEL STANISLAUS (Grenada): HIV/AIDS is a global crisis and world leaders have come together to try and formulate strategies to combat the pandemic. If we mobilize, forging a partnership for action that includes regional, national and local governments, as well as NGOs, private and corporate actors, humankind will be spared the scourge of this baffling disease. Many HIV victims have found themselves in this life-and-death struggle through no fault of their own -- poverty, underdevelopment and illiteracy also contribute to the spread of the disease. The most chilling side effect of the spread of this debilitating disease has been the wholesale devastation of the family unit in many regions of the globe.
The Caribbean is second only to sub-Saharan Africa in HIV prevalence rate and mortality. AIDS is now the leading cause of death in the region for those aged 15 to 45, and the number of deaths is practically doubling every year. Grenada is no exception. While our country is small, and the number of overall cases of infection is reflective of the country's size, when you consider that more than 75 per cent of the diagnosed cases are dead within two years, it becomes clear that we have a serious problem similar to some larger nations. Prevention, treatment and care are sadly lacking, mainly due to the scarcity and high cost of medication.
Monitoring mechanisms for sexually transmitted diseases (STDs), particularly HIV, are very limited in Grenada. Our National AIDS Programme is hampered by lack of cooperation in its efforts at contact-tracing and partner referrals for counseling and treatment. The issue of confidentiality is also a major concern, and as a result, people who are HIV-infected are often hesitant to come forward for fear of exposing themselves to discrimination and prejudice. Grenada's AIDS Programme, which includes education, counselling and advocacy, is actively working to combat the disease on all fronts, but it needs financial assistance in order to be able to do more. The way forward for Grenada and all nations would be to meticulously follow the principles of the draft declaration on AIDS.
AGIM NESHO (Albania): Since the fall of the totalitarian regime, our country is coping with many economic challenges and social problems common to a free society. The total number of AIDS cases registered in the country between 1993 and 2000 amounts to 52. Thus, Albania is among the countries with a low prevalence of HIV/AIDS, but there is a tendency for growth. To deal with the danger, Albania has made serious efforts to put in place a national strategy to fight the disease, which aims to create a strong partnership between the Ministry of Health and non-governmental organizations, with the technical and financial support of international agencies.
We have held two national conferences on prevention and control of the epidemic. The national programme of action is aimed at prevention, and the provision of services to diagnose, treat and support the persons at risk and those living with the infection. The implementation of these objectives is based on the strategic elements of political commitment, preventive measures, surveying, monitoring and research. Recently, the Parliament has adopted the law on the prevention of the spread of the epidemic.
NAMALAUULU NU’UALOFA POTOI, Director of Public Health Services of the Health Department of Samoa: We have heard poignant and moving accounts of the sufferings, anguish and losses of each and every country represented at this special session, particularly from those regions that are seriously afflicted. These were not easy to listen to, yet this is the reality we are faced with today: so many lives lost to an insidious disease that knows no boundaries, and respects no race, religion, creed or gender.
The fact that the prevalence of AIDS is low in Samoa is not a reason for complacency on our part. To prevent further spread of HIV/AIDS in Samoa, we must address the challenging realities brought about by the pandemic. My Government has developed its national prevention and control programme, aiming at detection and public awareness of the causes of HIV/AIDS. While prevention remains central, care is also important, and the Department of Health is the national focal point for HIV/AIDS management and control.
All present here today are fully cognizant of the behaviours that present the greatest risks of transmission and infection. In Samoa, our culture is central to our way of life. We have a strong affinity to our land and sea, based on our love for our values and strong Christian principles. It is through this bond that we are able to promote healthy and responsible sexual lifestyles and to have a successful, collaborative partnership with all key stakeholders, including our churches, village councils, women’s and youth groups and NGOs. We also welcome the establishment of the Global HIV/AIDS Fund, timely access to which would be pertinent to our prevention and care efforts.
ASTRID N. HEIBERG, President of the International Federation of Red Cross and Red Crescent Societies: It is in the communities that the battle against HIV/AIDS is going to be won. This is where we, the volunteers, help families and communities to care for their own members. That is where we use our unique network to promote prevention because we are part of the communities.
We have made a commitment to reduce the stigma associated with HIV/AIDS. Looking at ourselves, at our own attitudes and prejudices, is the first step in the fight against discrimination. We are not free from it. We must state clearly that there is no room for discrimination in the Red Cross Movement, that we will not tolerate any attempt to restrict or exclude people living with HIV/AIDS.
We call on governments to build partnerships with National Red Cross and Red Crescent Societies and with other members of civil society to protect and care for people living with HIV/AIDS. We look to the United Nations agencies for partnerships, so that our joint actions help combat the pandemic. With the private sector, we seek alliances to provide access to affordable treatments, and to protect employees.
JOHN B. RICHARDSON, Head of Delegation of the European Commission, speaking on behalf of the European Community: The statistics presented in recent days show convincingly that the world cannot ignore the AIDS epidemic. In developing countries, where 90 per cent of all HIV infections occur, AIDS is reversing hard-won gains in improving the quality of life. The average life expectancy in developing countries, on the increase since the 1950's, is now tumbling again. Last year in Africa, 10 times as many people died from HIV/AIDS as were killed in conflicts.
In contrast, we in Europe are fortunate to be alive at this moment in history. Never before has our world enjoyed so much prosperity with so few external threats. Global society is calling on the international community to recognize the magnitude of the problem and lend its support in combating it. This is the hour of global solidarity. The West must increase its efforts to help more nations and people break the vicious cycle of disease and poverty. Europe is fully committed to further stepping up its efforts to face this epidemic, and to increase its support for the fight against the three major communicable diseases –- HIV/AIDS, malaria and tuberculosis -- which kill more than five million people each year, especially the poorest of the poor.
The international community must help remove roadblocks such as ignorance, gender inequality, denial, discrimination, lack of resources, and the lack of credible investment in the development of preventive methods. The overarching international development goal of the Millennium Declaration, to reduce by half the number of people living in extreme poverty by 2015, cannot be achieved without greater investment in health. To achieve these goals will require far higher levels of investment than in the past. More can also be done on prices of products and development of new vaccines through innovative approaches and partnerships. The European Commission calls for a much broader application of effective global tiered pricing for the benefit of the poorest countries. It also underlines the importance of global rules on intellectual property rights in promoting investments in new medicines, and especially vaccines, in order to render prevention efforts more effective. It is also our intention to increase significantly our financial support for research and development.
ROBERT L. SHAFER, Observer for the Sovereign Military Order of Malta: We must have clear, feasible strategies to protect and help infected individuals, with special regard for the most vulnerable groups in our societies. Assisting the sick and the suffering has been the special focus of our Order. Prevention of infection is a needed long-range solution to the crisis. Public education must be a component of that solution, along with medicines and treatment.
While prevention is critical, the only definitive means of eliminating AIDS is through development of a vaccine. The heaviest concentration of AIDS in poor nations has impeded the process. We must call upon the governments of developed countries to increase funding for AIDS research and facilitate vaccine development.
Resources allocated thus far are insufficient to develop vaccines and preventive treatment for all those who need it. We are convinced that global strategy -– planned, programmed, and coordinated with the support of all in the decision-making process -— can be the most effective way to combat the present danger. We are eager to participate in this first step toward the definitive eradication of HIV/AIDS. The United Nations must take the lead in drawing that plan together, so that it may be a clear call for all nations and peoples of good will.
NDIORO NDIAYE, Deputy Director General of the International Organization for Migration (IOM): Tragically, many of the conditions surrounding the millions of migrations each year are connected to factors that increase migrants’ vulnerability to HIV. Among them are marginal occupations, loneliness, and involvement in commercial sex. Women are particularly at risk in various ways. In addition, victims of trafficking in human beings have little control over what happens to them.
Governments, non-governmental organizations, and groups of migrants in every country are working to reduce the HIV vulnerability of mobile populations. For awareness-raising, for example, the IOM is using sports events. The IOM is also reaching out to women and girls vulnerable to the traffic in sex workers.
National projects are important, but not sufficient, because people move across borders. For that reason, regional programmes must be expanded. The needs are great. Data must be gathered, people must be trained and public health delivery must be made mobile. Since it is a global issue, the IOM welcomes the creation of the Global Fund, and believes that such a fund must help counter the special vulnerability of migrant populations.
K. BURKE DILLON, Executive Vice-President, Inter-American Development Bank: Prevalence levels in the Caribbean are the highest outside of sub-Saharan Africa, and in Central America the epidemic is growing rapidly. How can the Bank help? The Bank can facilitate the regional dialogue on HIV/AIDS, it can provide technical assistance, and it can lend. There is still work to be done in our region to raise awareness and increase information about HIV/AIDS. At the same time, some of our countries have made important progress in the fight against AIDS, and these best practices must be shared.
The Bank can bring together governments, NGOs, the Networks of People Living with AIDS, labour, religious leaders and the private sector. We work with most of these groups regularly. We stand ready to help our governments and civil society facilitate dialogue at the local and national levels. In March 2002, at our Annual Meeting in Fortaleza, Brazil, the Bank will host a major seminar on HIV/AIDS.
However, as a development bank, our main contribution in the fight against AIDS will be through our technical assistance and lending. For our poorest member countries, we can lend on very concessional terms. One area where we have extensive experience is the strengthening of national health systems. This is critical to an effective response to AIDS. To date, we have lent almost
$2 billion to make national health systems more effective and efficient.
ROSEMARIE PAUL, Commonwealth Secretariat: HIV/AIDS is a common challenge, perhaps the greatest so far faced by Member States. It stretches across the globe, with the vast majority in developing countries in Africa, Asia and the Caribbean. The 54 Commonwealth countries represent approximately 30 per cent of the world's population, but carry a disproportionate 60 per cent of the world's HIV/AIDS burden. In 1999, the Commonwealth Heads of Government, at their meeting in Durban, declared HIV/AIDS to be a global emergency and called upon all sectors to mount a coherent and concerted response. They personally pledged to lead the fight.
Since the Durban meeting, the Commonwealth Secretariat has been steadily working to assist member countries in obtaining maximum benefit from readily available resources and to leverage additional funds to combat HIV/AIDS. The global call to action has been sounded, and strategic action areas have been defined and agreed. The Commonwealth Secretariat will continue to work with partners, with and for the member countries. Within the parameters of the agreed global and national plans, it will identify its particular and specific niches, and collaborate with all, using the special advantages that mark the Commonwealth fraternity to achieve synergies for the common good.
JIMMIE RODGERS, Deputy Director General, Secretariat of the Pacific Community: Never before in the history of humanity have we faced so formidable a foe. Never before has humankind's right to exist been so threatened. If nothing is done to halt the rapid transmission of this deadly virus, some countries could be devoid of their entire populations within the next two to three decades. Nothing we have come up against can compare with the destructive nature of HIV/AIDS. Plagues, war and pestilence have specific geographic boundaries and can be contained. HIV/AIDS, on the other hand, has no boundaries.
For the small developing island countries and territories of the Pacific region, the impact of an uncontrolled rapid transmission of the HIV/AIDS virus would be disastrous. The region comprises 22 island States and territories. Collectively, they have a population of just 8.5 million people, and a total land area of just over half a million square kilometres scattered over some 33 million square kilometres of ocean. To put those dimensions into perspective, the whole of Europe can fit into the Exclusive Economic Zone of French Polynesia alone, with room to spare. Despite its size, vision and foresight are not lacking. Many Pacific island countries have already developed nationally integrated, multi-sectoral strategic plans to contain HIV/AIDS. In many of these strategies, NGOs, churches, and civil society groups are very important ingredients of service delivery and outreach activities.
Like all participants, the Pacific island countries and territories come to this special session with great expectations. We welcome the establishment of the Global AIDS Fund and hope that access to it will be easy, timely and fair. The extent of the epidemic should not be the only determining factor for access to the fund. Rather, a country's vulnerability and its potential to arrest or exclude the epidemic at relatively low cost should be among the criteria. But prevention remains the main strategy. While the rates of infection in the Pacific are relatively low by world standards, they are very high by Pacific standards. For us, the fight against HIV/AIDS must take on a new recognition that it is not just a simple health issue.
JUAN SOMAVIA, Director General of the International Labour Organization (ILO): ILO’s commitment to be a partner in the challenge of HIV/AIDS stems from its social mandate in the field of rights at work, as well as the threat posed to its primary goal of providing men and women with decent work in conditions of freedom, equity, security and human dignity.
Our initial response to the challenge is a Code of Practice on HIV/AIDS and the world of work, formally launched here last Monday. It represents a balanced approach to the problems of discrimination, confidentiality, employee benefits, care and treatment and other AIDS-related workplace issues. Hard-won gains in terms of employment and social protection are being reversed because of this epidemic. Through our programme on HIV/AIDS, we will work with our tripartite constituents at national and regional levels to promote prevention in the workplace, and mitigate the social and economic impact of the disease.
In addition, ILO will expand its efforts to address the needs of children orphaned by AIDS and forced into the world of work, and gender dimensions will be addressed through the relevant ILO framework. We have become a co-sponsor of UNAIDS in order to put ILO’s unique tripartite structure and doctrine of social dialogue at the service of this global struggle. We must all make the Declaration of this special session work.
ANNA KAJUMULO TIBAIJUKA, Executive Director of the United Nations Centre for Human Settlements (Habitat): The recent special session of the Assembly to review the outcome of the Conference on Human Settlements (Habitat II) adopted a declaration which, among other things, resolved to formulate and implement appropriate policies and actions to address the impact of HIV/AIDS on human settlements. It also recognized the problem of accessing financial resources for housing by AIDS victims, and the need for shelter solutions for accommodating them, especially the orphans and the terminally ill.
Poor living conditions, including overcrowding and homelessness, undermine safety, privacy and efforts to promote self-respect, human dignity and responsible sexual behaviour. Young girls living in overcrowded conditions are most at risk, and quite a number have been subjected to incest, rape and associated HIV infection.
Housing and adequate living conditions have been established as critical in the success of care and treatment for HIV/AIDS. Moreover, homelessness or unstable housing belong to the biggest risks for continuous care. Individuals who are struggling with housing issues are often in and out of care, as other more pressing needs compete for their time and attention. Supporting developing countries in access to anti-retroviral drugs, as well as requisite supportive housing and services, is now a global public good.
THORAYA A. OBAID, Executive Director, United Nations Population Fund (UNFPA): In the worst-affected countries, the pandemic has threatened to destroy entire generations. Today, we are striking back. Today, AIDS has brought us together, and unity offers the only hope for success. The negotiations have been long and difficult, but all differences were set aside for one goal -- to say yes to prevention, care and treatment.
The UNFPA is one of the seven co-sponsors of UNAIDS, which is one of the success stories of inter-agency cooperation. For UNFPA, our area of comparative advantage is prevention. We have worked with governments and civil society to help provide health and reproductive services, including prevention and treatment of HIV/AIDS. We are putting HIV/AIDS in a health context, which includes other infectious diseases. We are also concerned about putting it in a development context.
Women are increasingly the victims of this disease, due to discrimination and the lack of resources. They need information and resources and have to be empowered to say no. Experience shows that men need to be further engaged in dialogue and educated. When it comes to adolescents and young people, it might be difficult to talk about sensitive topics, but cultures become stronger when they learn to adapt to change. All of our different cultures have common elements -- the most important is the value of knowledge. Ignorance is our worst enemy. When armed with information, young people will make the right decisions. From experience at the country level, prevention works best in the context of partnerships. With our emphasis on prevention, the UNFPA is on the forefront of the battle against HIV/AIDS.
MARK MALLOCH BROWN, Administrator of the United Nations Development Programme (UNDP): In the closing hours of this special session, we can all accept that we are facing the most devastating global epidemic in modern history. We must focus on three chief objectives: preventing new infections and reversing the spread of the epidemic; expanding equitable access to new HIV treatments; and alleviating the impact of AIDS on human development.
To succeed we must mobilize all elements of society, from international organizations to political leaders, from businesses to foundations and civil society groups. Preventing the spread of AIDS requires strong political leadership, driving a range of initiatives, including sex education, public awareness campaigns, programmes in the workplace, mobilization of religious and community leaders, action to mitigate the impact of poverty, support for orphans and allocation of resources to cope with the crisis.
The estimate for an adequate global response to the epidemic in low- and middle-income countries is $7 to 10 billion annually. There must also be increased development assistance and deeper debt relief. As part of the UNAIDS coalition, UNDP is committed to helping ensure we achieve real and measurable results in all these areas.
We cannot ignore the tragedy within our own ranks. It is estimated that at least 3,000 United Nations staff and their dependents are currently living with HIV/AIDS. As head of United Nations Development Programme, I have now committed to ensure that all international and national regular staff shall have access to the new treatments, regardless of duty station. They are fully covered by our health insurance schemes. I challenge other international employers to do the same for their staff in AIDS-affected countries.
NOELEEN HEYZER, Executive Director, United Nations Development Fund for Women (UNIFEM): The outcome for women and girls of this historic meeting can be summarized in four overall points. First, the threat that HIV/AIDS poses for women and girls, especially the young, and the more onerous effects of the pandemic on women’s lives and futures have now become undisputed matters of fact.
Second, there is a fast-growing understanding that gender inequality and power imbalances between women and men in every society heighten women’s vulnerability to infection, leaving them with heavier burdens when HIV/AIDS enters households and communities. At the same time, the world is gradually acknowledging that because of their sex, women and girls have more limited access to HIV/AIDS-related information, prevention, treatment, care, support, commodities and services.
Third, despite encouraging new levels of awareness that gender plays an aggressive, predominant role in spreading the virus and worsening its impact, consciousness does not lead automatically to commitment. Fourthly, as we speak here today, a promising global Fund is under construction –- a clean slate on which we can inscribe the lessons learned from the two decades of HIV/AIDS. If the gender issues highlighted this week are adequately addressed at this new starting point, and if the international community involves women equally in the design of the Fund and the decisions about its mechanisms, operation and allocations, we will have learned from history, and will not be doomed to repeat it.
A gender-sensitive Global Fund provides an unparalleled opportunity to design and reformulate international cooperation that will assist all countries to explicitly address gender inequalities, and in so doing, to halt the spread and soften the social and economic impact of HIV/AIDS.
BEATRICE WERE, Key African Contact of International Community of Women Living with HIV/AIDS: As a mother who has lived with HIV for five years, I would like to convey the experience of women in this situation. We face dilemmas in bearing children, breast-feeding, getting access to health care, dealing with legal rights, and rights to own or inherit property. All these dilemmas increase our vulnerability.
A person who is not supported or accepted can be a great liability; a person who is accepted or supported can be a great asset. We believe in self-empowerment of women with HIV. For this reason, I am dismayed by the omission of women with HIV from the majority of delegations. In order to understand their plight, they must be heard.
These negotiations are not about mere statistics. As you deliberate, remember you are talking about the lives of millions of women who are battling this virus. It is this reality that I bring here today. We call for your support and for the inclusion of women with AIDS at all levels of this struggle.
GEETA RAO GUPTA, President, International Center for Research on Women: This session and the pandemic has taught us five key lessons, which we must draw on to define our priorities as we move forward. First, we have learned that prevention, treatment, care and support are mutually reinforcing elements of an effective response to the epidemic.
Second, there can be no debate after this session about the role that gender inequality plays in HIV/AIDS. Gender inequality fuels the pandemic. Let us resolve that we will invest in girls and women because it is the right thing to do. We have also learned that we cannot hide behind a shroud of silence with regard to sex and sexuality and its role in the spread of this epidemic. Many countries have learned the hard way the cost of supporting a culture of silence and stigma surrounding sex –- by losing lives.
Third, we have learned that as adults, parents, decision-makers and experts, we must do all we can to empower our children and youth in this epidemic. Finally, we learned that to combat this epidemic, we need cooperation and collaboration, and a sharing of resources.
JAVIER HOURCADE BELLOCQ, Secretary-General of Latin American Network of People Living with HIV/AIDS (speaking for the Global Network): Between the first draft of the Declaration of Commitment and the text we are about to sign, there have been improvements. There were additions to reflect the concerns of various participants. Some of the more vital aspects have been left out. Everything that was omitted for fear of hurting national sensitivities of some countries contributes to the weakening of the final document.
The Declaration will be signed, and every country will have to confront the situation. The challenge is to go from words to action, from consensus to leadership. Together, we will be able to judge if we have made progress with our initiatives. We must stress the urgency of promoting universal access to treatment. We must reduce the grotesque difference between those with treatment and those who will die of AIDS without such access. Those who live with the disease are not part of the problem -– we are part of the solution.
WILLIAM ROEDY, President of MTV Networks International and Chair of the Global Business Council on HIV and AIDS: The business response to AIDS has gained momentum in the last few days. Previously, while there had been a broad range of good quality responses, they did not match the magnitude of the epidemic and the capability of business. Business has unique strengths that can be used to fight AIDS, including global and local leadership, marketing expertise, media outlets, distribution and supply channels, organization and infrastructure and, most importantly, people. Simply put, we have the potential to reach every human being on earth.
Businesses should use their particular expertise where applicable. MTV, for example, should communicate with young people. We should also take responsibility for our employees. Also, business leaders around the world must join local business councils. We must not tolerate complacency and we must form partnerships with governments.
Members of the Global Business Council want to work with every government represented in this room today. We ask that you bring us into your policy discussions, include us in all activities, use us and challenge us. Your leadership will be invaluable, especially if you endorse our initiatives, including workplace programmes and national business councils. Let us not get held back by cultural differences. Businesses should be utilized for their ability to act, and we pledge to be leaders in this fight.
CHRISTOPH BENN, Commission of the Churches on International Affairs of the World Council of Churches: We must fight HIV/AIDS, and not its victims. All persons affected by the disease should be accepted in their communities and provided with the treatment and care they require. The churches in those communities are committed to making that possible. The particular risks of women should be addressed in the areas of prevention, care and treatment, and the factors leading to their inequality should be eliminated.
Proven methods of preventing HIV/AIDS, such as abstinence and the use of condoms, should be supported and promoted. Harmful beliefs, practices and traditions, within churches and societies, which increase the risk of HIV/AIDS must be challenged. We realize that governments at all levels have the primary responsibility to protect public health.
The international community can take this opportunity to build on the resources of faith-based organizations. Governments alone will not be able to launch the approach necessary to address this problem decisively. This session should lead to broad-based cooperation. Given such cooperation and the necessary resources, we can make a tremendous difference in the fight against HIV/AIDS. We wish to express our sincere commitment to working within our own communities for the dignity and rights of all those living with HIV/AIDS, for an open atmosphere of dialogue, and for strong advocacy to mobilize the necessary resources. Together we can overcome.
N.M.SAMUEL of the International AIDS Society: We need to stop the spread of HIV and use the scientific insights already in our possession to do that. For the last 20 years, we have focused our attention on prevention alone in the developing countries. From now on, let us focus on prevention that includes care. As a doctor, I know that we have treatment strategies for HIV/AIDS. Making drugs available to the infected individuals is a basic human right. It is our responsibility to provide appropriate treatments for people under our care.
Whether the patients are in Africa, Asia or South America, the message is clear and loud: we need to provide anti-retroviral therapy as part of the care for patients infected with HIV. We need to allocate additional resources both at the national and international levels for the care of the infected.
The International AIDS Society has more than 12,000 members in over
120 countries and includes scientists, healthcare and public health workers engaged in HIV/AIDS prevention, control and care. We are committed to bringing the new scientific advances to the centre stage of public health. We need to use the currently available strategies to interrupt the HIV transmission. The only tools that are available at present are the anti-retroviral drugs. These are pivotal in reducing the transmission and in improving the quality of life of men, women and children. There is an urgent need to explore alternate treatment strategies appropriate for developing countries. There is another urgent need not to delay treatment until the perfect situation develops.
RICHARD BURZYNSKI, International Council of AIDS Service Organizations: If we are to turn back the tide of AIDS, if we are to reverse HIV infection rates, if we are to save the lives of millions of people, if we are to have any effect on this pandemic at all, we cannot shy away from being very specific about the groups who are the most vulnerable to infection, who need to be educated about prevention, and who need care and treatment. You have decided that you cannot name them -– I can. They include men who have sex with men, injecting drug users and their sexual partners, and sex workers and their clients.
Religious beliefs and cultural practices cannot impede the progress we have made thus far. Governments that place religious tenets above a candid and comprehensive response to the epidemic are committing an egregious sin. No god, in any religion, in any culture, could countenance the death and devastation this disease has caused. It is up to us, not to any deity, to stop this thing now.
You, the governments of the world, must act to mobilize the resources needed through whatever mechanism is most efficient. If that mechanism is the much-talked about Global Fund, I urge you to include civil society in the governance and administration of the Fund, and in its monitoring and evaluation. You must do all you can to ensure that the money from the Fund goes directly to the community groups who need it most, and who know best how to spend it.
DULCE MARIA PEREIRA, Executive Secretary to the Community of Portuguese-Speaking Countries (CPSC): The members of our inter-State organization -- Mozambique, Brazil, Guinea-Bissau, Angola, Sao Tome and Principe, Cape Verde and East Timor -- are all affected by the HIV/AIDS epidemic to various extents, with those in Africa among the most heavily affected in the world. In Angola, for example, it is estimated that over the next eight years 1 million new cases of HIV/AIDS will occur.
In response, the Community has agreed on pilot projects in its member countries as a support policy to fight the disease along with other sexually-transmitted diseases. It has also created a common fund and acted as a partner of the Organization African Unity in carrying out its plan to fight epidemics and infectious diseases.
It is shameful that existing medicines are not available to all who need them. A large part of the money used for wars and guns would be far better used in saving lives and providing a better quality of life toward our people. We are committed to directing resources to the developing countries in order to enable them to fight HIV/AIDS. Such resources must be given as “soft loans” and must not impact, in a negative manner, on their debt situations.
DENZIL DOUGLAS, Prime Minister of Saint Kitts and Nevis, Chairman of Round Table 1 on prevention and care: The round table was a lively and interactive discussion that brought out many issues to be addressed in order to scale up and expand prevention and care initiatives to a level that will impact significantly on the HIV/AIDS epidemic. Many speakers echoed the notion that prevention and care are inseparable and mutually reinforcing integrals of a holistic response to the disease. Delegates felt that there was a need to respond to the various scenarios of the epidemic, taking on board the various socio-cultural and economic situations of various communities. There was a need to address issues ranging from immediate preventive methods, such as abstinence and condom use, to long-term behavioural change, including efforts to empower women to say no to unsafe sex and to protect children from infection.
The critical need to empower communities to fight HIV/AIDS was echoed, as well as the need for effective leadership at all levels. Involvement and empowerment of civil society, particularly people living with AIDS, was stressed as a key component of an effective response. Concern was expressed about the role of poverty in fuelling the spread of the virus. Many delegates called for the Global Fund to fight the disease to be established as soon as possible. Interventions must be culturally sensitive and responsive to the needs of various groups, including women, youth, orphans and other vulnerable groups, and must strive to build a social fabric necessary to deal with the epidemic.
Very strong appeals were made to the international community and the pharmaceutical industry to provide the necessary resources and commodities, as well as to help build the infrastructure and capacity needed to combat HIV/AIDS in highly-affected countries. Delegates also emphasized the need to set up investments and research into HIV vaccines, especially those relevant to the strains found in developing countries. It was felt that advocacy efforts must be intensified to increase awareness, political commitment and resources for combating the disease and dealing with stigma, gender inequalities and other factors contributing to the epidemic.
GRZEGORZ OPALA, Minster of Health of Poland, Chairman of Round Table 2 on the relationship between human rights and HIV/AIDS: I would like to share my deep conviction that the round table gave participants the opportunity for truly open and creative discussions. There was clear and broad agreement that respect for and promotion and protection of human rights are vital for a successful assault on HIV/AIDS. Respect for human dignity must be at the core of our actions. The need for accountability at all levels was raised by governments of the international community, not only for what we do, but for what we neglect to do.
There are four aspects of the human rights based approach to the HIV/AIDS pandemic. First, respect for human rights is vital to prevent the further spread of the disease. When human rights are respected, people are able to better protect themselves from being infected. In addition, a society respecting human rights offers more efficient protection to those who are not infected. Second, respect for human rights empowers individuals addressing social, cultural and legal factors, thus reducing their vulnerability to infection. Fourth, respect for human rights allows individuals and communities to better respond to the epidemic. They are able to act effectively by organizing themselves and accessing relevant information for prevention and care. Many delegations indicated that it was time to break the silence around AIDS, calling for open and blunt public discourse about the factors that allow the disease to thrive, how it is transmitted and who is affected. Only by breaking the silence will problems and challenges be addressed and effective solutions found.
Participants indicated that there is a vital link between effective and sustainable response to the HIV/AIDS crisis and respect for all human rights, especially those that guarantee non-discrimination, gender equality and the meaningful participation of affected and vulnerable groups. Overall, the human rights message is a positive one. Many participants underlined that protecting the rights of people with HIV/AIDS means treating them not as victims but as bearers of rights. Many spoke of how HIV/AIDS impacts on a series of rights, including the right to the highest attainable standards of physical and mental health, to privacy, to freedom of expression and to development. They also noted that the protection of intellectual property rights was important, but it should not override enjoyment of human rights, especially the right to adequate access to medication and care.
ABDUL MALIK CASI (Pakistan), Chairman of Round Table 3 on the socio-economic impact of the epidemic and strengthening of national capacities to combat HIV/AIDS: All participants underscored the need for urgent collective global action against HIV/AIDS and expressed their keenness to evolve a common strategy to prevent and combat this unprecedented threat to humanity. Country representatives described their national and regional programmes and strategies to fight the epidemic and reduce its socio-economic impact. It was generally agreed that each country had to devise its own preventive and combative strategy and implement goal-oriented policies. International involvement should be limited to advancement and to making available adequate resources for affordable and sustainable treatment and medicine.
Participants agreed that HIV/AIDS and poverty were closely linked and that poverty-reduction must, therefore, be an integral part of the campaign against the epidemic. Debt relief and increased flows of official development assistance (ODA) were essential to that effort, and more information was sought about the operation of the recently established global fund. Participants also stressed the need for education and information, including value-based information, to change the behaviour of young people and provide social support for people living with HIV/AIDS. One speaker suggested that faith-based organizations could play an important part in those efforts. Emphasis was also placed on broader access to healthcare and treatment, including counselling and testing, prevention of mother-to-child transmission, and management of related diseases and infections. Health care infrastructure also needed to be strengthened.
Some speakers introduced the concept of social capital, which was defined as a network of shared values that strengthened the social fabric and in which societies must invest. Participants agreed on the need to place emphasis on vulnerable social groups, including the poor, orphans, women, children and the elderly, and to respect their rights and their dignity. The participants stressed that since this was a common challenge it must be fought with a unified approach. Views were expressed that any common approach must show full respect for each other's culture, faith and values. There should be no attempt to impose norms of one society over another.
It emerged that the paramount need is to reduce poverty and increase availability of resources for prevention, care, and treatment, which should be affordable for every victim without discrimination and selectivity. It was also generally agreed that political commitment at the highest levels was needed to successfully combat the epidemic. The gravity of the problem had now been recognized and efforts were being made to forge a common strategy.
ANNA ABDALLAH, Tanzanian Minister of Health, on behalf of the President of Tanzania, Benjamin Mpaka, Chairman of Round Table 4 on international funding and cooperation: James Wolfensohn, President of the World Bank, highlighted several issues for discussion, including the need for developing countries to lead their own efforts against HIV/AIDS, the need for developing countries to increase their national investments in HIV/AIDS, and the need for official, philanthropic and private contributors to increase and speed up disbursement of their financial and technical commitments to efforts to fight the disease.
Mark Malloch Brown, Administrator of the United Nations Development Programme (UNDP) said that $9.2 billion for the proposed Global Fund was a realistic and sober assessment of the projected cost of an effective global campaign to fight HIV/AIDS. While the private sector and civil society actors have an important role to play, the fight has to be led by national decision-makers at the country level.
In the general discussion that ensued, there was broad consensus that political commitment at the highest level was of crucial importance. The view was expressed that less affected countries, generally more affluent nations, had a moral obligation to contribute to the alleviation of the human suffering caused by the pandemic. It was also suggested that since the epidemic was constantly evolving, a dynamic, rather than static, approach was needed. Other speakers stressed the need to focus on vulnerable groups, including the poor, women, children and orphans. It was also suggested that the international community should take advantage of best practices and lessons learned in countries like Brazil and Thailand, which had succeeded in reducing the incidence of the epidemic.
Action on Draft
The President of the General Assembly, HARRI HOLKERI, informed the delegates that the Assembly had before it a draft resolution issued as document A/S-26/L.2. It was the outcome of a long and arduous negotiating process, conducted by the co-facilitators, to whom he expressed his appreciation.
One of the co-facilitators, PENNY WENSLEY (Australia) said that it had been her privilege to participate in the work of the historic special session on HIV/AIDS to produce the Declaration, which would commit the international community to take purposeful action against the spread of the HIV/AIDS epidemic. Included as an annex to the draft resolution, the text was not perfect, but it was good, action-oriented and practical. It started with what everybody recognized as most important –- leadership -- and ended with follow-up measures. Each section began with a caption designed to send a clear and striking message about the critical area to be addressed, whether it was resources or children affected by AIDS. The purpose was to raise international awareness of the scourge. Each section identified priorities and, where possible, specific targets for action. Each also showed where primary responsibility for taking action lay.
All the recommendations and specific goals and targets were firmly based on technical advice and on the practical direct experience of governments and those living with the pandemic, she continued. The text struck new ground on preventive approaches, and placed emphasis on gender issues and human rights. Particular attention was given to people with AIDS and civil society. It was no coincidence that the final words of that governmental document referred to civil society. Taking into account specific situations and concerns of countries was important to enable the countries to present to the leaders and the international community a generally agreed document, based on common principles and priorities, which everybody together could now begin to implement. It would be the implementation that would test the worth of the document, which could ease the suffering and pain of those affected and restore their faith in humanity.
IBRA DEGUENE KA (Senegal), co-facilitator, introducing the Declaration of Commitment on HIV/AIDS, said that the Declaration represented the global response to the global pandemic. The Declaration consists of a Preamble, a section on shared responsibilities on all geographical levels, and on leadership on the levels of Government, civil society and private sector. Prevention, care and treatment comprise the next sections.
The importance of the human rights of vulnerable groups, and better protection for them, make up the next two sections, he said. It is followed by a section on infants orphaned by the epidemic, on reduction of its social and economic impact, on research and development, and a depiction of the disease in regions affected by conflicts and other catastrophes. The next section describes resources needed for the various endeavours in the fight against HIV/AIDS. The Global Fund for Health and HIV/AIDS forms the centrepiece of this section.
He said that the draft resolution had been the subject of long negotiations which started on 15 December. Intergovernment and multiform discussions were carried out in a variety of contexts. The discussions were made difficult by the extreme sensitivity towards certain aspects of the subject matter, as well as by the inevitable differences between national situations. But consensus was reached. He thanked his co-facilitator Penny Wensley and the staff who had made the special session possible.
The Assembly then adopted the Declaration of Commitment on HIV/AIDS without a vote.
Explanation of Position
The representative of Nepal said that overall, his delegation was very happy with the final outcome of the session, and hoped that the session would make a real difference in the lives of those at risk and those affected. The war against the pandemic had always remained a high priority for Nepal. It had been clear that winning the war against HIV/AIDS was contingent on the concerted efforts of governments, civil society, the private sector and other actors. The availability of new and additional resources would be critical to implementing the Declaration.
His proposal to include, in the document, a clear reference to commitments to fulfil ODA targets was based on that need, he continued. However, despite his best efforts, the proposal remained unaccommodated in the Declaration. His intention had been to strengthen the Declaration, and not to stand in the way of consensus. He would have preferred to have the spirit of the Programme of Action of the Conference on the Least Developed Countries with regard to the inclusion of ODA. Nevertheless, he had joined consensus with the belief that the developed countries would continue to act in the spirit of the LDC Conference.
Statements after Adoption
The observer of the Holy See welcomed the consensus decision and the adoption of the Declaration, and offered the following interpretation. The family of nations had stated their resolve to address the needs of those ravaged by this disease. He joined in that resolve and in that commitment. He reaffirmed all of his reservations, previously expressed at the conclusion of other United Nations conferences and special sessions.
He hoped that the concepts of sexual health and reproductive rights would be applied to a holistic concept of health, which fostered the achievement of personal maturity and sexuality. He emphasized that in accepting the language on the use of condoms as a method of prevention of the disease, the Holy See in no way changed its moral position. He regretted that not enough emphasis was given to the promotion and protection of human rights as well as to the ability to be protected from the irresponsible behaviour of others. Also regrettable was that irresponsible, unsafe and risky behaviour was not adequately discussed in the elaboration of the Declaration. The only safe method of prevention was abstinence before marriage, and mutual fidelity within marriage.
The representative of Mexico (on behalf of Spanish-speaking delegations) said that she was happy that the Secretariat had noticed the technical errors and omissions in the Spanish translation of the Declaration. She requested that the official version in Spanish be corrected pursuant to the remarks that would be presented by her delegation.
The representative of France (on behalf of French-speaking delegations) welcomed the technical revision of the translation of the Declaration, particularly in its French version, and said that the delegations that he represented would submit suggestions which would improve its fidelity.
HARRI HOLKERI, President of the General Assembly: Despite the alarming statistics I highlighted in my remarks at the opening of the special session, and despite the human suffering they represent, there is hope. Speakers in the plenary and in the round tables emphasized that we have clearly reached a turning point -- either we will reach out to those who need this hope the most, or we will be held responsible for not acting when we had the chance.
During these three historic days, Member States, intergovernmental organizations, United Nations agencies, civil society and private sector partners have come together in discussions, panels and workshops, even in the corridors and cafés, to share experiences and explore potential collaboration in mounting an
expanded response to the epidemic. This special session provided ample evidence of how the United Nations can benefit from working together with partners in civil society and the private sector.
The Declaration of Commitment just adopted by Member States is the first global "battle plan" against AIDS. It contains concrete targets for all of us to implement. It also contains mechanisms to follow up on how those targets can be reached. The beauty and significance of the Declaration is in its pragmatic and straightforward approach. By adopting the Declaration, the world has made a commitment to scale up efforts with specific targets and time frames in all critical areas, including prevention, care, treatment and support. The Declaration is a call for leadership and commitment at all levels in all countries. It is a framework for broad partnerships and a tool for specific strategies involving communities, young people and people living with AIDS, to turn the tide of the epidemic.
The Declaration is also the global call for resources that we so desperately need. In this regard, the establishment of a global fund has been welcomed, and a number of countries have announced pledges both to the Fund and to the fight against AIDS. Let me finish by saying that we have worked hard -- but in fact, the real work starts now, with new determination and vision.
* *** *