|Department of Public Information • News and Media Division • New York|
Real Story of AIDS Is ‘On the Streets’, Where Shared Response Should Champion
Robust National Health Systems, Broader Social Development, Panel Told
Ten years after the world community had come together to forge the Declaration of Commitment on HIV/AIDS, participants in the first of five panels scheduled during this week’s three-day United Nations high-level meeting on HIV/AIDS called for a new paradigm in AIDS response that focused not only on the disease, but championed broader social development, supported the establishment of robust national health systems and, most importantly, responded to those without a voice.
“The real story is on the streets around the world, where the daily struggle of life is tough for even the most hardy and healthy of people,” panel moderator and Al Jazeera journalist Riza Khan said during an introduction to a three-minute video screened at the outset of the discussion on “Shared responsibility — A new global compact for HIV/AIDS”.
Offering opening remarks after the video’s conclusion, Denzil L. Douglas, Prime Minister of Saint Kitts and Nevis and Chair of the panel, said three major challenges had emerged in the last 30 years regarding how to define the roles and responsibilities of all the actors involved in combating HIV and AIDS, expand the number of actors and galvanize the political leadership needed to overcome the epidemic. To meet those challenges, he urged a new approach. “We cannot achieve any success beyond where we are now unless we recognize the change that’s necessary,” he said, underscoring that as a global imperative.
He argued that despite weak institutions, the State’s autonomy must be recognized. At the heart of that assertion, however, was the critical question of whether the State recognized its responsibilities, particularly regarding the epidemic’s human rights dimension. Similarly, the need for leveraging investments included domestic ones, he said. Overcoming the challenges to universal access, he stressed, meant practicing what was preached, taking action based on evidence and tearing down obstacles to access to services.
Further, the most sensitive issues — some of which were “bundled together as human rights issues” — must be acknowledged and tackled. “We must not turn a blind eye and do what is politically correct and expedient,” he said, emphasizing that that required a clear focus on the people being served.
Speaking as the panel’s national representative and offering the perspective of a donor country, Søren Pind, Denmark’s Minister for Refugees, Immigrants and Integration, said the solutions were simple, but not easy. Among other things, it was critical to ensure that money was wisely spent, particularly by ensuring that national delivery frameworks were strengthened. “We actually reach the best results when we make partnerships,” he noted, highlighting how dialogue, mutual goal-setting and mutual commitment secured results.
He argued that shared responsibility meant, on one hand, getting people to take responsibility and, on the other hand, stating the truth. Adding that there was a need for a certain sense of humility regarding the truth, he said it could not be defined everywhere simply as one person or country saw it. Indeed, AIDS response work was impossible if it did not include the people concerned. In that, certain principles could not be compromised.
Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said that, above all else, it was important to be pragmatic, particularly regarding shared responsibility. “I don’t know any country — any country — that can alone solve any emerging global issue,” he stressed.
Though acknowledging that the old paradigm was actually working well, he joined the call for a new one, pointing out that today’s debate could not have been held 10 years ago. “No way,” he said. But today, the world had completely changed and that wide-ranging change — illustrated by the fact that a majority of African countries had sustained growth rates above 5 per cent, as well as by the growing influence of countries like Brazil, India, Russian Federation and China — must be reflected in the global response to HIV/AIDS. Indeed, shared responsibility must be a call to fashion a shared paradigm, he said.
Speaking on behalf of civil society, Junéia Batista, General Secretary of the National Confederation of Municipal Workers in Brazil, said matters pertaining to HIV and AIDS must not be approached in isolation, but through associations. Moreover, that response, which must be directed at the individual, would inevitably be ineffective unless it combated discrimination and social exclusion.
As a corollary, she stressed that it was impossible to honestly refer to the need to reverse HIV/AIDS without addressing barriers against the production of and trade in generic drugs. Calling for further solidarity, she underlined access to health care and social protection as a human right, central to the AIDS response.
Launching the meeting’s interactive portion, Mr. Douglas said the disease must be placed in the broader development framework, as the number of actors engaged in that response and the funding sources underpinning it were expanded. Offering other prescriptions for the global response, several high-level officials and representatives of Member States and intergovernmental bodies stressed the need to further diversify funding sources. Institutional policies should also be made more responsive to the epidemic’s trends, several said.
Maintaining that the principle of shared responsibility was simple — the rich supported the poor and the healthy supported the less healthy — one speaker said that that universal principle applied between and among countries and called for a global approach to mutual social protection. Another reiterated that nothing would serve those suffering from HIV and AIDS more than improving public health infrastructure and national health systems.
A majority of speakers cautioned that punitive laws and ongoing stigma against those living with HIV and other at-risk populations undermined HIV programmes. Against that backdrop, they said that such laws must be abolished and that a rights‑based approach should be injected into internal State policies. Some speakers also stressed the need to include the voices of men who have sex with men in the discourse, while others pointed to the particular vulnerability of women and girls, whose human rights were too frequently denied.
Women and girls, several speakers argued, must be given the ability to take decisions regarding their own bodies. The Director-General of the United Nations Educational, Scientific and Cultural Organization (UNESCO) underlined the importance of women, girls and all youth in responding to HIV, particularly in giving them voice through leadership roles and in improving sexual education, which was needed to preclude risky behaviours.
Noting the recent prominence afforded to climate change, the Prime Minister of Grenada stressed that HIV and AIDS must remain on the national and global agendas. Whatever gains had been made must be sustained, he said, adding that that could only be accomplished through further financing, proper accountability and appropriate management. Along those lines, Norway’s representative called for “responsive donorship” that supported national ownership and local programmes. To that end, external and domestic finance, as well as policies on both the global and national levels, must be better matched, she said.
Other comments on financing largely focused on the need for mutual accountability, the elimination of redundancies and increased funding. “Innovative spending” was also required, several said, stressing that more must be done with less. The Executive Director of theGlobal Fund to fight AIDS, Tuberculosis and Malaria said that, among other things, the costs of pharmaceutical products must be contained. The former Minister of Health and Foreign Affairs of France added that the movement of mobile capital should be taxed as a specific source of future funding.
Several speakers suggested that the resources required were not just financial in nature. To that end, they called for leveraging underutilized human resources, such as civil society. Others stressed that South-South cooperation remained underused and must be developed through a strategic approach that did not replace North-South dynamics.
Joining today’s discussion were high-level officials and representatives of South Africa, India, Tunisia, Barbados, Benin, Mexico and Thailand.
The Regional Goodwill Ambassador for the Middle East and North Africa also made comments, as did the Executive Secretary of UNITAID and a researcher at Belgium’s Institute of Tropical Medicine.
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