Fifty-eighth General Assembly
4th, 5th and 6th Meetings (PM and Night)
GENERAL ASSEMBLY CONCLUDES HIGH-LEVEL DEBATE ON HIV/AIDS,
HAVING EXAMINED PROGRESS MADE, REMAINING CHALLENGES
More devastating than any terrorist attack or weapon of mass destruction, AIDS was challenging the advance of freedom and hope, the General Assembly heard as it concluded its high-level meeting early Tuesday.
Heads of State and government, and ministers from more than 100 nations participated in the 14-hour discussion on HIV/AIDS, two years after Member States agreed on a set of time-bound targets to curtail the disease. Their statements centred on advances made in many countries, particularly in heavily affected ones. The issue was now accorded a high priority on national agendas, with few governments, if any, underestimating the magnitude of the pandemic. Despite such gains, however, attention was drawn to the fact that the number of people with the infection was still growing, with some 5 million new cases detected annually, while the gap between need and resources remained huge.
Describing AIDS as cruel as any tyrant, United States’ Secretary of State Colin Powell said the disease tore apart families and communities and undermined governments. It had the potential to destroy countries and destabilize entire regions. In the United States, a $15 billion five-year emergency plan –- the largest initiative ever on a single disease -- had been signed into law with overwhelming support. The plan would target 14 of the most affected countries in Africa and the Caribbean, treat 2 million people with antiviral drugs, and provide care for 10 million orphans. Governance alone, however, could not address that global crisis; the private sector must be part of the fight, he stressed.
Expressing satisfaction at the establishment of the Global Fund for HIV/AIDS, Tuberculosis and Malaria, the Foreign Minister of Guyana, Samuel Rudolph Insanally, said he was disappointed, however, that many countries approved for funding had not received disbursements. Among the daunting challenges facing developing countries were debt burdens and debt-servicing obligations. Relief processes should be accelerated and must be made less restrictive to allow countries like Guyana to build social services programmes. Given his country’s constraints in retaining qualified personnel, especially nurses, he called for financial support for expanded training programmes for medical personnel.
South Africa had turned a corner, its Health Minister, Manto Tshabalala-Msimang, said. Awareness campaigns had reached most of the population, and, as a sign of significant behavioural change, the rate of young women abstaining from sex had grown. The private and public sectors were working together to combat the effects of the disease. With the withdrawal of a lawsuit against her Government by major pharmaceutical companies, access to affordable medicines had improved. Challenges remained, however, including the high cost of medical technologies and the continued “poaching” of South Africa’s valuable health workers.
The Minister of Health of Burkina Faso, Alain Bedouma Yoda, said that, since 2001, his Government had invested $4 million to fight HIV/AIDS, and implementation of national programmes on prevention was under way. Traditional and religious communities had joined that fight, and 21 per cent of pregnant women with the disease were currently participating in a mother-child transmission prevention programme. He expressed satisfaction that antiretroviral drugs had dropped in price following negotiations with pharmaceutical firms and talks with Brazil about purchasing generic drugs. Stressing the need to make antiretroviral drugs accessible to people everywhere, he appealed urgently for continued support.
Suggesting that the moment for debate was long past, the President of the International Federation of the Red Cross and Red Crescent Societies, Juan Manuel Suarez del Toro, said “we know what we need to do, and we know how to do it”. The level of actions should be massively scaled up, and the barriers of silence, stigma and discrimination should be broken. Investing $10 billion by 2005, under the 2001 Declaration of Commitment, was only $250 per person over three years, or less than $1 a day per person. Even the Global Fund, which was the best investment in the struggle, was in serious danger because of a lack of resources.
Secretary-General Kofi Annan, who opened this morning’s meeting, provided a summary this afternoon of an interactive panel discussion that took place in the margins of the plenary meeting. A key theme had been recognition that AIDS represented “the greatest leadership challenge of our time”. The panel had focused on three critical areas that must be addressed with courage and determination, in order to meet the Millennium Development Goal of beginning to reverse the spread of AIDS by 2015. Those include: the need to reduce stigma and discrimination against those living with or infected by HIV/AIDS; to implement and recognize the importance of broad-based partnerships; and the need to mobilize resources on a scale far greater than had been achieved so far. (See Press Release SG/SM/8890.)
The President of Estonia spoke this afternoon, as did the Foreign Ministers of the following countries: Iran; Morocco; Denmark; Norway; Viet Nam; Ireland; Sudan; Austria; Canada; Slovenia; Paraguay; Venezuela; The former Yugoslav Republic of Macedonia; Russian Federation; Finland; Cyprus; Croatia; Malta; Spain; Serbia and Montenegro; Sri Lanka; Yemen; and Pakistan.
Also speaking this afternoon were the Minister for Foreign Affairs, Cooperation and Communities, Cape Verde; Acting Minister for Foreign Affairs, Sweden; Minister of State, United Kingdom; Minister of State for Economic Cooperation, Germany; Minister for Foreign Affairs and International Cooperation, Sierra Leone; Minister for External Affairs, India; Minister for Foreign Affairs and Worship, Bolivia; Deputy Minister for Foreign Affairs, Bosnia and Herzegovina; Vice-Minister for Foreign Affairs, Thailand; Deputy Minister for Foreign Affairs, Japan; Deputy Minister for Foreign Affairs, Cuba; Alternate Minister for Foreign Affairs, Greece; Minister of State and Chairman, National AIDS Authority, Cambodia; and Minister for Foreign Affairs and Cooperation, Niger.
Additional speakers at the ministerial level were from: Indonesia; Namibia; Philippines; Iceland; Peru; Kenya; Malaysia; Cameroon; Angola; Bahamas; Botswana; Argentina; Bangladesh; Cote d’Ivoire; Congo; Mauritius; Romania; Lithuania; Burundi; Czech Republic; Trinidad and Tobago; and China.
Statements were also made by the representatives of the Republic of Korea, Colombia, Dominican Republic, Belize, Poland, Syria, Belarus, Grenada, Nicaragua, Swaziland, Ecuador, Bahrain, Malawi, Marshall Islands, Jamaica, Nepal, Uruguay, United Arab Emirates, Liechtenstein, Bulgaria, Guinea, Lao People’s Democratic Republic, Zambia, Albania, Eritrea, Haiti, Zimbabwe, Honduras, Chile, Benin, and Ethiopia.
The Permanent Observer for the Holy See also spoke, as well as the Chairman of the Observer delegation of the Sovereign Military Order of Malta, and the Chairman of the Observer delegation of the European Community.
The Assembly will meet at 10 a.m. on Tuesday, 23 September, to begin its general debate.
The General Assembly met this afternoon to continue its high-level plenary meeting on HIV/AIDs.
COLIN POWELL, Secretary of State of the United States, said he was pleased to reaffirm President Bush’s commitment to the global fight against HIV/AIDS. The advance of freedom and hope was challenged by the spread of AIDS. It was more devastating than any terrorist attack or weapon of mass destruction, and it was as cruel as any tyrant. It tore apart families and communities and undermined governments. It could destroy countries and destabilize entire regions. The disease continued to present moral, political, economic and security challenges. While the international community continued to face an AIDS crisis of crucial proportions, important progress had also been made. The Global Fund to Fight AIDS, Tuberculosis and Malaria was today a reality. The United States remained the largest single contributor to the Global Fund, and new contributions were coming in. The Fund was helping to deliver life-saving treatment and prevent new infections.
Since the special session, there had been a change of attitudes, he said. When people lacked knowledge, the virus thrived and hope withered. More public figures were speaking out, sending the message that people living with AIDS should not be treated with cruelty but compassion. He urged the Assembly to adopt a resolution reaffirming the need for all countries to reach the Declaration’s goals. The United States would remain at the forefront of the worldwide effort to combat AIDS, and it remained the largest donor of bilateral AIDS assistance, providing half of all international AIDS funding.
A $15 billion five-year emergency plan had been signed into law with overwhelming support. Noting that it was the largest initiative on a specific disease, he said the plan would focus on 14 of the most affected countries in Africa and the Caribbean; treat 2 million people with antiviral drugs; and care for 10 million orphans. Governance alone could not address the global AIDS crisis; the private sector must be made an integral part of the fight. In the worldwide fight against AIDS, every nation must be both a leader and partner. All countries had a strong ally in the United States.
KAMAL KHARRAZI, Minister for Foreign Affairs of Iran, said among the world’s continents, Asia was projected as having the highest infection rates for HIV/AIDS. Although Iran’s social traditions and religious beliefs had prevented the disease from spreading too much, its presence was growing nonetheless. Therefore, the Government had taken several steps towards implementing the Declaration of Commitment, including the establishment of a high-level commission, consisting of government officials, to monitor the National HIV/AIDS Control Programme. In addition, a National HIV/AIDS Control Committee had been formed to focus on information, education, treatment, risk reduction, social support and monitoring.
Although care and support services were provided free of charge, he said more financial and technical assistance was needed. Emphasizing the importance of cultural, family, ethical, and religious factors in preventing and treating the disease, he maintained that it was essential specifically to promote responsible sexual behaviour, family values, and better moral choices, as well as poverty reduction. Also, special attention must be paid to the affordability and accessibility of safe and effective drugs on the international market.
ACHMAD SUYUDI, Minister of Health and Social Welfare of Indonesia, said that while strong efforts were being made to combat HIV/AIDS, the grim reality presented by ever-increasing statistics suggested that the war was far from over. Efforts to combat the disease were being hampered by the continuing gap between the availability of resources and the demand for effective and prompt implementation of the AIDS commitments.
Enhanced facilitation through the leadership of the United Nations was crucial, especially for developing countries, he said. It was particularly important in the areas of technical cooperation and capacity-building programmes; reduction of debt burdens; and flexible implementation of Trade-Related Aspects of Intellectual Property Rights (TRIPs) in order to enable the least developed countries to provide cheap generic drugs to people living with AIDS.
Monitoring the impact of AIDS, and the programmes used to confront it, was critical to sustaining successful programmes and to continuing activities to raise funds, he said. It was a key role of the United Nations to use its unique position to help ensure that countries were able to programme resources in an efficient and transparent manner, that objective monitoring and evaluation was undertaken, that data were collected, and that the results of the work were used to adjust programmes and mobilize further resources.
KHURSHID M. KASURI, Minister for Foreign Affairs of Pakistan, said that HIV/AIDS had not only brought development in affected countries to a grinding halt; it had, in fact, reversed the achievements of several decades. Combating the disease and eradicating poverty must, therefore, go hand in hand. In order to achieve that, the active cooperation of the international community, particularly that of the developed countries, was necessary. In particular, the developed world must create an enabling international economic environment through enhanced debt relief, market access and official development assistance (ODA).
The establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria had been a step in the right direction, he said. It represented a new approach towards international health financing. Against a projected requirement of
$7 billion by 2007, the international donors had pledged $4.7 billion, he said. However, the amount received so far had not exceeded $1.5 billion. Unless sustained with the requisite resources, the Fund would fail to meet its objectives. Pakistan urged the donor community to allocate additional resources to the Fund.
LIBERTINA AMATHILA, Minister of Health and Social Services of Namibia, said prevention was central to her Government’s response to the spread of HIV/AIDS. In that context, she highlighted education programmes that had been instituted in offices, targeted at women and youth, and produced in all local languages. As a result of such campaigns, her country was beginning to detect the stabilization and reduction of HIV-infection rates, especially among young people. Additionally, programmes had been set up to prevent the transmission of HIV/AIDS from mother to child, and to treat parents free of charge in order to prevent a surge in the number of orphans.
Emphasizing that care, support, and treatment were fundamental to her country’s response, she said her Government was committed to providing free antiretroviral medicines to members of the Public Service Employees’ Medical Aid Scheme and their dependants. That endeavour was supported by private companies and faith-based institutions. Additionally, her country had enacted laws to prohibit discrimination against people living with HIV/AIDS. For the orphans that resulted from the epidemic, despite national programmes to prevent the deaths of parents, there was a programme of financial and educational assistance in place.
MANUEL M. DAYRIT, Minister of Health of the Philippines, said that early recognition of the threat of HIV had galvanized an early response in his country, but the high number of people at risk of infection, mainly those engaged in commercial sex and practising risky sexual behaviour, remained high. To address that issue, his country was providing nationwide education and information strategies through the schools, health centres and workplaces.
He said the Philippines was cooperating with other governments in the region regarding migrant populations by addressing the various stages of the migration process and was fully committed to the Association of South-East Asian Nations (ASEAN) five-year work plan on HIV/AIDS for mobile populations. His country was acutely aware of the fact that its low prevalence situation must spur it to strive for even more effective preventive and treatment efforts and reaffirmed its commitment to strengthen the political resolve to combat HIV/AIDS.
SAMUEL RUDOLPH INSANALLY, Minister for Foreign Affairs of Guyana, said that since the special session, several significant additions had been made to the world’s arsenal of tools to fight the pandemic, including the establishment of the Global Fund. It was disappointing, however, that many countries approved for funding had not received disbursements. He was pleased with the United States initiative to provide $15 billion to fight AIDS, including a major effort to fight mother-to-child transmission of the disease.
Among the daunting challenges facing developing countries were debt burdens and debt-servicing obligations, he said. Relief processes needed to be accelerated and must be made less restrictive to allow countries like Guyana to build social services programmes. Macrodevelopment issues were at the heart of the ability to fight the disease. In that regard, it was necessary to accelerate efforts to make voluntary testing and counselling available to every citizen.
He said human resources, as well as financial resources, played an important role in the fight against HIV/AIDS. Guyana was facing a constraint in retaining highly qualified personnel, especially nurses. Nurses were often offered compensation and working conditions that were far beyond the ability of developing countries to provide. Financial programmes to expand training programmes must be explored. The world should not underestimate the magnitude of the pandemic.
MOHAMED BENAÏSSA, Minister for Foreign Affairs of Morocco, said his country had developed a comprehensive strategy based on detection, therapy and prevention. This strategy, he said, called for the involvement of all actors, including government agencies and civil society in large awareness-raising campaigns.
He said that, for further progress to be achieved, there was a need for additional financial resources and that would provide access to affordable drugs, preventive education and effective implementation of the national strategies.
PER STIG MOLLER, Minister for Foreign Affairs of Denmark, said the right policies and institutional frameworks to fight HIV/AIDS now existed in many countries. What was needed was the implementation of the policies through broad-based, effective programmes. That would require political leadership and the willingness to talk openly about the epidemic and to make the fight against it a political priority. He stressed the need for political leaders to stamp out all discrimination and stigmatization of infected people and declared that increased financial and human resources must be set aside for the fight against HIV/AIDS in each and every country.
The role of women was of great significance, not least in sub-Saharan Africa, he continued, because they were particularly vulnerable to the epidemic. Most countries now had national policies to ensure equal access to services, but plans and policies alone would not reduce the special risks that women faced. To fight HIV/AIDS, women must achieve true economic and social empowerment, he stressed.
JON KRISTJANSSON, Minister of Health and Social Security of Iceland, said his Government had integrated the fight against HIV/AIDS into its national campaign against all sexually transmitted diseases. Thus, because HIV/AIDS had long been acknowledged, and effective treatment had been made available, it was rarely seen in his country nowadays. Nevertheless, he confessed that there had been a proportional increase in infection rates among immigrants to Iceland.
Calling on all countries to strengthen plans to reduce the epidemic’s social and financial impact, he said they needed to support steps to achieve the goals set down by the Declaration of Commitment. For example, governments had to improve the lot of socially disadvantaged classes who had greater risks of infection, and encourage the development of drugs and vaccines. To assist, his Government had committed itself to donating 15 million Icelandic kronas to the Global Fund on HIV/AIDS, Tuberculosis, and Malaria.
JAN PETERSEN, Minister for Foreign Affairs of Norway, said combating HIV/AIDS required global leadership, partnership and action. No government could deal with the challenges of the pandemic on its own. Extraordinary partnership between political leaders, international organizations, national public health systems, civil society and the private system was needed. He welcomed the opportunity to review achievements and reinforce efforts to reach the Declaration’s targets. Prevention, treatment and care were equally important to combat HIV/AIDS efficiently. Without well-functioning treatment and care, prevention would also fail. National health systems must be strengthened to make them better able to develop and sustain treatment programmes and care.
He welcomed the agreement reached by the World Trade Organization (WTO) to provide developing countries with greater access to cheaper medicines, including HIV-related drugs. The struggle against HIV/AIDS required the application of distinct and mutually reinforcing approaches that reached out to men, women and children. Norway was committed to the empowerment of women so they could protect themselves. Openness and dialogue towards children must also be encouraged. In southern Africa, emergency and long-term assistance must be better coordinated and combined. Norway was a firm supporter of United Nations efforts to halt the HIV/AIDS pandemic through the Joint United Nations Programme on HIV/AIDS (UNAIDS).
ARNOLD RÜÜTEL, President of Estonia, said the people of the world understood that the HIV/AIDS pandemic was neither the problem of only the infected and their families, nor a problem concerning only single States. That was a problem that the international community must tackle together and on a global scale. The spread of HIV/AIDS was a serious problem for Estonia, as well. In Estonia’s case, 70 per cent of those infected were young people of 15 to 24 years old; therefore, the Government put special emphasis on its work with the young and also on prevention campaigns.
Apart from governments, the non-profit and private sectors, as well as local authorities, should also be involved in HIV/AIDS prevention, he said. He also highlighted the role of schools and youth organizations and stressed that prevention in institutions of detention was also important. One of the main risk groups in Estonia consisted of drug addicts, he continued, and he, therefore, felt that the fight against HIV/AIDS should go hand in hand with drug prevention. That called for even more aggressive international endeavours, especially against both drug and human trafficking.
NGUYEN DY NIEN, Minister for Foreign Affairs of Viet Nam, said that since the emergence of HIV/AIDS in his country in 1990, the Government had given due attention and had taken strong action to prevent its spread. Constant efforts had been made to promote public awareness of HIV/AIDS infection and preventive measures, and the Government had gradually improved care and treatment services for the victims.
Given that the HIV/AIDS pandemic brought colossal burdens in terms of finances and health care to bear upon poor countries, Viet Nam called on developed countries to fulfil their commitments to contribute to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria. In the same vein, he urged big pharmaceutical corporations, which held intellectual property rights for HIV/AIDS medicines, to adopt a policy on price reduction for poor countries and to lease the patents so that poor countries could produce medicine for their own patients.
ME TSHABALALA-MSIMANG, Minister of Health of South Africa, said her country had turned the corner. In other words, HIV/AIDS awareness had increased to over 95 per cent and, the fact that the rate of young women abstaining from sex had increased, demonstrated a significant behavioural change. Stressing that many South African companies had HIV/AIDS policies in place, she added that, in her country, the private and public sectors were working together to combat the disease’s effects.
She declared that, with the withdrawal of a lawsuit against her Government by major pharmaceutical companies, access to affordable medicine had been improved. However, she lamented that the high cost of other medical technologies, such as diagnostic laboratory reagents, remained a challenge. Additionally, developed countries continued to poach her country’s valuable health workers. Nevertheless, she stressed that her Government had a definite framework set down to combat HIV/AIDS, and she suggested that international collaborating powers consider the national strategic plans of developing countries when “parachuting” programmes into them.
ALVARO VIDAL, Minister of Health of Peru, speaking on behalf of the Rio Group, said the Declaration adopted in 2001 had been a milestone in the struggle against HIV/AIDS. Today, health and well-being were affected by numerous factors. Threats to public health, such as HIV/AIDS, also represented a security threat. Political will was not always sufficient to fight the disease. In that respect, the Global Fund, which had contributed to implementing programmes and expanding infrastructure to combat the disease, played an important role. New financial resources were also needed to strengthen national responses to the epidemic, making it possible to frame new policies in cooperation with civil society.
At the regional level, efforts had been made to reduce the prices of medicine, he said. This year, the nations of the region had joined together to find the lowest prices for antiretroviral drugs. He reiterated the Group’s commitment to the pledges made in 2001, saying the Group was morally committed and responsible for the people in its region living with HIV/AIDS. The Group would continue working to eradicate the scourge of HIV/AIDS, which affected all of humanity in some way or another.
MUSTAFA OSMAN ISMAIL, Minister for Foreign Affairs of the Sudan, thanked the Secretary-General for his work to raise the profile of the problem of HIV/AIDS and his efforts towards creating the Global Fund to Fight AIDS, Tuberculosis and Malaria, the effects of which had already become measurable. He asked the donors, in particular the Group of Eight, to increase their contributions to the Fund. The number of declared cases of HIV/AIDS in the Sudan had grown continuously since the first case was diagnosed in 1986. That increase was the result of a number of common factors prevalent in sub-Saharan Africa, including malnutrition and the lack of institutional capacity to confront the disease.
His Government was trying to raise awareness of the disease among the Sudanese people, he said, and a considerable foreign aid component would be required to implement its plans. HIV/AIDS was a new and growing obstacle to development and was preventing local and international development efforts from reaching their goal.
MARIA DE FATIMA LIMA VEIGA, Minister for Foreign Affairs, Cooperation and Communities of Cape Verde, expressed deep concern that progress in the fight against HIV/AIDS was being hindered by a lack of resources. In her country, more and more people were becoming infected despite government efforts. The segment of the population that was most affected was between the ages of 15 and 55. That was worrying since they were the most active members of society, she said.
Declaring that her Government had started fighting HIV/AIDS in the 1980s, she told delegates that her Prime Minister chaired a committee to better address the issue. That committee included representatives from the Government, the private sector, civil society and other sectors. The group’s work was important, given the effects of the disease on peace and security. In that context, she appealed to partners in the developed world to be generous with donations that would assist the fight against HIV/AIDS.
WELLINGTON GODO, Permanent Secretary in the Ministry of Health of Kenya, said much progress had been made in implementing HIV/AIDS programmes, including through paternerships with non-governmental organizations (NGOs) and faith-based organizations. Young people in Kenya, who accounted for some 60 per cent of the population, were being targeted. There was an urgent need to reduce the suffering of people living with HIV/AIDS by increasing access to medicines, he said. By the end of 2003, some 11,000 Kenyans were expected to receive HIV/AIDS drugs, and the Government was strengthening its infrastructure for health-service delivery. To reduce the proportion of infected infants, the Government had expanded services for the prevention of mother-to-child transmission.
Kenya had one of the highest numbers of AIDS orphans, some 2 million, he said. In that regard, policies for orphans and other children were being developed. With key partners such as the United Nations Children's Fund (UNICEF), Kenya was working on initiatives for children affected by the disease. He thanked the Global Fund for approving Kenya’s financial requests, which would allow for the penetration of rural areas. He appealed to the international community and the private sector to continue contributing to the Global Fund.
JAN O. KARLSSON, Minister for Foreign Affairs of Sweden, said the only way to win the fight against HIV/AIDS was with “open eyes and open minds”. Young people needed support and guidance in order to protect themselves and their partners. He added that women’s empowerment was key in fighting the epidemic because of the high rate of infection among them and of the disproportionate burden they shouldered in caring for the sick and providing for the entire family.
He said his country had increased its ODA from 0.81 per cent of gross domestic product (GDP) to 0.86 per cent; appointed an ambassador for issues related to HIV/AIDS, and increased support to UNAIDS from $7 million to
$12 million and to the United Nations Population Fund (UNFPA) from $25 million to $33 million. Prevention was Sweden’s main focus, but the entire chain of actions needed to be strengthened with renewed focus on treatment, care, the development of vaccines and access to medicines. He also underlined that HIV/AIDS was about traditional power structures which must be broken in order to quell the epidemic
BRIAN COWEN, Minister for Foreign Affairs of Ireland, said he intended to his country’s presidency of the European Union in the first half of 2004 to drive forward the fight against HIV/AIDS and to “prioritize work on HIV/AIDS in the development agenda of the European Union presidency”.
The Secretary-General’s report pointed out that, globally, the fewer than one in four people at risk of infection were able to obtain basic information regarding HIV/AIDS, he said that was a key challenge that must be tackled if the lives of millions of young people were to be saved. Stronger coordination was needed at the global level between the relevant United Nations agencies, the World Bank and the Global Fund, and it was imperative that every cent mobilized for HIV/AIDS be well spent. Noting that Ireland was a supporter of the International AIDS Vaccine Initiative, he said countries needed to work together to ensure that future generations were protected from disease, through a cheap and effective vaccine.
BENITA FERRERO-WALDNER, Minister for Foreign Affairs of Austria, noting that human rights were inextricably linked with the spread and impact of HIV/AIDS on individuals and communities around the world, said the epidemic was more than a health problem –- it was a challenge to society as a whole. Where individuals and communities were able to realize their rights -– to education, free association and non-discrimination –- the personal and societal impact of HIV and AIDS were reduced. Thus, the importance of human rights education.
Combating HIV/AIDS must also be coordinated with efforts to reduce poverty, she said. The overwhelming burden today was borne by developing countries, where the disease threatened to reverse vital achievements in human development. HIV/AIDS and poverty were mutually reinforcing. In that context, she announced that the budget for Austrian development cooperation would increase by 35 per cent in 2004.
BILL GRAHAM, Minister for Foreign Affairs of Canada, said the ravages of the HIV/AIDS pandemic were affecting almost everything the United Nations and Member nations were trying to accomplish, threatening to subvert progress in areas such as development, trade and agriculture. The international community could not hope to achieve any real success in its collective efforts until it addressed that pandemic and the devastation it had wrought on societies around the world.
That was not to deny that some progress had been made over the past two years, he said, and in some countries, for example, Ethiopia and Uganda, the pandemic was showing signs of abatement. That trend would continue only if the cycle of transmission was broken, he declared. Among other priorities, that required addressing the disproportionate impact of HIV/AIDS on women and girls though measures, including access to high-quality sexual and reproductive health care and services.
ALAIN BEDOUMA YODA, Minister of Health of Burkina Faso, said that, since 2001, his Government had strengthened its commitment to fighting HIV/AIDS. From a financial standpoint, it had invested $4 million into various programmes in 2002, and he expressed hope that the figure would rise. Ministerial committees had implemented national programmes on prevention, and 13 provinces, accounting for 45 per cent of the total population, were also engaged in prevention activities. Noting that traditional and religious communities were helping in the fight against HIV/AIDS, he added that 21 per cent of pregnant women with the disease were currently participating in a mother-child transmission prevention programme.
He expressed satisfaction that antiretroviral drugs had dropped in price following negotiations with pharmaceutical firms and talks with Brazil about purchasing generic drugs. Nevertheless, he urgently appealed to developed countries to continue helping. Stressing that antiretroviral drugs must be made more accessible to people everywhere, he said that those suffering should not have to wait for a multitude of tests to be carried out on primary and secondary subjects. The world community must meet the challenge of HIV/AIDS vigorously so that the scourge would only be a horrendous memory in the future.
DIMITRIJ RUPEL, Minister for Foreign Affairs of Slovenia, said his country had invested sustained and consistent efforts to keep the number of HIV/AIDS cases at a very low level. The success of Slovenia’s HIV/AIDS policies was the result of a multisectoral and comprehensive approach. He underlined the fact that his country’s National AIDS Prevention and Control Programme had three broadly defined objectives: prevention, reduction of social and personal impact, and mobilization of national efforts.
He also reiterated Slovenia’s readiness to share its knowledge and experience with other countries, as well as its willingness to participate in regional and global efforts, to develop strategies and response to the HIV/AIDS epidemic.
DATO’CHUA JUI MENG, Minister of Health for Malaysia, said his country placed a great priority on prevention programmes for the young, including the Anti-AIDS Programme for Youth, which had trained 40,000 young people as peer educators. In addition, he said women were a top priority, with the Government providing free and voluntary HIV screening to pregnant women and free antiretroviral treatment to HIV-positive mothers to prevent transmission to their babies.
Treatment was an essential part of all national responses to HIV/AIDS, he said. Access to treatment, however, was not just dependent on financial means. “Stigma and discrimination plays a great part in both the effectiveness of prevention and treatment,” he said. Malaysia was committed to the fight against AIDS. Until 2001, an average $9 million per year had been spent on HIV/AIDS activities. In 2002 and 2003, an average of $10.37 million had been devoted to those activities, an increase of 13.1 per cent over the annual averages before the United Nations General Assembly special session.
URBAIN OLANGUENA AWONO, Minister of Public Health of Cameroon, calling HIV/AIDS a challenge for the international community, said that the infection rate in his country had reached 11.8 per cent in 2002, and the Government’s response must, therefore, be bold. The Government of Cameroon had, therefore, implemented a plan to tackle HIV/AIDS and its consequences head on.
Over the past three years, the expansion of access to treatment and support had improved the quality and effectiveness of the response to HIV/AIDS, he said. The Government had established 136 sites for prevention activities and was also targeting the problem of mother-to-child transmission. It was also important to focus on women and young people, who were the most vulnerable. Furthermore, the Government considered access to high-quality health services a fundamental right of each citizen.
ALBERTINA JULIA HAMUKWAIA, Minister for Health of Angola, said the spread of HIV/AIDS was seriously threatening the development achievements that African countries had made since independence. With a relatively low regional rate of infection, Angola was, nevertheless, interested in containing the epidemic. After all, the effects of HIV/AIDS were seen in many spheres, as the disease increased poverty, broke up families, and increased school dropout rates.
The President of Angola had responded to the problem by coordinating the National Commission to Fight HIV/AIDS, she said. Other initiatives included a special fund to combat the epidemic, massive education campaigns, free condom distribution, and the opening of testing and counselling centres. Highlighting the remarkable advances achieved through antiretroviral drugs, she lamented, nevertheless, that they were often not accessible enough.
MARCUS C. BETHEL, Minister of Health of the Bahamas, said his country had established a multidisciplinary, integrated and comprehensive national AIDS programme, which served as a model for the Caribbean region. Care and support of persons with HIV/AIDS had been a major component of its national response, coupled with prevention, epidemiological surveillance and public education. The Government was committed to the Declaration of Commitment and had spent some $5 million in recent years on services to implement an HIV/AIDS strategic plan. It intended to provide universal access to antiretroviral therapy by 2005, provided that the cost of such drugs continued to decrease and that negotiations with pharmaceutical companies for reduced prices were successful.
He said the Bahamas had started to meet some of its national targets to combat HIV/AIDS. Antiretroviral therapy had been provided to some 25 per cent of the targeted population in a one-year period. All HIV-positive pregnant women received full antiretroviral treatment during and after pregnancy, resulting in a reduction of mother-to-child transmission to some 3 per cent in 2002. As tourism was the main engine of economic growth, some 40 per cent of hotels had prevention programmes. Due to such programmes, the prevalence rate in the Bahamas had been significantly reduced over the last seven years, and deaths from the disease had decreased by some 50 per cent in 2002. Despite that success, the Bahamas faced many challenges that must be addressed in order to sustain its HIV/AIDS programme. Combating HIV/AIDS must remain a national and international priority, he stressed.
USCHI EID, Minister of State in the Foreign Ministry of Germany, said her country had actively supported international efforts to fight the HIV/AIDS epidemic. Germany had recently been involved in setting up the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria and had recently raised its financial commitment to the Fund from 200 million to 300 million euros. Noting her country’s advocacy of making drugs more accessible a major concern in discussions of the WTO’s TRIPs Agreement, she urged international players to deliver on their respective commitments, despite the recent stalling of the trade negotiations at Cancún.
She said Germany had been active in fighting HIV/AIDS in 50 countries, and in 16 of them, its cooperation was focused on the health sector. She also underlined her country’s success in using creative and innovative approaches, such as the social marketing of condoms and theatrical plays.
AICHATOU MINDAOUDOU, Minister for Foreign Affairs and Cooperation of the Niger, said it had been 20 years since the HIV/AIDS epidemic had dropped on the world like a bomb. Since then, there had been an explosion of negative effects across a wide spectrum. It was now time, she said, to see if the world was on the right path towards meeting future objectives. In order to make progress, the international community had to improve access to drugs in developing countries, where frightening figures revealed a dramatic health crisis. Thus, political will and greater financial support were needed.
In the case of the Niger, it had seen its first HIV/AIDS cases in 1987. Since then, infection rates were increasing, with the majority of new cases involving young people between the ages of 15 and 29. The Government had set up a framework to combat the spread of the disease. Included within that structure was the work of the Office of the President, which was engaged in improving access to antiretroviral drugs. It was also attempting to improve the economic situation of poor people, strengthen social services in rural areas, and enact legislation to protect the rights of those living with HIV/AIDS.
LEILA RACHID COWLES, Minister for Foreign Affairs of Paraguay, said that, despite the importance of the 2001 Declaration on HIV/AIDS, the international community was far from achieving its effective implementation and fulfilment. Since 1995, the Government of Paraguay had allocated a special budget to implement a national programme to combat the HIV/AIDS epidemic. It had developed measures designed to address the needs of vulnerable groups, such as women and children, and had given priority to the human rights of people living with AIDS, ensuring respect for human dignity and full access to sexual and other education.
ROY CHADERTON-MATOS, Minister for Foreign Affairs of Venezuela, said the Declaration was a milestone of far-reaching importance and an example of a vital United Nations initiative. The right to health was implicit in the right to life. Venezuela had made tremendous efforts to fulfil the international commitments it had undertaken, both at home and abroad. It had made significant progress, despite its recent economic difficulties. Significant financial resources had been earmarked for large-scale programmes. The Ministry of Health, for example, was carrying out an AIDS-prevention project for young people, which had included more than 150 local management teams. Through an ombudsman’s office, a number of workshops had been conducted in the area of prevention and education.
Saying that resources were insufficient and greater means were required to cover the high cost of treatment, he appealed to the international community to renew its political commitment and contribute greater financial resources to combat HIV/AIDS. That could be done by, among other things, promoting the building of technical capacities and the transfer of technology and expertise to the most affected countries.
HILARY BENN, Minister of State of the United Kingdom, said AIDS was increasingly affecting the whole world, and the international community must work hard to prevent epidemics elsewhere reaching the scale of those in Africa. What millions of fellow human beings dying of AIDS needed was action. First, money must be found for the fight. The United Kingdom had already pledged $280 million to the Global Fund over seven years, and was also backing research into vaccines and microbicides. Second, the international community must ensure that the way it offered money actually supported what countries were already doing, rather than demanding extra reporting or more meetings of hard-pressed staff.
Third, he continued, the international community must recognize that AIDS treatment was the most immediate and pressing issue, and it must use all means possible to fight the disease. He strongly welcomed the World Health Organization’s target of getting 3 million people in treatment by 2005. Fourth, the international community must begin grasping the awful inequity of four Africans dying of AIDS every minute, while antiretrovirals in richer countries made it possible for people with AIDS to return to work. Fifth, it must do more to support the staff, hospitals and clinics needed to deliver those drugs safely and fairly.
ILINKA MITREVA, Minister for Foreign Affairs of the former Yugoslav Republic of Macedonia, said the complexity of the pandemic knew no boundaries and required global efforts to fight it. The former Yugoslav Republic of Macedonia had taken the necessary steps to adopt a national strategy for 2003-2006 for the development, implementation and evaluation of HIV/AIDS programming. A number of innovative HIV/AIDS projects were being implemented, many of which were carried out in cooperation with various United Nations agencies.
While steady progress had been made in addressing HIV/AIDS, much remained to be done, she said. Although current infection rates were low, the trend in central and south-east Europe suggested a very real potential for the rapid spread of HIV/AIDS. On a national level, a number of gaps had been identified, including among youth and other vulnerable groups. The fight against HIV/AIDS required constant awareness and action and could only be won through coordinated global response.
LESEGO MOTSUMI, Minister of Health of Botswana, said that her country, with a small population of 1.7 million people, had the unenviable distinction of recording one of the highest HIV infection rates in a general adult population, which measured 35.4 per cent in 2002. A comprehensive response had been mounted with the assistance and support of partners. Political leaders, civil society, religious organizations and the business sector would be mobilized to integrate a response into the national development plan within a strategic framework for 2003-2009. The goal was to achieve an AIDS-free generation by 2016 by targeting prevention towards young people and other vulnerable groups.
Treatment services had been expanded and free antiretroviral treatment was available at seven sites in the country, she said. Another seven centres would be established by March 2004. The prevention of mother-to-child transmission was a high priority. Still, the epidemic had reversed much of the country’s progress in the health and development sectors, and its negative impact on economic growth threatened the sustainability of responses to it. In addition, the disease had reduced the country’s human resources and infrastructure for the provision of services. The support of partners and the international community was, therefore, vital, she said.
GINES GONZALEZ GARCIA, Minister of Health of Argentina, said risks to health stemmed not only from lifestyles, but also from fate. Poor populations all over the world could only overcome their inequitable fate of poverty if they were supported by the societies in which they lived. Argentina had declared its AIDS programme protected to shield it from financial crisis. In 2002, World Health Organization (WHO) and UNAIDS had supported the country in protecting and continuing its AIDS programme.
Healthy people were educated, employed and committed to growth and progress, which made fighting AIDS a priority, he continued. The State, community, and civil society had all helped in achieving significant results in that fight. Argentina was now treating 25,000 people with antiretroviral drugs, providing advice on AIDS prevention and mounting massive campaigns to promote the use of condoms. It was also providing assistance to national AIDS programmes in countries requesting assistance.
IGOR S. IVANOV, Minister for Foreign Affairs of the Russian Federation, said that unless HIV/AIDS stopped spreading in his country, the number of people infected with the virus could reach 5 million. Describing the situation as a demographic crisis, he said Russia had intensified measures to bring about a comprehensive solution. It had also implemented a federal programme providing urgent measures to prevent the spread of the virus and had been one of the few countries to successfully introduce a system allowing detection and monitoring of people with AIDS and those who were HIV-positive.
He said his country had passed a federal law that would protect the rights of those infected with the virus and implemented a series of special preventive measures carried out by Russian doctors. In addition, at the initiative of the Russian Federation, he said, urgent measures to counter the spread of HIV/AIDS in member States of the Commonwealth of Independent States (CIS) had been worked out. Russia had already invested $4 million in the Global Fund to Fight AIDS, Tuberculosis and Malaria and had pledged a total of $20 million.
KOFI ANNAN, Secretary General of the United Nations, reported on the High-level Interactive Panel held this afternoon, saying it had been attended by 10 heads of State and government, a large number of ministers, six heads of United Nations agencies, and more than 20 representatives of civil society. Three critical areas had been identified, that must be addressed with “courage and determination” in order to meet the Millennium Development Goals: the need to reduce stigma and discrimination; the importance of broad-based partnerships; and the need to mobilize resources on a scale far greater than had yet been achieved. A key theme running through the panel discussion was the recognition that AIDS represented the greatest leadership challenge.
He said the discussion had highlighted the need for leadership that must be characterized by frank and honest recognition of the impact of AIDS on societies. It identified stigma and discrimination as some of the most formidable obstacles to future progress, undermining the scaling up of both prevention and treatment efforts. The discussions had also focused on the massive impact of AIDS on women. Equally critical was the involvement of people living with HIV/AIDS in all aspects of the fight against the pandemic.
The question of resources was of paramount concern, he went on. While resources available to HIV/AIDS had doubled since the special session of 2001, they remained woefully inadequate. Resource flows must double once again to reach the $10 billion required annually by 2005 to stem the tide of AIDS. Panellists had stressed the need to ensure adequate funding for the Global Fund, as well as other key partners. Participants from developing countries had expressed their commitment to increasing their own spending on HIV/AIDS.
Noting that the conclusions of the panel had not been pessimistic, he said that every day one learned about what worked. Resources were increasing and political leadership was gaining steam. But he stressed the need to stay the course and redouble efforts in order to remain true to the Declaration of Commitment.
MOMODU KOROMA, Minister for Foreign Affairs and International Cooperation of Sierra Leone, said a national biological and behavioural survey to determine the sero-prevalence of HIV and various attendant sexual attributes in his country had revealed an average national HIV prevalence of 0.9 per cent. In spite of that low rate, the Government, with the support of the World Bank, was implementing a four-year multisectoral programme on HIV/AIDS, without which the rapid spread of the scourge would have had damaging consequences for the education, social welfare, transportation, defence, agriculture, mining and other sectors. At the same time, each of those sectors could, in turn, provide significant contributions to the overall fight against HIV/AIDS.
The Government was presently collaborating with the UNAIDS Inter-Country Team for West and Central Africa to develop a subregional response designed to strengthen partnership between Guinea, Liberia and Sierra Leone. The aim was to put together a comprehensive programme to address HIV/AIDS within the Mano River Union Basin. The Government was also collaborating with the United Nations Theme Group on HIV/AIDS to develop a National Strategic Plan. But in order for the national and regional programmes to succeed, additional support was needed from the international community.
ERKKI TUOMIOJA, Minister for Foreign Affairs of Finland, highlighted several of his Government’s objectives with respect to the fight against HIV/AIDS. First, it was essential that all people, especially the young, learn how to avoid infection. Thus, schools should work on providing youth-friendly, high-quality lessons on sexual health. Campaigns also had to include children who were not in school, he stressed. Regarding human rights, overcoming discrimination against victims and removing the stigma of infection were important in the fight against HIV/AIDS.
Also tied to the fight against the disease was the theme of poverty reduction, he said. After all, countries had to address the fact that the pandemic was having an immense impact on economies throughout the world. In conclusion, he said, no matter how good the various policies and strategies, they were worthless if not implemented at the national level. Such commitment to implementation would be a major challenge throughout the coming years.
GEORGE IACOVOU, Minister for Foreign Affairs of Cyprus, said that since the diagnosis of its first AIDS case in 1986, his country had given the disease top priority. A national AIDS committee comprising governmental authorities, NGOs and private institutions had been established. HIV/AIDS patients received medical treatment and social support at no cost. The committee acted to prevent discrimination against those infected with the virus and had launched several public-awareness campaigns. Such efforts were responsible for the low-prevalence rate of HIV/AIDS infections in Cyprus.
He said the situation was still closely monitored and that Cyprus was drafting a new strategic plan, which would incorporate new findings and promote multilevel interventions and intersectoral collaboration. He also called attention to an updated and comprehensive legal framework intended to safeguard the right to equal treatment for all citizens and to eliminate discrimination against HIV-positive people.
TONINO PICULA, Minister for Foreign Affairs of Croatia, said that the challenges posed by HIV/AIDS remained as large as ever. In that respect, he stressed the importance of the Secretary-General’s report, which warned the international community that, in spite of all the measures that had been taken by States so far, they were still insufficient to halt the epidemic’s negative impact or to reverse the acceleration of new cases in the future.
Parallel to global efforts, national policy-makers should be held accountable in the fight against HIV/AIDS, he said. Therefore, in looking for a holistic approach, Croatia had taken a number of measures nationally. As part of the Government’s commitment, campaigns had been organized through the electronic and print media. Preventive programmes included providing replacement paraphernalia for drug users and high-risk groups, as well as to the general public.
YASHAWANT SINHA, Minister for External Affairs of India, said that protection of the rights of the HIV/AIDS-infected population was an important responsibility, which the country sought to address. The National Programme on AIDS included campaigns to eliminate the stigma and discrimination faced by HIV-positive people. Among steps taken by the Government was the establishment of voluntary counselling and confidential testing centres to provide social and psychological support to patients. Indian pharmaceutical companies were producing antiretroviral AIDS drugs at relatively affordable prices.
In the efforts to step up medical research in the field of HIV/AIDS, governments should not leave the responsibility entirely to the private sector, he continued. The international community should also pool its technical expertise and resources for that purpose. While essential, political intervention and adoption of national strategies did not, by themselves, ensure the achievement of the targets established for 2005 and 2010. While the primary responsibility for dealing with AIDS rested with national governments, there was a greater need for international solidarity and burden sharing. The creation of the Global Fund had been a significant development, and India hoped to see increased commitment and resolve by the donor community so that the Fund could live up to its promise.
MIZANUR RAHMAN SINHA, State Minister for Health and Family Welfare of Bangladesh, said efforts to revise and update his country’s five-year strategic plan were in progress. He pointed to programmes on safe blood transfusion, injection safety, and the prevention and control of Hepatitis B as evidence of his nation’s commitment to fighting the disease.
In addition, he noted that strong religious and cultural values had helped keep the prevalence of HIV/AIDS relatively low up to now. However, he admitted that his country was still vulnerable as a result of its large population, high illiteracy rates, poverty, migration and its proximity to countries with high prevalence of HIV/AIDS. He said response to the epidemic must be multisectoral, and more informative research was required.
ANASTASIOS GIANNITSIS, Minister for Foreign Affairs of Greece, said the problem of HIV/AIDS had achieved the dimensions of a social, economic and even demographic catastrophe, especially in developing countries. The already existing differences between North and South were, therefore, exacerbated since developing countries had to cope with a disproportionate share of the global burden in the fight against AIDS.
The Declaration of Commitment on HIV/AIDS, adopted by Member States in 2001 represented a momentous milestone in the global struggle against the epidemic, he said. Progress already achieved in the crucial matter of access to medication by developing countries was an encouraging sign. However, the Government of Greece was under no illusion that the HIV/AIDS epidemic could be coped with, let alone eradicated, at the national level. A systematic international mobilization must continue for years to come, and success could be achieved only when the epidemic was under control on a global scale, he said.
CHRISTINE NEBOUT ADJOBI, Minister in charge of the Fight against HIV/AIDS of Côte d’Ivoire, announced that her country’s Government had drawn up a plan to combat HIV/AIDS and was participating in subregional projects to reduce poverty and mitigate the pandemic’s effects. It was also cooperating with actors from civil society and the private sector to better accomplish its goals.
She said that with an infection rate of 10.4 per cent, her country was the most affected in the entire West African subregion. In that context, Ivorians needed greater access to antiretroviral drugs. National laws were currently being strengthened to protect people from discrimination. Lauding the establishment of a ministry dedicated to fighting HIV/AIDS, she stressed that Côte d’Ivoire knew what it had to do, but needed resources. She said the procedure for contributing international funds to combat HIV/AIDS should be simplified in order to better meet the immediate concerns of victims.
ALAIN MOKA, Minister of Health and Population of the Congo, said his Government had organized a planning process to create a strategic national framework to combat HIV/AIDS. Every region of the country had a departmental committee to combat AIDS and had prepared its own plan of action. In that context, the Government had also launched a programme to increase accessibility to preventive drugs.
With regard to the reduction of mother-to-child transmission, he said two main projects were under way in major cities. There was also a pilot programme to support orphans and other vulnerable children affected by the pandemic. The Congo had decided to increase its contribution to the implementation of a national AIDS plan by $1.6 million, he said. Hopefully, the international community would make available to the Global Fund the necessary funds to enable it to fight HIV/AIDS.
CARLOS SAAVEDRA BRUNO, Minister for Foreign Affairs and Worship of Bolivia, said that, despite the fact that less than 1 per cent of his countrymen was infected with HIV/AIDS, he was convinced that the disease represented a grave global threat. Therefore, it was necessary for the United Nations to continue offering support to economically disadvantaged countries. His Government was doing its part by addressing the problem as a priority public health issue, and focusing on discrimination, stigmatization, and human rights in the fight against the disease.
Expressing the belief that the HIV/AIDS crisis could not be solved from solely a medical standpoint, he stressed that other aspects, such as social, humanitarian, educational, economic, political, cultural, and legal factors, needed to be considered, as well. Nevertheless, he lamented that his country was not economically stable enough to adequately fight the disease. In that context, he called on the Global Fund to honour his Government’s request for financial aid. He also mentioned that Bolivia’s health-care system was currently providing comprehensive care to patients throughout the country.
ASHOCK JUGNAUTH, Minister of Health and Quality of Life of Mauritius, said that until now, Mauritius had been considered as a low-prevalence HIV/AIDS country, with an infection rate of 0.08 per cent in a population of 1.2 million. However, with the changing lifestyle and the high mobility in the population, there was a high risk of increasing incidence of AIDS cases. As a tourism destination, the presence of tourists and foreign workers could be a potential factor for the spread of HIV/AIDS in the local community. The Government had undertaken several initiatives to maintain the low prevalence of HIV/AIDS and was adhering strictly to the commitments made in June 2001.
It was essential that prevention, care, support and treatment be integrated in a comprehensive and holistic package, he said. Developing countries must scale up programmes of care and support, including antiretroviral therapy. States needed to spend more from their respective national budgets on health and to make the most of the Doha trade agreement to input generic patented drugs to treat HIV/AIDS patients. Failure to maintain a balance between prevention and treatment would increase the risk of further incidences of infection.
MIRCEA BEURAN, Minister of Health of Romania, said HIV/AIDS was not only a matter of health policy, but also one of foreign policy. His country had been the first in the region to conclude major agreements on the reduction of the price of antiretroviral treatments, and was proud of its efforts to combat HIV/AIDS. A major beneficiary of grants from the Global Fund, some 30 per cent of the Romanian grant, or $21.8 million, would be used for non-governmental partnerships. Romania was also the first country to grant tax exemption for all services and products purchased through the Global Fund’s grant, thereby releasing an additional $3 million for programmes to monitor HIV/AIDS and tuberculosis.
However, he said, governments could not deal with the problem alone. Public private partnership were both vital and promising. If the international community intended to succeed, partnership among governments, businesses, and non-governmental institutions was fundamental. Like terrorism, AIDS killed without discrimination or pity. It had the potential to destabilize entire regions. People living with HIV/AIDS should not be treated with cruelty, but with dignity and compassion. The business world was a key element in the emergency plan to treat AIDS. Working in partnership, the international community could ensure that ignorance was replaced by information, stigma by support, and despair by a dream for a better future.
ANA PALACIO, Minister for Foreign Affairs of Spain, said that the scourge of HIV/AIDS had taken an especially savage grip on the African continent. It was a new pandemic, unknown 20 years ago, and its widespread nature was a product of globalization. HIV/AIDS was an all-embracing challenge for the whole of humankind, but, first and foremost, a human tragedy that did not distinguish between rich and poor, young or old. It had devastating economic consequences, and had even become a factor for political destabilization and economic breakdown.
For that reason, she said, combating HIV/AIDS could not stop at the borders of States. Action must be taken both at a regional and at a global level. Preventive measures to combat the epidemic should be based on information, communication and education, she continued. Furthermore, the fight against AIDS would not be effective if the international community did not address poverty, illiteracy and the advancement of women. No stone should remain unturned in the fight against the disease, she said.
JUOZAS OLEKAS, Minister of Health of Lithuania, said the presence of modernized infrastructures for both HIV prevention and drug treatment in Lithuania had allowed for decisive action –- quelling the initial outbreak of HIV infection in that country and keeping its incidence low compared to neighbouring countries. In fact, Lithuania’s reported HIV-infection rates were among the lowest in Europe. Multisectoral strategies had been developed to combat HIV/AIDS through the health, education, labour and science sectors. The Government followed a general policy to promote information, education and communication on HIV/AIDS.
In addition, policies to reduce mother-to-child transmission were included in the National HIV/AIDS Prevention Programme for 2003-2008. Lithuania had a clear strategy to ensure and improve access to HIV/AIDS-related medicines, with emphasis on vulnerable groups. The Government of Lithuania supported the ideas expressed by the Executive Director of UNAIDS, that low-prevalence countries must not be excluded from active participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria. HIV/AIDS was a unique global threat, and the entire world must join together in the fight against it.
GORAN SVILANOVIC, Minister for Foreign Affairs of Serbia and Montenegro, said that the severity of the HIV/AIDS scourge was obvious, not only in Africa and the Central Asian region, but also in Eastern Europe, which was experiencing the world’s fastest growing HIV/AIDS infection rates. The vast majority of reported infections were among young people, mostly drug addicts, and the number of HIV/AIDS-infected persons was on the rise among all segments of the population, with the age barrier even shifting to elementary school pupils.
He highlighted the protection and promotion of human rights as a core principle in the fight against HIV/AIDS. Despite the fact that appropriate measures had been taken at the national and international levels to promote the human rights of sufferers and prevent discrimination, much remained to be done. More prevention and treatment programmes should be devised, and treatment should be made accessible to all, he added.
MAM BUN HENG (Cambodia) said his country had the highest prevalence of HIV/AIDS among countries in Asia and the Pacific, but had seen a decline in prevalence among sub-populations at higher risk. Recognizing the pandemic as a priority, the Government had formed a National AIDS Authority, as well as a multisectoral HIV/AIDS management/coordination body, involving 26 ministries.
He said that prevention efforts had reduced new infections from about 100 per day in 1997 to about 20 in 2003, and the 100 per cent Cambodia’s Condom Use Programme was seen as a model for South-East Asia. Care and treatment had improved significantly, and the rights of people infected and affected by HIV/AIDS, as well as those vulnerable to it, were respected. The multisectoral and comprehensive approach adopted in the National Strategic Plan included attention to reducing vulnerability. That had begun with adequate awareness programmes for young people. Some 69 per cent of young people aged 15 to 24 could correctly identify ways to prevent the sexual transmission of HIV.
TYRONNE FERNANDO, Minister for Foreign Affairs of Sri Lanka, said that the global HIV/AIDS epidemic was one of the gravest challenges to human security, threatening not only the very existence of humankind and the social fabric of communities, but also undermining the ability of nations to pursue economic development. Transnational challenges such as HIV/AIDS could only be addressed effectively through collective, integrated, long-term measures and strategies. The United Nations had a crucial role to play in that respect. The AIDS epidemic was threatening to roll back decades of social progress and economic development, he said. A multidimensional crisis such as HIV/AIDS required a multisectoral response.
A sustained, effective campaign against HIV/AIDS, he continued, required the strengthening of partnerships between governments and United Nations agencies, donors, NGOs and religious and private sector leaders. There was also an urgent need to incorporate HIV/AIDS education into the work programme of all government agencies.
ROGER BOYNES, Minister of Sport and Youth Affairs of Trinidad and Tobago, said that, despite significant progress in some areas in the global response to HIV/AIDS, the challenges posed by the pandemic remained as insurmountable as ever. The effects wrought by the scourge in terms of destruction of human lives, societies and economies were analogous to that of the First and Second World Wars combined. Regarding the Caribbean, in the absence of effective responses, the negative impact on life expectancy, the dissolution of households and the erosion of the quality of life would be intensified. As HIV/AIDS posed a serious threat to national development, the Government had developed a National Strategic Action Plan to provide a comprehensive framework for national response. The Government was also increasing its funding for the treatment and prevention of HIV/AIDS, particularly through increased resources to NGOs.
An important focus of the Government’s action was the development of a youth-led approach, he said. The Government was committed to spending some $80 million over the next five years on all aspects of its HIV/AIDS campaign. Other government actions included expanding access to comprehensive care and treatment; reducing the costs of HIV/AIDS drugs through State subsidies; and providing antiretroviral drug treatments to persons living with HIV/AIDS. The battle against HIV/AIDS could only be won through collaborate efforts.
ABUBAKAR AL-QIRBI, Minister for Foreign Affairs of Yemen, said that, since the appearance of HIV/AIDS in the 1980s, his Government had drawn up national programmes to combat the disease. In the 1990s, for example, a high-level committee had been set up to ensure safe blood transfusions, and combating HIV/AIDS had been integrated into his Government’s five-year plans. Stating that his country had been one of the first in the region to elaborate a prevention strategy, he added that the strategy was attached to a precise timetable, left room for participation from civil society, and involved measures for scientific research.
Declaring that his country was among the least developed in the world, he spoke of the difficulties in stemming the spread of the epidemic. In that context, he asked the international community to show political determination and offer badly needed resources. Optimistic that the Global Fund would be able to help his country, and confident that the United States and Europe would increase their efforts to combat HIV/AIDS globally, he maintained that it was important to coordinate all HIV/AIDS-related activities, be they national or international.
JOE BORG, Minister for Foreign Affairs of Malta, aligned himself with the European Union and reaffirmed his country’s commitment to increasing its efforts to address the problem of HIV/AIDS in all its aspects. He said that the problem had to be fought globally, on the fronts of both containment and prevention.
He said that an accessible, well organized health-care system was key to containment. Malta offered centralized service within a comprehensive approach that integrated prevention, voluntary counselling and testing, care, support and treatment, as well as recognized that the fight against HIV/AIDS must include all sexually transmitted infections. In conclusion, he emphasized the key role the family must play in the struggle against the disease.
GENEVIEVE SINDABIZERA, Minister in Charge of the Fight against AIDS of Burundi, said that the situation in developing countries, especially in Africa, was even more dire than in the world, in general. Two years after the Declaration, in Burundi the infection rates were alarming, upwards of 9.4 per cent, and had been exerbated by the war.
She described the Government’s action plan to combat the disease for the period 2002 to 2006, which included a national council and local committees, designed to involve the total population from top to bottom and led by the President himself. Civil society was also involved. But the plan of action required $230 million, $140 million of which was still needed. She commended those institutions that had made good on their pledges, and urged others to contribute. The time had come, she said, to combine all efforts to eradicate the scourge and save the world’s youth.
MICHAEL VIT, Deputy Minister for Health of the Czech Republic, noted that only 633 cases of the HIV infection had been diagnosed among his country’s 10.3 million citizens by 31 July 2003. With respect to the country’s national AIDS programme, the teachers of 93 per cent of the country’s grammar schools had been trained in life skills-based education and taught the subject during the last school year. All young people, he said, had the right to obtain correct information on how to protect themselves and adopt skills to reduce risky behaviour.
The country was also collecting updated information on behaviours among young adults (15-24 years of age) and drug users, and would be analysing and interpreting that data by the end of this year. Regarding overall impact of the pandemic, the country had diagnosed only three cases of the vertical transmission of HIV among 30 deliveries of HIV-infected women, due to the universal antiretroviral prophylaxis. The prophylaxis was delivered free of charge to all pregnant women infected by HIV.
GAO QIANG, Deputy Minister of Health of China, said HIV/AIDS was a common enemy of mankind, as it seriously threatened public health and safety. His Government attached great importance to HIV/AIDS prevention and treatment and had treated it as a strategic issue for social stability, economic development, national prosperity and security. Medium- and long-term strategic action plans had been developed to prevent and control HIV/AIDS, while clamping down on criminal activities, such as illegal blood collecting, smuggling, drug trafficking and prostitution. Each year, more than 200 million yuan were used as a special fund for HIV/AIDS prevention, care and treatment.
China, a developing country with large income gaps, still faced challenges in HIV/AIDS prevention and care, he said. In particular, socio-economic development in rural areas was still in an early stage. In some areas, HIV/AIDS prevention and treatment had not been adequately funded. Among its actions in that regard, China would strengthen efforts to fulfil its responsibility for public health and safety. It was committed to providing free treatment and medicines to HIV/AIDS patients in urban and rural areas. China would also improve its laws and regulations, and would protect the legitimate rights of HIV/AIDS patients. His country would be more active in international cooperation in the global fight against HIV/AIDS. In that regard, it had pledged $10 million to the Global Fund.
LIDIJA TOPIC, Deputy Minister for Foreign Affairs and Vice-Chair of the National Advisory Board for Fighting against HIV/AIDS of Bosnia and Herzegovina, said HIV prevalence did not exceed 5 per cent within any defined sub-population in Bosnia and Herzegovina. However, HIV/AIDS reporting and supervisory systems had been considerably degraded during the war. That could be the reason why very few HIV/AIDS infections had been registered. In Bosnia and Herzegovina, energetic action had been undertaken in fighting HIV/AIDS.
The National Advisory Board, she said, had established the principles of HIV/AIDS prevention. Those principles were based on permanent cooperation of governmental institutions at all levels. Other guiding principles were transparency in work at all levels; the establishment of appropriate legal framework; continuous education and training for all actors involved in the implementation process; equal participation of all actors; and self-sustainability of programmes following the termination of international assistance. She stressed the importance of media getting involved to promote the Government’s campaign. The most important task would be to break the stigma and silence relating to the HIV/AIDS issue.
SORAJAK KASEMSUVAN, Vice-Minister for Foreign Affairs of Thailand, said that since the outbreak of the AIDS epidemic, no less than 1 million people had been infected, nearly 400,000 had died, and around 600,000 were currently living with HIV/AIDS. To meet the challenge of HIV/AIDS, strong leadership and firm political commitment were of utmost importance. The political leaders in Thailand had successively placed HIV/AIDS prevention high on their national agenda and committed much-needed resources to the National AIDS Programme. Since 1984, his Government had progressively increased the national HIV/AIDS budget from less than $50,000 a year to more than $35 million in 2002.
Successful measures to stop HIV/AIDS transmission in Thailand also included awareness-raising campaigns and the “100 per cent condom use” policy, he said. Thailand’s policies to prevent mother-to-child transmission had resulted in a decline from 140,000 cases a year to around 20,000 cases. The Thai Government was committed to providing comprehensive care for people living with HIV/AIDS, including voluntary counselling and testing, as well as medical, nursing and social welfare care. More recently, the antiretroviral treatment programme had been adopted to cover the cost of medicine and medical supplies for all needy patients. In addition, the Government had pledged $5 million as a contribution to the Global Fund for the period 2003 to 2007.
ICHIRO FUJISAKI, Deputy Minster for Foreign Affairs of Japan, said the international community was at war. Millions of people were dying each year, and millions more suffered each day. While mankind had fought and was still engaged in many wars against disease, it was now facing one of its toughest opponents -- HIV/AIDS. Outlining four major points, he said prevention was the surest and most effective way of containing an epidemic. The dissemination of information and the promotion of education should be given priority. Increased access to treatment and care was also needed. The development of health systems, including enhancing health-personnel capabilities, was necessary. All stakeholders, including developing countries and donor countries, NGOS and the private sector, had to be engaged.
Continuing, he said a sense of ownership and partnership would play a major role in enhancing the effectiveness of actions in the war. Closer cooperation and coordination were needed. Each international organization was not an independent division, but formed “one regiment of an entire army”. As one of the founders of the Global Fund, Japan had announced its contribution of some $200 million in the first three years. Japan was faithfully implementing that commitment and would continue to support a wide range of measures to fight infectious diseases through a combination of bilateral and multilateral programmes.
ABELARDO MORENO, Deputy Minister for Foreign Affairs of Cuba, noting that the disease was still expanding, said that in today’s divided world it was predominantly spreading among the poor and marginalized populations. More than two thirds of people infected with AIDS lived in Africa, and millions had no access to the treatment they needed.
Despite the blockade imposed on his country by the United States, he said, Cuba had succeeded in its fight against AIDS. The Government provided free comprehensive health, including antiretroviral treatment. The country’s efforts also included sex education in schools and among vulnerable groups. To overcome the scourge of AIDS on the global level, he said, strong international commitment was needed, based on solidarity and cooperation. Cuba was willing to participate in international efforts to combat AIDS. Having already developed medical programmes for several countries, Cuba was prepared to provide doctors, professors to create medical schools, educational specialists for campaigns to prevent AIDS and medical equipment.
FAYSSAL MEKDAD (Syria) said that Syria’s understanding that the disease was a source of key concern had prompted it, in 1997, to establish a national programme and a national strategic plan to combat it. That had led to the creation of a national committee on AIDS, which was making every effort to implement the Declaration of Commitment. Areas of focus had included awareness-raising among youth, aged 15 to 24, both inside and outside of schools, and the preparation of manuals on AIDS prevention. The committee was also making use of information technologies and the media to raise public awareness, and it was cooperating with various sectors to ensure early detection of the disease and strengthen the education of high risk groups.
In addition, he said, medical care and counselling for infected persons was being provided, as well as the necessary medications to deal with the opportunistic diseases flowing from the AIDS virus. Those and other efforts undertaken by health-care agencies and religious and social institutions had produced a lull in the rate of incidence of the disease. He reaffirmed the international appeal to support those countries seriously affected by the disease, particularly in Africa, where entire economies had been crippled. The external debt of those nations should be cancelled to enable them to divert the necessary resources to deal with HIV/AIDS.
ALEG IVANOU (Belarus) said his country was actively involved in countering the spread of the pandemic, having established a cross-sectoral system under the leadership of the Deputy Prime Minister, including a nationwide system to assist children and other groups that were highly vulnerable to HIV infection. Eastern and Central Europe were seeing high rates of infection, but, with full funding from the Global Fund, he was confident that the international community could reach the goals set by the Declaration.
TAWFEEQ ALMANSOOR (Bahrain) said that the 2001 Declaration of Commitments had established the international commitment to combat HIV/AIDS. While progress had been made since then, the scourge of AIDS continued to claim victims, particularly among the most disadvantaged segments of society. The negative impact of the epidemic was not limited to the loss of human lives, but also weakened the labour force and national development plans. Thus, the struggle against AIDS had become a global responsibility. Genuine political will was required to address the pandemic and implement the Declaration.
For its part, he said, Bahrain had focused all of its efforts on the need to reduce the spread of the disease. A national strategic plan was promoting preventive measures, in addition to the provision of care for people with AIDS. Free treatment was being provided to patients, and the Government emphasized educational efforts.
EDUARDO SEVILLA SOMOZA (Nicaragua) said HIV/AIDS was a particular threat to the youth in his country. In the past, Nicaragua had had the least recorded cases of HIV infection in Central America. However, since 2002, the rate of infection had increased, with people between 20 and 34 years of age being particularly vulnerable.
It was alarming that the epidemic was becoming more generalized, he said. The Government had, therefore, established intervention plans with the cooperation of the WHO. Activities had been coordinated in various sectors through a multisectoral strategy against HIV/AIDS. The national strategy aimed to strengthen networks of cooperation; ensure equality before the law and the principle of non-discrimination; design and implement actions to provide funding; and guarantee safe blood transfusions, as well as access to health care for people living with HIV/AIDS. In addition, the plan aimed to strengthen systems to monitor HIV/AIDS in all health sub-sectors.
LAMUEL STANILAUS (Grenada), emphasizing the crucial importance of prevention in the human tragedy of huge proportions that was HIV/AIDS, said that within the “ABC of AIDS prevention”, young people must learn “Abstinence, Be faithful and Condomize”.
He said the efforts of the Governments of Uganda and Senegal to contain the epidemic should be emulated, and expressed sympathy for all those around the world who had lost family members to AIDS.
ANNA MARZEC-BOGUSLAWSKA (Poland) said the HIV epidemic appeared in Poland in the 1980s, and her country has made every effort to maintain the effectiveness and the variety of its preventative activities. The National Adviser on HIV/AIDS and Drugs Addiction had played a leading role in shaping the HIV/AIDS policy at the governmental level. The main goal of Poland’s approach was the gradual development of a stable national policy in managing HIV/AIDS-related issues. That policy was implemented by establishing and supporting the National AIDS Centre, raising funds for HIV/AIDS treatment, and supporting NGOs dealing with HIV/AIDS prevention.
She also noted that, since 1996, prevention, treatment and support were carried out in Poland on the basis of the National Programme of Prevention of HIV Infections and Care Offered to People Living with HIV and AIDS. That programme aimed to limit the spread of HIV infection in Poland, as well as improve the quality of and access to care for people living with HIV/AIDS. Gender equality was a fundamental element of the entire programme.
CLIFFORD S. MAMBA (Swaziland) said his country had not been able to meet the goals set for 2003 in the Declaration of Commitment, to a large extent due to insufficient financial resources. “The epidemic continues to spread”, he said. “Furthermore, the situation has become a humanitarian crisis as it has resulted in a diversion of resources from other areas of need.” Financial assistance granted by the Global Fund had come as a major boost to the national response, he said, enhancing the concerted efforts of the Government, civil society, the private sector and others. Before the end of the year, it was hoped that a number of people would be on free antiretroviral therapy. “This is an achievement the country would not have realized without the support from the Global Fund.”
LUIS GALLEGOS CHIRIBOGA (Ecuador) said that the crisis generated by HIV/AIDS flourished in the conditions of economic disadvantage, lack of education and inequality. The undeniable global dimensions of the problem required that the international community addressed the issue together. The Declaration adopted two years ago had been widely accepted, but despite significant progress in reducing the rate of infection, efforts were still insufficient in the struggle to achieve the proposed objectives. For example, while the Global Fund had become a real instrument in combating AIDS, there was limited progress in the area of human rights.
The stigma associated with HIV/AIDS remained a serious problem, and global financial resources to combat HIV/AIDS were still short to overcome the scourge of AIDS, he said. Increased vulnerability among women and girls deserved special attention, and all the affected individuals needed access to antiretroviral drugs and medicines required to combat opportunistic infections.
ABDULAZIZ N. AL-SHAMSI (United Arab Emirates) expressed his concern that, despite international efforts to combat HIV/AIDS, there would be an estimated 45 million new cases between 2002 and 2010, most of which would occur in developing countries that were suffering from poverty, illiteracy and armed conflict. In the light of that, he stressed the importance of mobilizing international efforts to implement development programmes and outcomes of conferences and summits on development, so that developing countries could implement their national strategies to combat HIV/AIDS.
He emphasized the importance of facilitating easy access to drugs and medications to treat the disease in a manner suitable to the financial abilities of developing countries and reaffirmed the importance of enhancing preventive means, especially in relation to education and changing behaviours.
DOLORES BALDERAMOS-GARCIA (Belize) offered assurances that her country’s Government would continue the fight against HIV/AIDS in the face of the enormous challenges posed by the epidemic, particularly in the Caribbean. In Belize, a national commission had been established to oversee a multisectoral approach. Stigmatization of those with AIDS continues, however, and the face of the disease remained largely hidden.
To mitigate that problem and others, she said, a law would soon be passed to make the commission a statutory body. Other priority concerns were mother-to-child transmission and the economic effects of the epidemic. The mobilization of funding for all those efforts, while extensive, was not yet enough. All must contribute to meet the goals of the Global Fund.
ISAAC C. LAMBA (Malawi) said the interplay between poverty, famine and HIV/AIDS necessitated new approaches that would integrate HIV/AIDS into national and international humanitarian responses. For sub-Saharan Africa, HIV/AIDS was a complex humanitarian crisis with effects that defied description. The pandemic was unravelling years of hard-won gains in socio-economic development. Malawi remained fully committed to the fight against the spread of HIV/AIDS. The national HIV/AIDS Strategic Framework and Agenda for Action for 2000-2004 continued to guide the national response, while the National AIDS Commission provided leadership in planning and resource mobilization. Non-governmental, faith and community-based organizations and the private sector increasingly participated in the fight against the pandemic.
The realization of human rights and fundamental freedoms for all was essential for reducing the vulnerability to HIV/AIDS, he said. His Government had, in that regard, developed a “home grown” draft HIV/AIDS policy to provide a legal and administrative framework for the implementation of a rights-based and expanded multisectoral national HIV/AIDS response. HIV/AIDS mainstreaming in the public sector was one of the key strategies for scaling up the national response to the epidemic. In 2003, the Government had launched a nationwide programme on the prevention of mother-to-child transmission. There was a great need to scale up HIV/AIDS care, treatment and support. Lack of openness remained the major impediment to turning the tide of the epidemic.
ALFRED CAPELLE (Marshall Islands) said HIV/AIDS was now a major concern for the countries of the Pacific region, including his own. But although the number of registered cases in the Marshall Islands was low, with its very small population and high rates of sexually transmitted diseases, the risk of the virus spreading was a matter of great concern to the Government, as the potential social and economic consequences posed a particularly grave threat to small island communities.
He said the vulnerability of the people of the Marshall Islands had intensified due to a variety of factors, including high mobility within and across borders, risky lifestyle choices of the high percentage population of youth, and traditional cultural barriers that prevented open discussion about sexual behaviours. Like many other small developing countries, the costs of effectively combating HIV/AIDS were more than his country could sustain. He appealed to countries with experience in combating the disease to share their experiences on best practices, and to offer financial and technical assistance to developing countries.
STAFFORD NEIL (Jamaica) said the issue of adequate resources was critical for the expansion of access to treatment and care in developing countries, as well as the sustainability of progress achieved to date. In Jamaica, for example, the high cost of antiretroviral drugs remained a major problem. While the Government had been able to successfully negotiate with leading pharmaceutical companies for a reduction in the price of those drugs, the costs were still a significant problem. In that connection, he underscored the need for support to be given to developing countries to effectively utilize the Global Fund. Developing a broad-based approach to HIV/AIDS had become a central feature of Jamaica’s response to the pandemic. Efforts were reinforced at the regional level within the context of the Caribbean Regional Strategic Framework aimed at mitigating the consequences of the disease at both the national and regional level.
MURARI RAJ SHARMA (Nepal) noted that 42 million people in the world were now living with HIV/AIDS, saying that such staggering numbers called for a massive and coordinated response. The Declaration adopted in 2001 had mobilized international efforts to combat AIDS, and he took heart that a number of United Nations agencies had been working with national governments towards that end. Nepal welcomed the contributions announced today, in particular, by the United States and the European Union.
Despite all the progress, however, the disease continued to claim new victims, he said. In Nepal, HIV/AIDS was spreading like a wild fire, with more than 30,000 infected people recorded there by September 2000. Nepal was fully committed to fight the disease, but resource constraints seriously hampered its efforts. Prevention and treatment were critical to reverse the surge of the epidemic.
Nepal had accorded priority to prevention and treatment of the disease, as well as raising awareness, he said. It had allocated resources within its capacity to anti-AIDS programmes, and regional cooperation was one of the key elements of its strategy. He called on the international community to contribute generously to the Global Fund and relevant United Nations agencies and to make antiretroviral drugs available to disadvantaged countries.
SUSANA RIVERO (Uruguay) said her country’s 2002-2003 national strategic plan aimed at implementing policies for the prevention and treatment of HIV/AIDS. The three main objectives were: preventing new infections, fighting stigma, and mobilizing efforts to eliminate the disease.
One issue of particular importance to the Government was the need to prevent discrimination against people living with HIV/AIDS, she said. In addition, Uruguay had, since 1996, provided 100 per cent antiretroviral treatment coverage. However, the Government’s main aim was prevention through education in order to reach the most vulnerable group -– the youth. As the incidence of infection among women was also steadily rising, government policies promoted participation in and evaluation by women of HIV/AIDS strategies, she said.
TERUNEH ZENNA (Ethiopia) said it was encouraging that all countries now had multisectoral HIV/AIDS strategic plans and had established national AIDS councils chaired by people at the highest levels of government. But despite those achievements, HIV/AIDS was becoming more alarming with its devastating effect on socio-economic developments in some affected countries of sub-Saharan Africa. HIV infection rates continued to rise as the meagre institutional capacity to fight the epidemic was seriously undermined.
Out of 67 million Ethiopians, he said, 2.2 million -- including 200,000 children -- were living with HIV/AIDS. The Government had established a national HIV/AIDS prevention and control council which regularly evaluated the status of the prevalence rate, disseminated information and promoted awareness. Centres of distribution for antiretroviral medicines had also been established at the national level.
KIM MOON-SHIK, Director-General of the National Institute of Health, Republic of Korea, noted with satisfaction the advances made in many countries, particularly in the heavily affected ones. Yet, the remaining challenges were still enormous. The number of infected people was still growing, with 5 million new cases detected every year. The prevalence of HIV/AIDS in the Latin America, the Caribbean and Eastern European regions showed no sign of abating. In sub-Saharan Africa, where 11 million children had lost one or both parents to the disease, it was disheartening to imagine the long-term consequences. Despite unprecedented levels of contributions from governmental and other sectors, the gap between need and resources was huge.
He said HIV/AIDS had proven to be an “intractable enemy”. The slightest indifference could cause huge setbacks. Everything possible must be done to save lives and relieve the suffering of those affected by the disease. Recently, his country, relatively safe from the virus, had experienced a “dramatic” rise in the number of affected persons. The Government, in close partnership with NGOs, was developing prevention and awareness programmes for young people, as well as providing free antiretroviral agent. Efforts must continue to make such drugs available at a reasonable cost, especially in developing countries. International support mechanisms should also be strengthened.
CHRISTIAN WENAWESER (Liechtenstein) said it was essential to maintain momentum in the international struggle against HIV/AIDS; his country was in the process of determining the size of its next contribution to the Global Fund. In addition, the experience of the past two years has made it clear that prevention and care must be considered as complementary.
He echoed the call for national policies to combat discrimination against persons with AIDS, and emphasized that special attention must be paid to the rights of women and girls in the context of anti-HIV/AIDS efforts.
TONKA VURLEVA, National Coordinator on HIV/AIDS and General Secretary of the Committee on Prevention of HIV/AIDS and Sexually Transmitted Diseases of Bulgaria, said her country was fortunate to rank among the countries with low HIV/AIDS prevalence. Bulgaria had shown strong political will to control the spread of the epidemic with its adoption of a national strategy and a National Action Plan for Prevention and Control of AIDS and Sexually Transmitted Diseases.
She highlighted the important role played by international donors, academic and research institutions and civil society in fashioning a successful national response. Openness, global solidarity and firm political leadership were a must in order to prevent the stigma, discrimination and denial associated with the HIV/AIDS epidemic, she added.
PAUL GOA ZOUMANIGUI (Guinea) stressed the shared duty of the international community to overcome the problem of HIV/AIDS and the role of the Declaration of Commitment in that regard. The 2001 special session had allowed his country to convey its priorities and challenges. The primary goal was stabilization of the situation and reduction of the economic impact of the disease. However, HIV/AIDS was spreading in Guinea at an alarming pace. The number of those infected was expected to double by 2010, unless radical measures were taken. Priority was given to financing, prevention and treatment. To be successful, however, the country needed the support of the international community. In that connection, he expressed gratitude to the donors, including the United States and the European Union, who had announced new contributions to the Global Fund.
RICARDO LUQUE NUÑEZ, Adviser, Direction of Public Health, Ministry of Social Protection of Colombia, said his country had achieved important progress concerning the 2001 Declaration, including the formulation of a strategic plan on sexual and reproductive health. Moreover, a mechanism to purchase drugs was established in 2003 as a way to mitigate the economic impact of antiretroviral medicines. Regarding prevention, Colombia had allocated additional resources in its budget, with a focus on youth, and had considered the most vulnerable population groups. His country had also received international cooperation funds and was working to develop a managerial model to strengthen the health system at the national level.
Colombia had faced many problems in fulfilling its agreements, he continued. Although Colombia had specific HIV/AIDS legislation with a strong human rights basis, the law was sometimes ineffective, partly due to a lack of understanding. Just as the best education process would have little effect for a woman who was subjected to abuse, discrimination and poverty, it would be difficult for a country to establish effective prevention programmes if it suffered from violence, drug trafficking and oppressive debt.
ALOUNKEO KITTIKHOUN (Lao People’s Democratic Republic) said that two years after the adoption of the Declaration, the outcome of the special session on HIV/AIDS still remained far from being implemented, despite the growth of political commitment and resources, as well as various efforts undertaken at the national, regional and international levels. The situation now called for a broad-based approach and adequate resources to tackle the spread of the scourge.
While still having a relatively low HIV/AIDS infection rate, estimated at 0.05 per cent in 2003, he said his country had already undertaken comprehensive measures to control and prevent the disease with the coordination of national efforts ensured by the National Committee for AIDS Control. The Government was committed to achieving internationally agreed targets in the social sector despite a limitation in its domestic resources. With continued support, cooperation and investment from the international community, the country would be ale to overcome the challenges it faced.
AHMED TAHIR BADURI (Eritrea) expressed dismay that despite the determination and collective efforts of the international community to eradicate HIV/AIDS, it continued to decimate populations around the world without any encouraging sign of a cure. The epidemic’s prevalence in Eritrea was considerably less than in the rest of Africa, he said, but the Government was gravely concerned, nevertheless.
He said the Eritrean Government had launched its first five-year plan even before the special session on HIV/AIDS. As an implementing agency, it had created the National AIDS Control Programme, which was involved in counselling, prevention of mother-to-child transmission, social mobilization and condom promotion. The Government and people of Eritrea were committed to the realization of international goals and would actively participate in the concerted effort to eradicate the scourge.
JEAN ALEXANDRE (Haiti) said Haiti had experienced an increased incidence of HIV/AIDS, with rates spiking as high as 30 per cent in certain rural areas. In addition, there were already 200,000 AIDS orphans. Haiti had been dreadfully affected by that scourge, which, last year alone, had affected 30,000 citizens, thereby exacerbating an already difficult economic situation in the country. Haiti’s President had launched a strategic plan (2002-2005), which focused on, among other aspects, prevention, including mother-to-child transmission, caring for the sick, security of blood banks and vaccine research. The plan had also highlighted the need for legislation, as well as the effective integration of civil society in the struggle.
He said his country was very aware of the gravity of the situation and, with civil society, was seeking to reduce the spread of AIDS through education and awareness-raising campaigns. It was also trying to assist those already affected. As part of those efforts, the Government had opened several new health centres in remote geographical areas, making it possible to treat hundreds more patients. In addition, many more pregnant women now had access to maternal-care education. Special attention would also be given to sex workers and homeless persons, and to heavily affected communities.
LUIS EMILIO MONTALVO ARZENO, Executive Director of the Presidential Council for AIDS of the Dominican Republic, said that his country had set up a high-level council to deal with the pandemic, of which the island of Hispaniola was the western epicentre. The epidemic was levelling off though because of the political commitment that his Government had undertaken, involving all sectors of society, in addition to international organizations.
He described many of the programmes that were undertaken nationally and with bilateral and multilateral support. In particular, he spoke of information and other prevention campaigns carried out with the cooperation of national media. HIV/AIDS was a priority in the country’s development policies, he said, and assessments by UNAIDS rated the efforts highly.
BONIFACE CHIDYAUSIKU (Zimbabwe), speaking on behalf of President Robert Mugabe, said that in Zimbabwe the tragic reality was that an estimated 2 million people were living with HIV/AIDS and 600,000 had full-blown AIDS, while 782,000 children had been orphaned by the epidemic. Over 70 per cent of admissions to medical wards in the major hospitals were patients with HIV and AIDS-related opportunistic infections. The capacity of the health delivery system to cope with the demands of the epidemic in the face of limited and competing resources, coupled with human resource shortage caused by the brain drain, had been severely undermined. The crisis had been further worsened by the food shortages experienced over the last two years.
The Government was committed to the provision of antiretroviral drugs and had, therefore, declared AIDS a national emergency, in order to improve access to those drugs in line with the Agreement on TRIPs. The Government had also developed an orphan-care policy providing for an enabling legal environment for support and protection as Zimbabwe was facing an orphan epidemic. Zimbabwe, like most countries in the region, depended mostly on donor support for its HIV/AIDS programmes. Unfortunately, donor support had declined since 1999. While the Global Fund had approved the component on prevention and care in 2003, he sadly noted that no disbursements had been made so far.
MARCO ANTONIO SUAZO (Honduras) said that his Government was seeking new and constructive ways to alleviate the suffering of people living with HIV/AIDS in the country. When the United Nations brought together the highest political representatives, raising their voices in unison to find solutions to a problem such as HIV/AIDS, hope was raised. Last year, the President of Honduras, in collaboration with the Secretary-General, had developed a forum on HIV/AIDS focusing on key components in the prevention of HIV/AIDS, such as education. Despite some progress, there was still a long and difficult path to travel, both for Honduras and the international community. He stressed that the poorest and least developed countries affected by HIV/AIDS must be allowed to distribute generic versions of HIV/AIDS drugs.
AGIM NESHO (Albania) said his country was part of the global consensus to undertake all necessary actions to fight the disease. Though not a heavily affected country, Albania still paid attention to the issue, with the implementation of national policies and programmes, which form a national strategy of awareness, prevention and care. During the past year, measures had been taken to strengthen the national response, both of the governmental and civil society level. Government structures had been set up to coordinate such efforts and a coordinator had been appointed to raise both responsibility and accountability. Other steps under way included work on a legal framework, the inclusion of HIV/AIDS education in schools, and the establishment of medical centres specifically for AIDS patients.
Still, he said, Government acting alone would not likely be able to mount the necessary response. Thus, efforts in Albania had included support for civil society. Through partnership with the Government, as well as with international donors and organizations, several public activities had been organized, with a focus on such areas as education and communication, contraception and prevention. The responses were not yet strong enough to fully prevent the spread of the disease, and national efforts still required international support.
Ms. ARREDONDO (Chile) stressed a comprehensive approach to the problem of AIDS and the need to strengthen the network of responsibilities shared between governments, civil society and international organizations. For her Government, unconditional respect for the rights of persons living with the disease and the most vulnerable population was a duty of the State and a requirement for controlling the epidemic. A law had been promulgated in the country, which defined the responsibility of the State in the prevention of AIDS and sought to promote prevention and non-discrimination against persons living with HIV/AIDS.
He said that the country had elaborated a strategy for combating the epidemic on the basis of a participatory, inter-sectoral and decentralized approach. Prevention plans were being developed for the general population. Among the Government’s initiatives, he mentioned specific inter-sectoral projects at the regional level to increase prevention, including the army’s Comprehensive HID/AIDS Prevention and Education Plan. With its strategy to increase access to drugs, Chile had succeeded in covering 100 per cent of the demand from public sector beneficiaries (90 per cent from national resources and the remainder from the Global Fund).
JOEL ADECHI (Benin) said that the epidemic in his country had been growing like wild fire, despite the extensive efforts of his Government. The HIV/AIDS prevention process in Benin included a multisectoral project for combating AIDS and a new framework laying out strategies for the next five years, with a high-level committee led by the head of State himself. He hoped that all those infected could be treated, but stressed that more resources were needed, even while Benin’s partners were already providing much assistance. He hoped that the synergy of all national and international efforts would stem the tide of the scourge.
MWELWA C. MUSAMBACHIME (Zambia) said that a National AIDS Council had been created in his country with a mandate to coordinate and support the development, monitoring and evaluation of multisectoral national responses to HIV/AIDS. Zambia’s national programme for combating HIV/AIDS was beginning to show positive results, especially in the reduction of the infection rate among young people.
Despite those positive developments, he said, Zambia still had a long way to go in its fight to combat the epidemic. Greater efforts and additional support were needed to secure medicines, enhance programmes to prevent mother-to-child transmission, care for AIDS orphans, and protect women and young girls from infection.
CLAUDIO HUMMES, Observer for the Holy See, drew attention to the plight of young HIV/AIDS victims, who could be helped more by medical science were it not for the high cost of medications and contentious legal issues. Hopefully, there would be more agreements that would allow pharmaceuticals to be provided at a lower cost.
Pointing out the efforts of the Holy See and Catholic institutions in the global struggle against the epidemic, he said 12 per cent of those caring for people with HIV/AIDS and 13 per cent of global relief providers came from Catholic NGOs. In order to better coordinate such efforts, the Holy See had established an ad hoc working group committee for the fight against HIV/AIDS and was willing to cooperate with the rest of the international community in defeating the “scourge of the century”.
JUAN MANUEL SUÁREZ DEL TORO, President, International Federation of the Red Cross and Red Crescent Societies, said he spoke with a great sense of responsibility, as the only international organization represented here with a civil society dimension. The debate simply must not become a cold one around numbers and figures. Instead, it must be made an ethical debate, centred on the ethics of dignity. Focusing the discussions on how much money was needed or what types of interventions should be done was an affront to the dignity of every person living with or infected by HIV/AIDS. If it was imperative to speak of numbers, fine, but he urged talking in terms of making the necessary investment to prevent and alleviate the suffering.
Asserting that the moment for debate was long gone, he said, “we know what we need to do, and we know how to do it”. The struggle should take the form of innovative and integrated approaches to prevention, care and treatment grounded in preserving the dignity of every affected person. The level of actions should be massively scaled up, and the barriers of silence, stigma and discrimination should be broken. Punishment for people who were ill was not just inhumane, it was a guarantee of policy and programme failure. Investing $10 billion by 2005, under the Declaration of Commitment, represented only $250 per person over three years. That was less than $1 a day per person. Even the Global Fund, which was, by far, the best investment in the struggle so far, was in serious danger because of a lack of resources.
JOSE ANTONIO LINATI-BOSCH, Observer for the Sovereign Military Order of Malta, said HIV/AIDS control must remain a specific priority over the long term, particularly in those countries and regions where destitution was most urgent, where adequate public services were lacking, and where self-help initiatives were worthy of being sponsored. Such programmes must also focus on providing clean drinking water, setting up sanitation facilities and offering public education and nutrition programmes. He stressed that all the legal, practical and social measures taken in the struggle against HIV/AIDS must be accompanied by education –- education based on the traditional value of morality. Only a global strategy could be effective to combat the threat represented by HIV/AIDS.
JOHN B. RICHARDSON, speaking on behalf of the European Community, said the AIDS crisis was not only a personal tragedy for men, women and children, but also a global economic catastrophe as it attacked active members of society. HIV/AIDS, malaria and tuberculosis had to be tackled on many fronts at once. In that regard, the European Community had taken a comprehensive approach in the European Union Programme for Action launched some two years ago. The Programme addressed issues such as peace and security, economic development, the struggle against poverty, research and trade. More than 1 billion euros had been allocated to the Programme for Action to date. Progress had also been made in tiered pricing of medicines, an approach that had received a boost through the adoption of unprecedented European Union legislation that sought to prevent the re-importation of reduced-price drugs into Europe.
It was possible, he said, to protect scientific innovations while preserving the right of all to treatment. Since the beginning, the European Commission had strongly supported the idea of setting up a Global Fund to finance specific actions. A mechanism was needed to provide additional resources. Within the Fund, the Commission encouraged the supply of tiered-price, high-quality products to its partner countries and the distribution of generic products. The Commission had paid some 120 million euros to the Fund and allocated an additional
340 million for the coming years. The European Union had collectively increased its funding through additional aid to national and regional programmes and multilateral channels.
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