Fifty-eighth General Assembly
3rd Meeting (AM)
OPENING HIGH-LEVEL GENERAL ASSEMBLY MEETING ON HIV/AIDS, SECRETARY-GENERAL
CALLS FOR DRASTIC ACTION TO COMBAT DISEASE
Says That None of Agreed Targets Will Be
Achieved by 2005 at Current Rate of Progress
Addressing this morning’s high-level General Assembly meeting on HIV/AIDS, Secretary-General Kofi Annan called on the international community to drastically increase its efforts against the disease –- a necessary step if there was to be any hope of reducing the scale and impact of the epidemic by 2005, as pledged in the Declaration of Commitment adopted two years ago.
Introducing his progress report on global efforts to implement the time-bound targets aimed at turning back the epidemic reached at the Assembly’s special session on HIV/AIDS in June 2001, Mr. Annan set the stage for the day-long debate with a sobering observation: at the current rate of progress, none of the agreed targets would be achieved by 2005. “On this the report is crystal clear”, he said.
By 2005, “we should have cut by a quarter the number of young people infected with HIV in the worst-affected nations; we should have halved the rate at which infants contract HIV; and we should have comprehensive care programmes in place”, he said, recounting some of the report’s troubling findings, chiefly that much more needed to be done to provide access to prevention and care for women, and to care for the increasing number of AIDS orphans.
While he mentioned the progress -- significant new resources pledged both by individual Member States and through the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has now committed $1.5 billion to 93 countries -– he stressed that “We are still only half way to the $10 billion a year that is needed by 2005.”
“We have come a long way, but not far enough. Clearly, we will have to work harder to ensure that our commitment is matched by the necessary resources and action. We cannot claim that competing challenges are more important, or more urgent. We cannot accept that ‘something else came up’ that forced us to place AIDS on the back burner. Something else will always come up", he added.
Assembly President Julian Robert Hunte of Saint Lucia, echoed the Secretary-General’s warning that without an “unprecedented mobilization of resources”, near-term international goals were in critical danger of being missed. HIV/AIDS constituted much more than a public health problem, he said. In order to fight the pandemic successfully, HIV/AIDS policy must go hand in hand with policies addressing poverty, social welfare and social cohesion, among other issues.
While the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its co-sponsoring agencies had proved to be important partners whose work constituted a commendable contribution to the fight, the ultimate responsibility fell to governments to confront the HIV/AIDS crisis in their own countries. He said the international community needed to reconfirm its pledge to halt and reverse the pandemic and to build upon the commitments of 2001.
Among the nearly 30 speakers that took the floor this morning, a host of African heads of State and government urged the Assembly not to forget their countries, many considered among the most affected in the world. Senegal’s President, Abdoulaye Wade, stressed that it was of primary importance to address the “hellishly paradoxical” situation in which the drugs necessary to fight the disease were in the North, while the sick were in the South.
Nigerian President Olesegun Obasanjo argued that inadequate resources, the lack of technical capacity in developing countries and the high cost of antiretroviral drugs for HIV/AIDS victims were among the issues to be addressed internationally. In that regard, he called for research priorities that were designed to take into account the health needs of developing countries and the allocation of additional resources for research in the development of a vaccine against the virus.
Joaquim Alberto Chissano, President of Mozambique and Chairperson of the African Union, said that of the estimated 42 million people around the world with HIV/AIDS, 70 per cent were in Africa, “where the rate of infection continued to rise”. That situation had drastically affected the social and economic fabric of communities and constituted a major obstacle to the achievement of development goals.
But Pakalitha Bethuel Mosisili, Prime Minister of Lesotho, stressed that, while it was easy to be overwhelmed by the scale of the pandemic, infection was preventable and the pandemic “can be turned around”.
Jacques Chirac, President of France, agreed, saying that the spread of HIV/AIDS was no longer inevitable. The means to bring it under control now existed, and the international community owed it to the millions of men, women and children prematurely deprived of their lives, to countless orphans, and to future generations to mobilize on an exceptional scale. “The United Nations embodies a universal conscience in the fight against HIV/AIDS -– a political will on a global scale”, he said.
He said the decisions of the General Assembly and Security Council in recent years had helped to roll back taboos, prejudices and stigmas so that the fight against HIV/AIDS was no longer a simple health and social imperative, but a moral imperative and an integral aspect of global peace and security.
Italian Minister of Foreign Affairs, Franco Fratini, speaking on behalf of the European Union, said the group was committed to promoting the availability and reliability of drugs and to lowering prices and supporting the local manufacture of drugs. The Union had erected legislation to prevent the re-importation of reduced-price drugs in an effort to encourage further participation by the pharmaceutical industry.
Also speaking this morning were the Presidents of Ghana, Madagascar, Ukraine, Democratic Republic of the Congo, Algeria, Switzerland, and Portugal.
The Assembly was also addressed by the Prime Ministers of Barbados, the Netherlands and Uganda.
The Deputy Prime Ministers of Belgium and Luxembourg also spoke.
The Vice-President of Costa Rica also spoke.
The Foreign Ministers of Italy (on behalf of the European Union), New Zealand (on behalf of the Pacific Islands Forum), Gabon, United Republic of Tanzania, Australia, and Kazakhstan, also addressed the Assembly, as did the Ministers of Health of Mexico, Tunisia and Brazil.
The Assembly will continue its high-level meeting at 3 p.m. today.
While the 2001 Declaration of Commitment on HIV/AIDS provides a framework for effective action on the pandemic, unprecedented resolve and intensified efforts –- driven by bold political leadership and a threefold increase in annual programme funding -- will be required to raise the international response to the level needed in order to achieve the Declaration’s targets, writes Secretary-General Kofi Annan in a new report. With many countries at risk of falling short of the Declaration’s early goals, “action must be taken immediately to put policies in place to mount an effective response”, he adds.
Convening for a special day-long debate, the General Assembly today is set to consider Mr. Annan’s second progress report on worldwide efforts to implement the outcome of the 2001 special session on HIV/AIDS (document A/58/184). At that session, which was held in New York, for the first time ever, world governments and the international community agreed to a set of time-bound targets aimed at turning back the pandemic. Building on the goal set in the 2000 Millennium Declaration -- to halt and reverse the spread of HIV/AIDS by 2015 -- the outcome of the special session laid out strategy to, among other things, enhance access to care, support and treatment; reduce vulnerability; and protect human rights and empower women.
The first of those targets fall due this year and chiefly pertain to the establishment of an enabling policy environment, which sets the stage for the programme and impact targets in 2005 and 2010. In his report, Mr. Annan writes that, during the past year, there has been significant progress in the global response to HIV/AIDS: virtually all heavily affected countries now have multisectoral AIDS strategies, as well as national AIDS councils, many of which are chaired by high-ranking government officials.
Resources available for AIDS programmes in low- and middle-income countries have increased rapidly and are expected to total some $4.7 billion in 2003. But, “That figure is still less that half the estimated $10.5 billion that will be needed by 2005”, the Secretary-General says. The report goes on to note that a growing, but still limited number of countries has recorded reductions in infection among young people. Numerous regional political bodies have committed themselves to cross-country cooperation in the fight against the epidemic.
“In important respects, however, the challenges posed by the epidemic remain as large as ever”, writes the Secretary-General, stressing that in the most affected countries of sub-Saharan Africa, the impact of the epidemic is becoming alarmingly more acute, as reflected in the deadly triad of food insecurity, HIV/AIDS and the loss of institutional capacity. Furthermore, little progress has been made worldwide in reducing the number of new HIV infections and there are indications that the global rate of infection could accelerate as the epidemic expands in Asia and Eastern Europe.
Responses provided by 100 Member States on 18 global and national indicators developed by the United Nations Development Programme (UNDP), while not a comprehensive listing of all activities, reveal some startling facts. According to the report, women and girls now represent half of all global HIV infections and as many as 58 per cent in Africa. Globally, more than 14 million children under the age of 16 have lost one or both parents to the disease, including 11 million in sub-Saharan Africa alone. “Yet 39 per cent of reporting States with generalized epidemics lack national strategies for children orphaned or made vulnerable by HIV/AIDS”, the report says.
It notes, among other things, that fewer than one in four people at risk of infection are able to obtain basic information regarding the disease, and that less than half of the responding countries were able to articulate the specific role played by people living with HIV/AIDS in their national response. Although the Declaration requests countries to enact, strengthen or enforce legislation to prevent discrimination against people living with HIV/AIDS and against vulnerable populations, only 26 per cent of responding States have relevant laws in place. Substantially fewer, some 38 per cent have policies that prohibit discrimination against vulnerable populations.
“The stigma associated with HIV/AIDS continues to impede an effective global response to the epidemic, underscoring the importance of immediate action by States to enact and enforce the anti-discrimination policies provided for in the Declaration”, Mr. Annan writes. He also notes that nearly one in four countries have no national strategy to provide comprehensive care and support to people living with HIV/AIDS and to the families affected by the epidemic.
The Secretary–General stresses that several Member States at risk of falling short of their 2003 commitments under the Declaration. “With support from the highest levels of government, countries should immediately assess their national policies in relation to the Declaration’s provisions for 2003 and accelerate the development and implementation of policies needed to come into compliance with it,” he writes.
According to the Secretary-General, special emphasis must be placed on a number of areas, including national leadership. He stresses that such leadership is necessary, particularly in Asia and the Pacific, Eastern Europe and Central Asia, to prevent a major expansion of HIV/AIDS. Although political commitment to battling the disease has increased significantly in recent years, too few political leaders are aggressively leading national efforts to respond to the epidemic.
He also urges countries to prioritize the engagement of civil society and people living with HIV/AIDS; to assess and address laws and policies that increase the vulnerability of women; to develop and implement national strategies to promote the delivery of comprehensive prevention, treatment, care and support to people living with or affected by HIV/AIDS; and to implement strategies aimed at building and maintaining institutional capacity. Countries with generalized epidemics should develop and implement strategies to address the needs of the growing number of children being orphaned by the disease.
The report says that urgent, sustained and coordinated action among a broad alliance of international donors and other stakeholders is needed to respond to crisis conditions that exist in the countries of southern Africa -- the response must match the epidemic in both complexity and scale.
Finally, the report states that to finance the global response needed to ensure achievement of the Declaration’s future commitments, annual funding for HIV/AIDS efforts must increase threefold over current levels by 2005, and fivefold by 2007. Momentum for increased funding for HIV/AIDS efforts must accelerate in low- and middle-income countries, as well as from donors.
Statement by President of General Assembly
JULIAN ROBERT HUNTE (Saint Lucia), President of the General Assembly, said that the primary purpose of today’s high-level plenary meeting was to assess how well the commitments undertaken by Member States within the 2001 Declaration on HIV/AIDS had been fulfilled. It was only through keeping those commitments, that the number of people living with HIV/AIDS worldwide would be decreased. Prevention and awareness programmes aimed at reaching those at risk, particularly among the most vulnerable populations, were needed to combat the devastating impact of the disease.
However, the Joint United Nations Programme on HIV/AIDS (UNAIDS) had estimated that the funds allocated to fighting HIV/AIDS were falling far short of what was necessary, he said. HIV/AIDS constituted much more than a public health problem; in order to fight the pandemic successfully, HIV/AIDS policy must go hand in hand with policies addressing poverty, social welfare and social cohesion, among other issues. And although there had been signs of progress in the context of action under way and resources allocated, as highlighted in the Secretary-General’s report, these must be juxtaposed against the shortfall in funding of the Global Fund Against AIDS, Tuberculosis and Malaria.
The Secretary-General’s warning that the fight against HIV/AIDS required an “unprecedented mobilization of resources” must be heeded, he continued. While UNAIDS and its co-sponsoring agencies had proved to be important partners, whose work constituted a commendable contribution to the fight, the ultimate responsibility fell to governments to confront the HIV/AIDS crisis in their own countries. The international community needed to reconfirm its pledge to halt and reverse the pandemic and to build upon the commitments of 2001. Thus, today’s activities would only have an important impact if they were followed up with action at the national, regional and international levels.
Introduction of Secretary-General’s Report
Introducing his report (document A/58/184), KOFI ANNAN, Secretary-General of the United Nations, said that two years ago the United Nations had agreed that a victory over HIV/AIDS would require will, resources and concrete measures. “Today, we have the will. Our resources are on the increase. But when it comes to action we are still far from our goal.”
At the Assembly’s 2001 special session, Member States adopted the Declaration of Commitment, which contained specific time-bound targets for fighting the epidemic. “This morning, you have before you a report card provided by your governments, about progress towards meeting those goals”, he said. One hundred three countries had provided information to the Joint United Nations Programme on HIV/AIDS (UNAIDS).
In many respects there had been progress, he continued. Significant new resources to fight the epidemic had been pledged, both by individual Member States and through the Global Fund Against AIDS, Tuberculosis and Malaria. Since its establishment, the Fund now had pledges of more than $4.7 billion and had committed funds to more than 93 countries. He said there had also been new levels of collaboration among national governments, the United Nations family and civil society in developing proposals to the Fund, and in bringing essential services to those who need them most.
Along with improvements at the country level, and an increase in HIV/AIDS policies covering the workplace, civil society was also becoming an increasingly important partner in pursuing comprehensive measures against HIV/AIDS. Faith communities were also more and more active, he said, often bridging the gaps between North and South.
“And yet, this report makes for sobering reading. We have failed to reach several of the Declaration’s objectives set for this year”, Mr. Annan said. Even more important, the international community was not on track to begin reducing the scale and impact of the epidemic by 2005. By that date, it should have cut by a quarter the number of young people infected with HIV in the worst affected nations; halved the rate at which infants contract HIV; and put in place comprehensive care programmes.
“On this the report is crystal clear”, he said, “at the current rate of progress, we will not achieve any of those targets by 2005.” One third of countries still had no policies to ensure that women had access to prevention and care, even though women accounted for 50 per cent of those infected worldwide. More than one third of heavily affected countries still had no strategies in place for looking after the increasing number of AIDS orphans. And fully two thirds of all countries failed to provide legal protection against discrimination for the groups that are most vulnerable to HIV.
“If we are to stand any chance of meeting the 2005 targets, these ratios will have to be improved drastically”, he said. There had also been progress in the allocation of resources, but not nearly enough. Over the past year, spending in low- and middle-income countries had grown by 20 per cent, to $4.7 billion per year. Since 1999, domestic spending by governments on those countries had doubled.
“Yet we are still only half way to the 10 billion dollars a year that is needed by 2005”, he said. The resources available must continue to increase –- through the Global Fund, but also through all other efforts, including those of national governments in heavily affected countries.
“We have come a long way, but not far enough”, he said. “Clearly we still have to work harder to ensure that our commitment is matched by the necessary resources and action. We cannot claim that competing challenges are more important, or more urgent. We cannot accept that ‘something else came up’ that forced us to place AIDS on the back burner -– something else will always come up.” That was why the international community must always keep AIDS at the top of the political agenda.
OWEN S. ARTHUR, Prime Minister of Barbados, said it was sobering that beyond the social havoc caused by the HIV/AIDS pandemic, it was even a greater threat to global economic stability and development than market failures and policy disturbances. It was a moral obligation to declare and to treat the HIV/AIDS pandemic for what it was -- the single greatest threat to human security.
He wished to renew his country’s commitment to work in harmony with its Caribbean neighbours to alleviate the threat posed by AIDS to the region’s stability and security, which was exceeded only by that faced by sub-Saharan Africa. “My Government proclaims its dedication to the creation and enforcement of supportive laws, full empowerment of the HIV/AIDS community and the eradication of AIDS-related stigma and discrimination”, he said. As a mark of that commitment, Barbados pledged to contribute $100,000 to the Global Fund to fight AIDS, Tuberculosis and Malaria.
JOHN AGYEKUM KUFUOR, President of Ghana, said global statistics indicated an increasing rate of AIDS infection and called for intensive action through preventive strategies and ultimately, the eradication of the menace. In Ghana, the prevalence rate of HIV/AIDS of 3.4 per cent has not shown any reversal in the past two years, even though it was lower than rates in other West African countries where rates ranged between 5 per cent to 11 per cent.
His Government was intensifying the pursuit of appropriate, cost-effective strategies to ensure that the rate was reduced, otherwise projections indicated that the current infected population of 600,000 would increase to 1,360,000 by the year 2014, and the number of orphans to 236,000. Since 2001, when implementation of the national response started, the Ghana AIDS Commission has disbursed $20 million out of an International Development Association (IDA) credit of $25 million to fund activities of several organizations around the country to carry out HIV/AIDS intervention projects. Prevention of mother-to-child transmission was being tackled through educational campaigns and more direct interventions at points of service.
ABDOULAYE WADE, President of Senegal, recalled that the Declaration of Commitment on HIV/AIDS had been adopted two years ago, emphasizing that a global crisis required global action. Yet the millions of men and women living with this terrible virus continued to be overwhelmed with suffering, while millions of others were unaware that they carried it and so facilitated its spread. This was the cruel reality of the virus, which spared no country and made it necessary to find a collective response to a global threat. Amazingly, the “Coordinates 2002” report of UNAIDS, United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) showed that 30 per cent of young people in 22 countries covered in the report had never heard of HIV/AIDS or its means of transmission, while 87 per cent of those 15 to 19 did not believe they were at risk of infection. Combating HIV/AIDS meant talking about the disease, breaking taboos.
Within Senegal, he said, the fight against HIV/AIDS rested upon a double imperative: rapid response and a spirit of anticipation. In addition to screening all blood donations, Senegal had begun to decentralize its anonymous HIV/AIDS centres. It had also received a 95 per cent cut in the cost of antiretroviral drugs from large pharmaceutical groups. Awareness raising was also an important aspect of the fight, in which respect the religious officials of Senegal had complemented the public sector’s message. Thus, Senegal had shown that a developing country could keep infection rates within a level comparable to the rate of infection in developed countries, while Uganda, with a 10 per cent infection rate, had shown that with the necessary will, the upward trend of infection could be reversed. Finally, he noted that it was of primary importance to address the hellishly paradoxical situation in which the drugs necessary to fight the disease were in the North, while the sick were in the South.
PAKALITHA BETHUEL MOSISILI, Prime Minister and Minister of Defence and Public Service of Lesotho, said his Government had declared HIV and AIDS a “national disaster” and continued to use every opportunity to exhort all to do everything in their power to help control and manage the pandemic. The Government’s goal was to reduce HIV and AIDS prevalence in the 15 to 40 age group from its current 31 per cent to 25 per cent by the year 2006. That will be done by reviewing the national strategic plan from 2002/2003 – 2004/2005 in order to shift the national response from the health sector to a multisectoral and multistakeholder paradigm. The primary focus in prevention has been on communication and education for behavioural change, particularly for youth.
It was easy to be overwhelmed by the scale of the pandemic, but the infection was preventable and the pandemic “can be turned around”, he said. And, following on recommendations made at the recent Southern African Development Community extraordinary summit on HIV and AIDS, Lesotho had also pledged to implement an “aggressive response” to the HIV and AIDS pandemic through multisectoral programmes, including prevention through education and social mobilization, improving care, access to counselling and testing services and treatment and support, mitigating the impact of HIV and AIDS and intensifying resource mobilization.
JORGE FERNANDO BRANCO DE SAMPAIO, President of Portugal, said good global governance was needed to tackle the problem of HIV/AIDS. Some progress had been made following the 2001 Declaration, in terms of the objectives, that have been “quantified and chronologically established”. There had been a number of regional initiatives, including the effort by the Community of Portuguese-speaking Countries to benefit African member States that had the least resources, but were the most affected.
He said the urgency with which the fight against AIDS has been pursued in the last two years must be kept up and heightened in the face of the rising curve in the number of infected persons. The world must look at the epidemic as a threat to humanity, which demanded a strategy on a global scale. It was one of the most striking examples of the need to co-ordinate political guidelines and to take concrete measures “not unilaterally, but in solidarity”. The international political agenda, while understandably concerned with the fight against terrorism, must not forget “this other source of terror”.
MARC RAVALOMANANA, President of Madagascar, said that the HIV/AIDS figures in his country were emblematic of the seriousness of the problem. While two years ago, the infection rate had been just .03 per cent, there had been a threefold increase in just one year. In the face of the inertia of bureaucracy, he had decided to take on the national fight against AIDS personally. He had established a national anti-AIDS Committee that was in charge of combating the disease on all fronts. It provided a focal point for a strategic national response that included civil society. A grass-roots radio station had been launched to reach the farthest parts of the country.
He went on to highlight the stark differences in the ability to combat, treat and cope with the virus. He hoped that they all would leave today’s meeting having made progress towards specific action and adequate means to implement it, as it was most urgent. “We must not wait, for AIDS is not waiting”, he said, adding that “there can be no progress or development for a society that is ill”.
LEONID D. KUCHMA, President of Ukraine said there were currently more than 57,000 HIV-positive cases in Ukraine, though some independent estimates showed that the total number of AIDS-infected people could be several times higher. In recent years, though, the National Programme on HIV prevention had made substantial progress in combating the spread of the disease, particularly in cases where infection was transferred from mother to child.
He said, however, there were still a number of uncovered problems, in particular, financial problems. Still, he said, “I am confident that the engagement of resources of the Global Fund and of the World Bank will enable us to significantly improve the current situation”, he said, adding that it was easier to prevent the disease than to treat it.
OLUSEGUN OBASANJO, President of Nigeria, urged countries that had not yet redeemed their pledges to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria to do so. As an indication of its commitment to that global fight, Nigeria had already redeemed its $10 million pledge to the Fund.
He said there was an urgent need to intensify purposeful and coherent global policies and functional partnerships in the fight against the scourge. Inadequate resources, the lack of technical capacity in developing countries and the high cost of antiretroviral drugs for HIV/AIDS victims were among the issues to be addressed internationally. In that regard, he called for research priorities that were designed to take into account the health needs of developing countries and the allocation of additional resources for research in the development of a vaccine against the virus.
JACQUES CHIRAC, President of France, said that the spread of HIV/AIDS was no longer inevitable. The means to bring it under control now existed, and the international community owed it to the millions of men, women and children prematurely deprived of their lives, to countless orphans, and to future generations to mobilize on an exceptional scale. The United Nations, he said, embodied a universal conscience in the fight against HIV/AIDS -– a political will on a global scale. The decisions of the General Assembly and Security Council in recent years had helped to roll back taboos, prejudices and stigmas so that the fight against HIV/AIDS was no longer a simple health and social imperative, but a moral imperative and an integral aspect of global peace and security.
There were no further excuses for inaction, he said. Effective treatments now existed and had become accessible to the poorest members of the world community, in which regard the recent decisions of the World Trade Organization (WTO) constituted a breakthrough and source of hope. Having fought for that outcome, France remained committed to ensuring its generous application. Moreover, all governments now accepted that access to medications was inseparable from prevention. For those reasons, France was committed to ensuring the 3 billion dollars needed annually by the Global Fund and to the provision of 1 billion dollars each by the European Union and the United States annually, while other donor countries made up the third billion. Finally, he proposed that the General Assembly devote one session each year to a discussion of HIV/AIDS.
JOSEPH KABILA, President of the Democratic Republic of the Congo, said HIV/AIDS was a terrible scourge for all. The armed conflict in his country had exacerbated the spread of the virus. The international community must not forget a more insidious war, one with which there could be no ceasefire or peace talks -- the war on AIDS. There were about 3 million people infected in the Democratic Republic of the Congo and over 1 million AIDS orphans.
“Despite the bleak picture, we have not sat back and done nothing”, he said. His country had been the first, in 1983, to open up to study of the disease and had also contributed to the worldwide definition of the disease and its parameters. The country was now working on antiretroviral treatments and on lowering mother-to-child transmissions. It was trying to jump-start its health sector response to the disease. But there were some concerns: reunification and restoring the territorial integrity of the country. He believed the broad cooperation, at all levels, was the way to fight the disease in the years to come.
ABDELAZIZ BOUTEFLIKA, President of Algeria, said that while progress had been made in raising awareness and coordination of efforts to reverse the trend and spread of HIV/AIDS transmission, the epidemic had reached such proportions that it required further efforts at the national, regional and international levels. The scaling up of efforts was particularly needed in the areas of prevention, financing, access to medication, and coordination among the different initiatives.
He underscored the key role of the private sector and civil society in securing additional resources to be allocated to efforts aimed at stamping out HIV/AIDS, adding that it was necessary to ensure better coordination in order to avoid a dispersal of efforts and, thus, ensuring optimal use of those resources.
JOAQUIM ALBERTO CHISSANO, President of Mozambique and Chairperson of the African Union, acknowledged that HIV/AIDS was the unprecedented human disaster of the era, the solution to which constituted a worldwide challenge requiring worldwide and integrated collaboration. According to UNAIDS, 42 million people around the world lived with HIV/AIDS, 70 per cent of them in Africa where the rate of infection continued to rise. That situation had drastically affected the social and economic fabric of communities and constituted a major obstacle to the achievement of the Millennium Development Goals. Thus, African States, which with the Abuja Declaration and Plan of Action had declared HIV/AIDS an emergency, were implementing multisector strategic plans, involving the active participation of governments, civil society, international partners and other stakeholders in the fight against HIV/AIDS.
HIV/AIDS had been included as a crosscutting issue in the New Partnership for Africa’s Development (NEPAD), he said, and in the establishment of other initiatives, such as Africa AIDS Watch and the Commission for HIV/AIDS and Governance in Africa. Moreover, with the Maputo Declaration, African leaders had reaffirmed their commitment to reducing the mortality and morbidity associated with HIV/AIDS. While seeking to capitalize upon regional and subregional approaches to effective treatment and delivery, Africa maintained the need for a strong international partnership, particularly between the public and private sectors, to successfully combat HIV/AIDS. The global problem of HIV/AIDS demanded global action; all States were in the same boat and so should pull together.
PASCAL COUCHEPIN, President of Switzerland, said that, in the face of this terrible epidemic, prevention and access to care and treatment were inseparable. But while the dangers of the disease concerned everyone, it was critical to remember that the ravages of the virus did not affect all to the same extent. “We cannot forget that 70 per cent of persons infected with the AIDS virus live in sub-Saharan Africa”, he added. It was necessary to persevere in all efforts aimed at making medication more accessible to those who needed it.
Just three days ago, the Swiss Government had decided to classify the Global Fund as an international organization, and it would now be granted the same privileges and immunities in Switzerland that were usually accorded such organizations. The decision would intensify the worldwide fight against AIDS –- the Fund must enjoy conditions that enabled it to operate with the necessary flexibility and efficiency required to respond to the urgent financial needs of countries affected at health, economic and social levels. The Fund would also cooperate closely with the World Health Organization (WHO) and UNAIDS, both headquartered in Geneva.
LINNETTE SABORIO, Vice-President of Costa Rica, said HIV/AIDS took her country by surprise in 1983, but that, since then, Costa Rica had developed a notable response capacity, which nonetheless needed to be continuously improved. In 1997, Costa Rica made antiretroviral therapy available to its patients with AIDS, increasing their life expectancy and quality of life. However, certain challenges remained: the needs to intensify efforts to educate the youngest groups on self-protection behaviour; to provide universal testing to pregnant women; and to draft and disseminate a protocol for the prevention and control of HIV, among others.
She said the international community’s response to the challenges must cover various fronts, including making progress in the development of more effective therapies, overcoming prejudices and eradicating stigmas, and practicing a more militant international solidarity featuring governments, pharmaceutical companies and non-governmental organizations to make prevention more effective. “Costa Rica is doing everything possible, within its limitations, to respond to this pandemic”, she said.
LOUIS MICHEL, Deputy Prime Minister and Minister of Foreign Affairs of Belgium, said the HIV/AIDS epidemic continued to progress at an alarming rate. The 36 million people with AIDS –- most of them in Africa –- suffered from more than physical manifestation of the disease. The poverty in which people in those countries found themselves, endemic indebtedness and the continuation of conflict affected the impact of the virus on social and economic levels.
Those factors also affected the country’s ability to adequately address health-care needs. He said accessibility to antiretroviral drugs must immediately be guaranteed. Advances must also be made in the fight against stigma and discrimination, as well as in debt relief. Good results could only be obtained with the requisite political will at the top levels.
LYDIE POLFER, Deputy Prime Minister and Minister for Foreign Affairs of Luxembourg, concluded that not enough had been done in the past two years to fight the scourge of HIV/AIDS, as available resources fell far short of need. However, a considerable amount had been done. There was now a need for new partnerships to be formed and creative initiatives to be undertaken to increase the efficiency of the fight against HIV/AIDS.
Highlighting a European initiative to pair hospitals in the North and South, thus making it possible for patients in the poorest countries to have the same hopes and access to treatment as those in developed countries, she said that Luxembourg had made many contributions to the fight against HIV/AIDS, including 1 million euros annually to the Global Fund. If all industrialized countries were to join the small group giving 0.7 per cent of the gross national product to official development assistance (ODA), significant strides could be made.
JAMES F. WAPAKABULO, Second Deputy Prime Minister and Minister of Foreign Affairs of Uganda, said his country had made fighting AIDS a major priority. Substantial finances had been committed finances to fighting the disease nationally. Uganda had opted for a multisectoral approach to ensure that programmes were streamlined into national strategies and then maintained. It was also in the process of finalizing an overarching AIDS policy and regulatory framework.
Uganda had established a strong HIV/AIDS partnership within government and among private and civil society actors, he said. The focus would be on, among other things, a strategy for reducing mother-to-child transmission and managing and upgrading health-care clinics. Still, there had been limited progress on a number of indicators: access to drugs, the large number of AIDS orphans, and fully implementing national plans. Uganda must also work to raise and maintain awareness among the younger generation.
FRANCO FRATTINI, Minister of Foreign Affairs of Italy, speaking on behalf of the European Union, said that the tragic toll of HIV/AIDS demanded a “global” response; preventing the spread of HIV/AIDS was difficult, but not impossible, as had been shown by those countries successful in slowing the growth of the epidemic and even reversing it. Having defined European Union policy in the May 2001 Council on HIV/AIDS, malaria and tuberculosis, the member States of the Union had committed themselves to collectively raising the level of official development assistance (ODA) to 0.39 per cent of gross national product by 2006 as a first step toward the goal of 0.7 per cent. Furthermore, the Union held that an efficient and effective health-care system, accessible to all, was an absolute priority in the fight against HIV/AIDS, as was sector-by-sector planning at the single-country level. Public and private partners must work together to carefully identify and promote priorities and needs, between bilateral and multilateral donors, as well as between United Nations agencies.
The European Union, he continued, had decided to allocate an extra 351 million euros to the European Union Action Programme on Communicable Diseases for the next four years; more than 1 billion euros had been allocated to date. Committed to promoting the availability and reliability of drugs and to lowering prices and supporting the local manufacture of drugs, the Union had erected legislation to prevent the re-importation of reduced-price drugs in an effort to encourage further participation by the pharmaceutical industry. Finally, he announced that while the Union had contributed 472 million dollars to the Global Fund in 2001-2002, it was scheduled to contribute a further $233 million in 2003 and $96.9 million in 2004.
PHIL GOFF, Minister of Foreign Affairs and Trade of New Zealand, speaking on behalf of the Pacific Island Forum Group, said more attention must be given to combating HIV/AIDS. The implementation of the Declaration of Commitment on HIV/AIDS was crucial to Pacific Island Forum Countries since it recognized that an important first step in addressing the epidemic was to establish an enabling policy and legislative environment.
While noting that global efforts to fight the infection had fallen short, he said the Pacific Island countries had taken a proactive regional approach to address the sharp increase in HIV/AIDS infection rates in the Pacific region. Forum members also welcomed the recent agreement by World Trade Organization members to assist developing countries in accessing affordable drugs to fight serious public health problems including HIV/AIDS.
JAN PETER BALKENENDE, Prime Minister of the Netherlands, said his country had learned to fight HIV/AIDS by using a three-part strategy to win: to acknowledge the problem; to provide clear and evidence-based information about HIV/AIDS and safe sex; and to work with those who were vulnerable in society. Recently, the Netherlands had intensified its international HIV/AIDS policy with a special emphasis on Africa. “Our aim is to increase local capacity and political commitment in affected countries, while reducing the stigma of HIV/AIDS and addressing gender inequality”, he said. Mr. Balkenende noted his country’s recent agreement with the United States to cooperate on HIV/AIDS prevention, treatment and care at the country level, starting with Rwanda and Ghana.
Mr. Balkenende stressed that the overarching framework of his country’s policy was the international consensus on development established at United Nations summits, particularly the International Conference on Population and Development. He also said that in the focus on HIV/AIDS, the importance of sexual and reproductive health and rights should not be forgotten. “The window of opportunity is still open. But it is closing fast, so we must shoulder our responsibilities to each other.”
JEAN PING, Minister for Foreign Affairs, Cooperation and Francophonie of Gabon, reading out a statement by his President, said that although HIV/AIDS did not yet constitute a terribly alarming situation in Gabon, the Government had made the fight against HIV/AIDS a top priority, aware as it was of the potential social tragedy that the virus could bring. Thus, preventive action had been taken by the Government and was supported by the involvement of the First Lady of Gabon, who was also the Chairperson of the group of First Ladies of Africa.
Among other policy decisions, he said the Government had decided to integrate all HIV/AIDS programmes as part of the national health sector. Finally, while international support for the fight against HIV/AIDS was invaluable, the resources available were far exceeded by need, despite all the best efforts. It was essential to remember that HIV/AIDS was a common problem requiring a common effort.
JAKAYA KIKWETE, Minister for Foreign Affairs and International Cooperation of the United Republic of Tanzania, said his Government had set up a National AIDS Commission to spearhead well-coordinated national multisectoral responses. In May 2003, the National Multi-Sectoral Strategic Framework on HIV/AIDS, which defined, directed and coordinated the national response, had been launched. The framework included a broad range of stakeholders, including the public and private sectors, civil society and labour unions. It translated the National Policy on HIV/AIDS and spelled out the basic approaches, principles, goals, objectives and strategies for 2003-2007.
His country, he continued, had also finalized the Second Health Sector Strategic Plan (2003-2008) and Health Sector HIV/AIDS Strategy for Tanzania (2003-2006). A draft Business Plan for HIV/AIDS Care and Treatment for People Living with HIV/AIDS had been developed in collaboration with the William Jefferson Clinton Foundation. The plan aimed to provide antiretroviral treatment to people living with HIV/AIDS.
Modest progress had been achieved in raising awareness of people and society of HIV/AIDS, he said, but behavioural change was slow. Consequently, AIDS was still a threat with an 8 per cent infection rate. Open acknowledgement was gradually replacing the denial of people living with HIV/AIDS, but efforts must be made to intensify sensitization programmes with all people and strata in society. In particular, attention must be paid to programmes addressing quality adolescent sexual and reproductive health, empowering girls and women to negotiate safe sex, and promoting responsible male behaviour in sexual and family relationships.
JULIO FRENK, Minister of Health of Mexico, said that Mexico’s national HIV/AIDS policy was based upon prevention, holistic medical care, respect for human rights and the active participation of society. Mexico had one of the lowest rates of infection on the American continent and the virus had been prevented from spreading to the population at large; this had been accomplished through efforts to eliminate the spread of HIV/AIDS through blood transmissions and prenatal transmission.
Among other policies, Mexico had initiated legislation to protect HIV/AIDS victims from catastrophic medical expenses, and free medical assistance would be available to all living with HIV/AIDS by 2006, he said. The Congress had also promulgated a specific law prohibiting discrimination related to sexual preference and medical condition, among other factors. During the coming years, Mexico would step up its prevention strategies, particularly those aimed at vulnerable populations such as homosexuals, intravenous drug users and those involved in the sex trade. Mexico also pledged to promote the production of high-quality generic medications comparable to those available in developed countries.
ALEXANDER DOWNER, Minister for Foreign Affairs of Australia, said that two decades of nationally coordinated response to HIV/AIDS had made real inroads into the epidemic in his country. Infection rates were relatively low, and about one person in every 1,500 now lived with the disease. The Government, affected communities and the medical, scientific and health professions were working together to tackle the cause of HIV/AIDS, prevent its spread, care for those who lived with it and engage with groups most at risk.
Australia was concerned that “the Asia-Pacific region could become another epicentre of the epidemic to rival Africa”, he continued, and was at the forefront of regional efforts to contain the disease. There were now more than 7.2 million people living with HIV/AIDS in the Asia-Pacific, and about 3,000 people were newly infected with HIV every day. Australia had worked hard to forge a regional consensus and solutions to HIV/AIDS. Two years ago, it had hosted a regional ministerial meeting in Melbourne, at which ministers had agreed on the need to develop strategies to fight the pandemic. They had since identified practical steps for action and had begun to establish partnerships –- including the Asia Pacific Leadership Forum on HIV/AIDS and Development.
KASSYMZHOMART TOKAEV, Minister for Foreign Affairs of Kazakhstan, said that despite a relatively low incidence of HIV/AIDS in Kazakhstan, without the deep involvement of international cooperation in addressing the disease, AIDS would seriously affect his country’s internal stability. That was why Kazakhstan had adopted legislation on HIV/AIDS, providing governmental preventive measures and guaranteeing fundamental rights to people affected by the disease. The National AIDS Coordinating Committee, established eight years ago, was fully operational. A multi-faceted approach to HIV/AIDS had been possible due to his country’s rapid economic growth over the past four years.
A partnership between government and civil society was now primarily aimed at decreasing vulnerability of high-risk groups and enhancing their protection. Serious efforts were being made to ensure the awareness of the population at large and to educate young people. “It will not be an exaggeration to say that the issue of HIV/AIDS demands no less attention than other issues of international security”, he said.
HABIB M’BAREK, Minister of Public Health of Tunisia, reading a statement from his President, recalled the guidelines followed in Tunisia since the Change of November 7 1987, at the forefront of which were respect for human rights, and the fight against illiteracy, poverty and disease. The data on HIV/AIDS infection confirmed that fighting HIV/AIDS represented a form of the combat against poverty and underdevelopment.
Commending the achievements made in implementing the Declaration of Commitment on HIV/AIDS, he said the World Trade Organization’s decision regarding the availability of generic medications would certainly help to check the propagation of contagious disease by making medicines available at reasonable prices. Since the appearance of the first case of HIV/AIDS in Tunisia in 1985, the Government had worked to launch a national campaign to combat HIV/AIDS, which had resulted in the achievement of safe blood transmissions, free laboratory analyses and the supervision and provision of social and psychological care of affected persons.
HUMBERTO COSTA, Minister of Health of Brazil, stressed the importance of comprehensive access to care and medication. In the past, humanity had faced epidemics without medicine, but that was not the case regarding AIDS. “The great success of the antiretroviral drugs has allowed people to live normal and dignified lives”, he said.
Brazil had produced some antiretroviral drugs and had managed, in the past, to bring down the cost of imported drugs through fair-handed negotiations. “We acknowledge the importance of promoting invention and creativity in the area of pharmaceuticals. We respect all the agreements in that area. But we will not hesitate to use all the procedures and flexibilities to bring down the prices and make drugs available”, he said. Years from now people would ask what was done to fight the pandemic -- the answer must be sought before it was too late.
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