In General Assembly, Secretary-General Describes ‘Cause for Hope’ in Fight against HIV/AIDS, But Warns Redoubled Effort Needed to ‘Win the Race’ against Epidemic
In General Assembly, Secretary-General Describes ‘Cause for Hope’ in Fight against HIV/AIDS, But Warns Redoubled Effort Needed to ‘Win the Race’ against Epidemic
|Department of Public Information • News and Media Division • New York|
Sixty-sixth General Assembly
115th & 116th Meetings (AM & PM)
In General Assembly, Secretary-General Describes ‘Cause for Hope’ in Fight against
HIV/AIDS, But Warns Redoubled Effort Needed to ‘Win the Race’ against Epidemic
Assembly Reviews Progress since 2011 High-Level Political Declaration;
President: Wave of Accelerating Progress, but Critical Challenges Remain
While efforts to halt new HIV infections and AIDS-related deaths had steadily intensified in the last year, United Nations Secretary-General Ban Ki-moon pressed Governments in the General Assembly today to enhance prevention measures, provide greater access to treatments and step up badly needed investment for AIDS — as agreed at last year’s High-level meeting on HIV and AIDS — “so that we can win the race” against the epidemic.
Taking that message to heart, the Assembly adopted a consensus decision welcoming recommendations in the Secretary-General’s report entitled “United to end AIDS: achieving the targets of the 2011 Political Declaration”, as input for consideration in preparation for its special event on the Millennium Development Goals in 2013, and in discussions on formulating the post-2015 development agenda.
In his report, Mr. Ban notes that, while there is “cause for hope and optimism” in the response to HIV and AIDS, many challenges remain. Substantial access gaps persist for key services, with especially difficult obstacles experienced by high-risk populations. Punitive laws, gender inequality, violence against women and other human rights violations continue to undermine national responses. Of special concern is the first-ever decline in HIV funding in 2010, which could jeopardize the global community’s capacity to close access gaps and sustain progress in the coming years. “Efforts must be refocused to achieve real results and end a global epidemic of historic proportions,” he wrote.
The “bold” Political Declaration adopted at last year’s high-level meeting outlined clear targets to stop new infections, stamp out discrimination and end AIDS-related deaths, Mr. Ban said in opening remarks. In such work, prevention was critical. The number of new HIV infections must be cut by 1 million by 2015, which required reaching out to those most at risk: sex workers; men who have sex with men; people who inject drugs; women; and youth. To treat 15 million people by 2015, as pledged, the number of people receiving treatment must double.
Finally, all countries must strengthen existing financial mechanisms, he said, including the Global Fund to Fight AIDS, Tuberculosis and Malaria. International investment for AIDS had dropped 13 per cent from 2009 to 2010 and he urged States to make the struggle against AIDS integral to their vision of the future they wished to see. “We cannot slow down,” he stressed.
Echoing those comments, Assembly President Nassir Abdulaziz al-Nasser said that, while the world was “riding a wave of renewed hope and accelerating progress against HIV”, critical challenges remained. Every effort must be made to ensure that commitments made in 2011 were implemented, so that the course of the epidemic could be redirected and that future costs to society could be averted. In remarks delivered by Vice-President Jean-Francis Zinsou, of Benin, he said it was critical to support the integration of HIV prevention, treatment, care and support into relevant health and development programmes, including those for reproductive health, gender equality and non-communicable diseases.
He said the post-2015 development agenda hinged on a strong vision that united all parts of the social sector: health, education and social protection among them. Achieving the 10 targets set out in 2011 was a journey towards a single outcome. The international community must act strategically and effectively to achieve the vision of zero new infections, zero discrimination and zero AIDS-related deaths. “This is a world for all of us,” he declared.
When the floor was opened for debate, speakers from more than 30 countries reaffirmed their commitment to ending the HIV epidemic, pledging to focus on high-risk populations and to build shared responsibility for achieving targets outlined in the 2011 Political Declaration. Many pointed to national and regional advances, including South Africa’s representative, who said his country had “shifted the way we think about the response to the epidemic and recognized the need to expand beyond the health sector”. South Africa’s new National Strategic Plan on HIV and AIDS and Tuberculosis for 2012-2016 marked the first time the country had integrated those illnesses in the same plan.
Several others described the daunting challenges ahead, particularly for countries in sub-Saharan Africa and other low-income areas, where Governments continued to cope with the heavy burdens of HIV/AIDS, but had scant room in their stretched budgets to make major investments public health. Poverty, inadequate health facilities, the high cost of medicine and unsafe sexual behaviour were just some of the factors hindering progress.
To make a difference, Governments in concentrated or high-prevalence epidemic countries must put in place strategies that focused on the needs of high-risk populations, some said, including drug users, sex workers and men who have sex with men. Vertical mother-to-child transmission could be eliminated if pregnant women living with HIV and their newborns were provided with antiretroviral prophylaxis during pregnancy, delivery and breastfeeding.
On that point, Brazil’s representative argued that access to medicine was a huge challenge and that public health must always prevail over commercial interests. “Flexibilities” in the Trade Related Aspects of Intellectual Property Rights (TRIPs) Agreement provided an effective tool that must be used to make HIV programmes financially sustainable.
Australia’s delegate insisted that punitive laws against people living with or at risk of HIV must be repealed. Wastage from ineffective programming and governance structures must be expelled and both prevention and treatment programmes must be scaled up. Overall, more political resolve was needed to follow through on past commitments. “Complacency is not an option,” he declared.
Also speaking today were the representatives of Botswana (on behalf of the African States), Suriname (on behalf of Caribbean Community (CARICOM)), Cambodia (on behalf of the Association of South-East Asian Nations (ASEAN)), Angola (on behalf of the Southern African Development Community (SADC)), Canada, Luxembourg, United States, Lesotho, Ukraine, Russian Federation, Indonesia, Kenya, Cuba, Thailand, India, Kazakhstan, Gabon, Mexico, Algeria, Norway, El Salvador, Zambia, Viet Nam, Pakistan, Bangladesh and Zimbabwe.
A representative of the European Union delegation also spoke.
Iran’s delegate spoke in explanation of position after action.
The General Assembly will reconvene at a date and time to be announced.
The General Assembly met today to review progress on implementation of the Declaration and Commitment on HIV/AIDS and the United Nations Political Declaration on combating the scourge. It had before it the report of the Secretary-General entitled “United to End AIDS: Achieving the Targets of the 2011 Political Declaration” (document A/66/757).
JEAN-FRANCIS ZINSOU (Benin), Vice-President of the General Assembly, delivering a statement on behalf of the Assembly President, said that one year ago, at a high-level meeting on HIV/AIDS, the 193-member body had unanimously adopted a historic Political Declaration that “helped shape the end game of the AIDS crisis.” Member States had set clear targets to reduce HIV transmissions. Today, the Assembly had gathered to review progress to that end, and, he said he was struck by Member States’ commitment to realizing their shared goals and responsibilities. “This commitment has inspired a new unity of purpose; a resolve to focus on results, and an opportunity to carve out clear roles for Governments, donors, civil society and the United Nations,” he said.
“Today we are riding a wave of renewed hope and accelerating progress against HIV,” he continued, noting that the international community had achieved dramatic reductions in new infections in the hardest hit countries and among young people worldwide. The international community was also witnessing dramatic scaling up of treatment in low- and middle-income countries, “from thousands to millions in just a decade”. The AIDS response had had a profound impact on human health and development and had advanced the agendas of human rights, social justice and gender equality. This had helped to build more inclusive societies and had moved science forward in the service of the people.
Yet, critical challenges remained, he said, noting that HIV still disproportionately affected vulnerable populations. In addition, populations at higher risk still faced stigma and discrimination, which only fuelled the spread of the disease. “Funding is declining, diminishing the international community’s ability to sustain necessary progress,” he said, noting that today’s meeting was taking place three years before the 2015 deadline set by Member States in the Political Declaration. Every effort must be made to ensure that commitments that were made in 2011 were implemented so that the course of the epidemic could be re-directed and so that future costs to society could be averted.
“It is critical that we support the integration of HIV prevention, treatment, care and support into relevant health and development programmes,” he said, adding that such programmes included reproductive health, gender equality, and non-communicable disease response. The international community must also explore ways in which the increase in HIV prevention, treatment, care and support could be leveraged to strengthen not only high quality health services, but to respond to a range of health conditions and development challenges, such as food security, poverty and drug dependence. The international community must also use today’s meeting as an opportunity to reflect on the links between HIV/AIDS and the Millennium Development Goals.
He went on to say that the post-2015 global development agenda hinged on a strong vision that united all components of the social sector, including health, education, and social protection. Achieving the 10 targets set out in 2011 was a worthy and achievable aim. It was also a journey towards a single outcome. Built into the AIDS movement was the vast potential for global development that would be felt far beyond 2015. “It is up to every single one of us - Member States, civil society, private sector and individuals – to work together, to step up the campaign to implement the commitments made for a better tomorrow,” he said, adding that he international community must act strategically and effectively to achieve the vision of a zero new HIV infections, zero discrimination and zero AIDS-related deaths. “This is a world for all of us,” he declared.
Secretary-General BAN KI-MOON recalled that one year ago this week, Governments, intergovernmental organizations, United Nations agencies and others had pledged to show “decisive, inclusive and accountable leadership” to reach the goal of an AIDS-free world. Their bold political declaration had clear targets to stop new infections, stamp out discrimination and end AIDS-related deaths.
Over the last year, efforts had intensified, he said, noting that just last week, he had helped to launch the Integrated Implementation Framework to track commitments to the Millennium Development Goals, including on HIV/AIDS. UN Women recently joined UNAIDS to help address how the virus impacted women and girls, and UNAIDS itself had expanded its activities around the world.
Recalling he had launched his five-year action agenda in January, pledging to reach the goal of ending all paediatric HIV infections, he said: “I am here to ask you to do even more so that we can win the race”.
“Prevention is critical,” he said. The number of new HIV infections must be cut by 1 million by 2015, which required reaching out to people at risk: sex workers, men who have sex with men, people who inject drugs, women and youth. Five million young people lived with HIV and each day, 3,000 more were infected. It was within our power to stop that spread and, armed with the right information, young people would do what was right for their health.
To treat 15 million people by 2015, as pledged last year, the number of people receiving treatment must double, he said. Patients must be diagnosed more quickly, therapies must be provided more efficiently and better medicines must be developed.
Further, women needed sexual and reproductive health services and HIV-positive mothers must have antiretroviral drugs, he said. Countries should support the Global Plan to Eliminate New HIV Infections among Children by 2015 and Keep Their Mothers Alive, as well as the “Every Woman, Every Child” initiative. Further, as had been pointed out at last year’s meeting, “stigma fuels HIV” and discrimination hampered efforts to respond to the epidemic. He urged countries to end restrictions and penalties for people living with HIV.
Pointing out that international investment for AIDS had dropped by 13 per cent from 2009 to 2010, he said: As we drive towards 2015,“we cannot slow down”. All countries must do their part by strengthening existing financial mechanisms, including the Global Fund, and making the most of all resources. “An AIDS-free generation is a generation that can help to end poverty,” he asserted. Ahead of the Rio+20 United Nations Conference on Sustainable Development, he urged countries to make the struggle against AIDS an integral part of the “campaign for the future we want.”
CHARLES THEMBANI NTWAAGAE ( Botswana), speaking on behalf of the African group, said that his continent was the most affected by the HIV/AIDS pandemic. He said that the June 2011 Political Declaration provided a road map of key targets the international community could use to combat the scourge, including curbing new infections from sexual transmission and injection drug users and scaling-up funds for maternal and child health care. Over the past two years, African nations had stepped up their efforts to address the challenges posed by HIV/AIDS, with the rate of infection stabilizing and declining in some 22 countries. AIDS deaths were decreasing, as were incidents of mother-to-child transmissions. At the same time, infection rates on the whole continued to outpace treatment and care programmes. Also troubling was that HIV-infected persons in Africa still had to struggle to gain access to available treatments.
Stigma remained a major challenge, and African Governments were focusing on the role of the family and bolstering education, including sexual health education, as a way to reverse that trend. Still, he reiterated that overall, the lack of resources was the most challenging hurdle, and welcomed the call in the Political Declaration for scaling up funds for health care and to ensure access to medication. He also called for assistance to build the capacity of health care systems in Africa and other developing nations, as a shortage of adequately trained health care workers had proved to be a chronic impediment to efforts to effectively combat the spread of the disease.
HENRY MACDONALD (Suriname), speaking on behalf of the Caribbean Community (CARICOM), recalled that at the United Nations High-level Meeting on HIV and AIDS last year, States reaffirmed their commitments to ending the HIV epidemic, pledging to focus on high-risk populations and to build shared responsibility for achieving targets outlined in the political declaration. His region’s response to HIV and AIDS was articulated through the Pan Caribbean Partnership on HIV and AIDS and last year, countries reaffirmed their commitment to eliminating new infections among children, increasing access to care and treatment by 80 per cent and halving new infections.
The Caribbean had also led efforts to ensure that HIV and AIDS were retained as a key issue on the post-2015 development agenda, he said. CARICOM had taken the lead in raising awareness of the impact of non-communicable diseases on development by working to identify the policy and programmatic nexus between HIV and chronic, non-communicable diseases, in order to increase the efficiency of resource allocation. In such work, the underlying causes of risk and vulnerability must be systematically addressed, including gender equality, poverty, inequity and social inclusion. There was a regional consensus on the need to focus on vulnerable groups.
Indeed, CARICOM aimed to be the first region to eliminate mother-to-child HIV transmission, he said. CARICOM would continue working with the Global Fund to overcome excessive eligibility constraints and to access funding for targeted populations. Accelerating the human rights agenda around HIV also remained a priority. With support from the Global Fund, the Pan Caribbean Partnership on HIV and AIDS was working to implement an anti-discrimination legislative agenda. Model legislation had been considered by Ministers of Health, chief Parliamentary Councils, and would soon be examined by CARICOM Attorneys General.
SEA KOSAL (Cambodia), speaking on behalf of the Association of South-East Asian Nations (ASEAN), underlined his region’s efforts to eliminate the transmission of communicable diseases, including HIV/AIDS. Since the adoption of the Declaration of Commitment on HIV/AIDS, regional countries were steadfast in their commitment to reverse the spread of new infections. At the nineteenth ASEAN Summit, held last year in Bali, Indonesia, States adopted the ASEAN Declaration of Commitment: Getting to Zero New HIV Infections, Zero Discrimination, Zero AIDS-Related Deaths, which sought to reduce HIV transmission by 50 per cent, eliminate new HIV infections among children, and scale-up antiretroviral treatment by 2015.
Further, the ASEAN Task Force on AIDS met in Bangkok last year, he said, and its first report on HIV, stated that an estimated 1.5 million people were living with HIV in the region. Thanks to a coordinated regional response, prevalence rates had dropped in Southeast Asia, and many ASEAN countries had reached their targets for treatment coverage. Despite such progress since 2001, two member States had seen a 25 per cent increase in new infections, and high prevalence among sex workers and their clients. As such, the Task Force supported fast-tracking accreditation for licensing to produce affordable generic antiretroviral drugs.
In addition, he said the ASEAN Socio-Cultural Blueprint recognized that HIV had profound consequences for socio-economic development. Effective responses must deliver focused, evidence-informed interventions that addressed the unique needs of at-risk populations. There was much work to be done. Eliminating HIV/AIDS had profound consequences for security. Given the nature of epidemics, zero AIDS-related deaths could not be achieved without strong political commitment of ASEAN Governments, complemented by the cooperation, and both the technical and financial assistance of the international community.
ISMAEL ABRAÃO GASPAR MARTINS ( Angola) speaking on behalf of the Southern African Development Community (SADC), said that significant gains had been made in the HIV/AIDS response in his region over the past few months, including declines in HIV-related deaths, declines of infection rates in children and pregnant women. Achievement of the goals set out in the Declaration was essential for Southern Africa and the world. Yet, with only fours years to go before 2015, all African nations were concerned that the targets might not be met, threatening to derail other development efforts. The HIV/AIDS pandemic was placing enormous pressure on African healthcare systems and infrastructure, and the cost of many drugs remained prohibitive. Those obstacles were exacerbated by ongoing challenges such as food insecurity and lagging general health care. In response, SADC nations had joined together to exchange best practices and build regional capacities. Yet, outside the region, there was still a need to redouble efforts to strengthen technical assistance and scale up resources.
There was also a need to better integrate HIV/AIDS work into the general national health plans. In the meantime, he said SADC was calling on, among others, men and boys to become more active in the fight against the pandemic. It also supported scaling up maternal and child health care and education. “We want to make sure every girl and boy has the correct information about HIV/AIDS, as well as the skills to protect themselves from infection” he said, adding that regional Governments were working with civic organizations to enhance home care support and to provide nutrition and psychiatric care for home-bound persons with HIV. He hoped that the international community would continue to work with SADC to do everything possible “to address this millennium challenge together”. He renewed his delegation’s commitment to achieving the goals of the 2011 Political Declaration.
MARTIN BULANEK, delegation of the European Union, said that while the Assembly had achieved a commendable goal by adopting the 2011 Political Declaration, only by including men and women and girls and boys in the fight could real progress be made. The Union remained committed to combating stigma and marginalization of most-affected groups, including sex workers, intravenous drug users and men who had sex with men, and it would continue to press for achieving the aims of the declaration as regarding those groups.
The HIV/AIDS epidemic remained a global challenge and the European Union’s policy aimed to bolster global support for reducing infections and scaling up prevention, treatment and care. Most infections were spread through unsafe sex, so there was a pressing need to address that issue as a major driver of the epidemic, including through promoting health and sexual education and reproductive health care services. He said that it was also necessary to include men and boys in that effort. The HIV response had always been a joint effort and all nations should continue that trend. Having an open and honest dialogue about the HIV virus, its drivers, most affected communities and impacts, would and could lead to more focused and targeted actions against the epidemic.
DOCTOR MASHABANE ( South Africa) said his country was among the 22 priority countries identified in the Global Plan. He urged international support for national programmes that focused on poverty eradication and economic growth. No single country could succeed in the fight against the epidemic. Partnership was critical. Financial resources were a challenge, as HIV funding had dropped since 2010. Further, only $15 billion had been available for the HIV response in 2010 against the target of $24 billion by 2015. He urged that more funding be made available to the Global Fund to Fight AIDS, Tuberculoses and Malaria.
Access to HIV drugs was another challenge, he said, and investments in local manufacture of generic drugs should be considered. More efforts were also needed to address gender inequality, the empowerment of women and girls - especially in exercising their reproductive rights and access to education – and human rights protection for high-risk populations who faced stigma based on their sexual orientation and gender identity. They often were excluded from national economic and health programmes. Further, safe and cost-effective methods must be developed to reduce women’s vulnerability to HIV transmission, including female condoms.
Travel restrictions on people living with HIV were discriminatory and must be reviewed. He said South Africa’s response to HIV and AIDS was based on strengthening health systems, including primary health care. It had integrated HIV programmes with other health services, including women and children’s health, tuberculosis and non-communicable diseases. “We have shifted the way we think about the response to the epidemic, and have recognized the need to expand beyond the health sector”, he said. The new National Strategic Plan on HIV and AIDS and TB for 2012-2016 marked the first time South Africa had integrated those illnesses in the same plan. South Africa ensured that pregnant women and their newborns could access treatment that reduced the HIV risk during pregnancy and delivery. Mother-to-child HIV transmission had significantly dropped in 2011 thanks to those efforts.
GARY QUINLAN (Australia), calling the Political Declaration “bold and ambitious”, said targets adopted by the General Assembly in 2011 offered, for the first time, quantified, achievable targets based on current realities. But absent an immediate change in the way States worked, they risked becoming “yet another set of targets we fail to reach”. States were not on track to achieve the targets, and during this morning’s three-hour session, 1,000 people would become newly infected with HIV. More than 600 will have died. “We need the courage to change our approach to HIV prevention and treatment”, he said, sounding alarm that few countries had started the process of formally incorporating the Political Declaration’s commitments and timelines into their national HIV strategies and financing plans. He encouraged UNAIDS to help countries complete such work by 2013.
States must take an investment approach to the HIV response, he said, informed by data analysis. “We must expel wastage on ineffective programming and governance architecture,” he said. The approach must be based on realistic results that used the Political Declaration targets as the foundation. That should help bring savings that allowed for reassessing the “immense” funding shortfall. Australia encouraged countries to recognize HIV prevention and treatment as their core responsibility and allocate their budgets accordingly, especially for men who have sex with men, people who inject drugs and sex workers.
All partners must align with the new investment approach, he said. Countries must understand when and how to integrate the HIV response and what that meant in concentrated, generalized or low-level epidemics. Prevention and treatment programmes must be scaled up and medication costs must be lowered. An enabling environment for that work must be supported through legal, social and economic frameworks. Punitive laws against people living with or at risk of HIV must be repealed. More political resolve was needed to follow through on past commitments. “Complacency is not an option,” he insisted, urging States to ensure the HIV response received the required attention in the post-2015 development agenda.
GUILLERMO RISHCYNSKI ( Canada) said that in the current global environment, it was important for the international community to renew its sense of shared responsibility and ensure that the principles of national ownership, mutual accountability and sustainability underpin the future global response. Canada was an active player in the fight against the disease through its investments in prevention, care, treatment and support, as well as its commitment to maternal, newborn and child health and healthcare systems. His Government’s domestic response had helped the country achieve significant progress in addressing the needs of populations disproportionately affected by the virus, and this year alone, Canada planned to invest more than $93 million in HIV-focused initiatives for research, laboratory science, surveillance, vaccine development and raising public awareness.
He went on to say that the Canadian Government recognized the important role of community partners in reaching people most at risk and in preventing the spread of HIV and AIDS. Such partners must be actively engaged throughout all stages of research and programme initiatives. To achieve the targets set out in the 2011 Declaration, Canada would continue to invest in policies and programmes that most effectively met the needs of people living with or affected by HIV/AIDS. “ Canada remains committed to preventing HIV transmission, supporting those affected or at risk of HIV and AIDS and eliminating this devastating disease, at home and globally,” he said.
SYLVIE LUCAS ( Luxembourg) said that her delegation was committed to attaining the “3 zeros” agreed in the Political Declaration. That strategy focused on the current salient aspects of the fight, including integrating HIV services into broader national health systems. At the same time, she did not believe the fight against HIV/AIDS should be limited to the health sphere, rather, it should encompass efforts to promote human rights fundamental freedoms. The fight against AIDS was the responsibility of all humankind. The war against the pandemic had not been won, but there was hope.
She said that “success is in sight”, but, with victory within reach, it would be necessary to step-up, rather than scale back, the fight. Luxembourg was, therefore, troubled by the decrease in resource earmarked for combating the disease – by some 13 per cent in just the past year alone. The developed world, particularly the traditional donors, must not relent on commitments in that regard, especially with only three years left to achieve the goals agreed in 2011. At the same time, she said, there was also a need to ensure better and more efficient use of resources already available. She also called for enhancing synergies among all development-related programmes, including the Millennium Goals related to health care. Finally, she noted Luxembourg’s long commitment to the fight against HIV/AIDS, having, since 2005, contributed some €35 million to UNAIDS. In addition, by last year, Luxembourg had become the Joint Programme’s ninth largest contributor and had launched support for two thematic programmes; “The 3 Zeros” and “Delivering as One”.
ROSEMARY DI CARLO ( United States) said last year’s high-level meeting had outlined a bold goal of treating 15 million HIV-infected people by 2015. The United States had committed to meeting the targets of the Political Declaration. Her Government planned to support treatment for an additional 6 million people by the end of 2013. It was working to reach 1.5 million more pregnant women with HIV by 2013 and would continue to make such work a priority. To meet the 2015 targets, it was critical that other donors do more to ensure a sustained, innovative and funded response to the disease. The United States was seeking a $4 billion appropriation from Congress to the Global Fund.
In addition, meeting the targets of the Political Declaration depended on finding efficiencies and increasing the impact of all programmes, she said. In 2004, the President's Emergency Plan for AIDS Relief (PEPFAR) indicated that the costs for providing antiretroviral treatment to one person had averaged $1,100. Today, the cost was $335 and falling. The global community had developed tools for creating an AIDS-free generation, she said, citing the expansion of voluntary male circumcision, and scaling up treatment for people living with HIV as efforts that could change the trajectory of the disease.
In addition, States must embrace new scientific findings and translate them into evidence-based interventions, she said. Governments, the private sector, non-governmental organizations, faith-based organizations and people living with, and affected by, HIV must be involved. There could be no effective public health response without attention to key populations: the lesbian, gay, bisexual and transgender communities, women and minorities. Collective efforts must be strengthened and the United States looked forward to working with others to meet future challenges.
REGINA MARIA CORDEIRO DUNLOP ( Brazil) said the Political Declaration paved the way towards eliminating HIV infections and AIDS-related deaths. Today’s meeting allowed States to assess progress and evaluate how national and collective actions had reduced HIV prevalence and incidence. While sexual transmission of HIV had significantly reduced, “there is a lot we must accomplish in order to reach the 50 per cent reduction target by 2015,” she said. Comprehensive human sexuality education must be made available, as must expanded access to male and female condoms.
Countries should be able to respond to specific patterns of the epidemic, she said. Governments in concentrated or high-prevalence epidemic countries must put in place strategies that focused on the needs of high-risk populations, including drug users, sex workers and men who have sex with men. Vertical mother-to-child transmission could be eliminated, if pregnant women living with HIV and their newborns were provided with antiretroviral prophylaxis during pregnancy, delivery and breastfeeding.
She said access to medicine was among the biggest challenges to public health, citing price as an obstacle. The World Health Organization (WHO), UNAIDS, the Global Fund and other efforts must be aligned with global health priorities in their work to compensate for the lack of resources in some countries for treating AIDS. Also, the imperative of public health must always prevail over commercial interests. The Trade Related Aspects of Intellectual Property Rights (TRIPS) Agreement did not, and should not, prevent World Trade Organization (WTO) members from exercising their right to adopt measures to protect public health and ensure universal access to medicine. “Flexibilities” in that agreement provided an effective tool that must be used to make HIV programmes financially sustainable.
MAFIROANE MOTANYANE ( Lesotho) said that HIV/AIDS continued to be a major global challenge and one of the leading causes of death. More people were being infected with the virus each day, with women and children being the most vulnerable to its myriad impacts. Most developing countries, especially those in sub-Saharan Africa, continued to cope with the burdens of the virus. He said that due to a variety of factors, overall progress in curbing the spread of HIV/AIDS had been slow, including due to high poverty levels, poor health facilities, high-cost medication, and unsafe sexual behaviour. He added that the ongoing economic and financial crisis was exacerbating the situation chiefly by affecting the amount of resources devoted to HIV/AIDS.
Such challenges required a concerted effort from the international community to ensure that adequate resources were available and dedicated to the fight against the scourge on all fronts. In that regard, he applauded UN Women for joining the organization-wide effort, a move that would go a long way in bolstering global measures aimed at providing women and girls with the tools to fight the disease. He said that Lesotho was committed to implementing its commitments on HIV/AIDS, but with nearly one quarter of the population affected, the challenges were great. Specifically, large numbers of women were infected, leaving equally high numbers of orphans throughout the country. Infection rates were also high among the youth population. Yet, the people of Lesotho were known for their resilience and their determination to eliminate the scourge would not wane. Neither would the determination to achieve the Millennium Goals, he said, adding that the Government was continuing its advocacy programmes on prevention, treatment and care. It also provided grants to orphans and vulnerable children.
YEVHENII TSYMBALIUK ( Ukraine) said that his Government had made combating HIV/AIDS one of its major priorities, and therefore remained committed to the objectives of the Declaration, as well as to the UNAIDS Global Strategy, which aimed towards zero new HIV infections, zero discrimination and zero AIDS-related deaths. He said that Ukraine had adopted a law on overcoming the disease and the legal and social protections for people living with HIV/AIDS. It had also adopted a broader national strategy and had established a State agency to coordinate the activities of all partners working in the area.
He said that Ukraine counted some 360,000 HIV-positive people and was proud that they were among the broad network of individuals and organizations working with the Government to bolster its response to the AIDS threat. For the most part, Ukraine’s overall success was due to donor assistance, including through the Global Fund, which had recently approved an $88 million grant and was proving to be an effective mechanism for sustained help. Expressing his country’s gratitude to all donors, he hoped all of Ukraine’s partnerships aimed at combating HIV/AIDS would continue to yield positive results.
DMITRY MAKSIMYCHEV ( Russian Federation) said his country had supported the adoption of the Political Declaration, which provided a key basis for international cooperation to combat the HIV epidemic. His Government shared the assessment of the progress made on implementing that far-reaching document, as outlined in the Secretary-General’s report. But, it could not support the proposal supporting the decriminalization of drug use or sex industry as a way to combat discrimination. The Russian Federation did not consider replacement therapy the correct way to decrease HIV infections among drug users. His Government had consistently implemented commitments for early HIV detection and universal access to treatment.
Federal legislation guaranteed for all people a broad range of programmes and no-cost testing, he said. In 2011, there were 550,000 HIV-infected people in the Russian Federation. The epidemic had been stabilized and the country had since entered a controlled stage. A significant role had been played by health agencies in implementing steps within the framework of the health plan, in that regard. The Government ensured that 100 per cent of HIV-infected people needing medication received it and today, 100,000 people were receiving highly effective treatment.
Attention had also focused on decreasing mother-to-child transmission, he said, while other actions had been taken to prevent infections among high risk populations, and to involve those people in voluntary testing. An early detection system now detected HIV in people seven to 10 years ahead of AIDS onset. From 2006 onward, the Russian Federation had donated to the Global Fund and its contributions had reached $317 million. In October 2011, participants in the “MDG6 Forum” agreed to an action plan that contained the commitments of partner countries, donor countries and others to achieve HIV performance targets by 2015.
YUSRA KHAN (Indonesia), noting that HIV had killed more than 25 million people to date, said such figures raised the spectre of a lost generation of youth who were doomed before reaching their productive age. The world had struggled for years to control the HIV epidemic, but it was not at all clear if the rising tide of HIV infection would be reduced. The last five years had shown that infection could be prevented, lives could be saved and the quality of life for millions of people could be improved.
He urged several actions to keep up momentum, saying that countries must learn from past experiences and share best practices. Efforts and resources must focus on strategically important interventions, while the critical social and human rights issues that reduced access to information and services must be addressed. Broad partnerships must be pursued that brought together the knowledge, influence and expertise of many players. For its part, Indonesia had worked hard to achieve the internally agreed goals, and progress had been made on universal access over the past decade.
At the same time, Indonesia was well aware of the challenges ahead, he said, as too many people remained reached and unserved. Too many were still victims of stigma and discrimination and, without increasing prevention and services for them, the epidemic would not be controlled. Given the size of Indonesia and the complexity of the AIDS response, the situation would be controlled only by working together to promote a compassionate and inclusive response. Fighting AIDS in his country was growing more difficult, due to the funding gaps for activities to combat the disease. Success would require strengthened partnerships. Collaboration with civil society was showing good results.
JOSEPHINE OJIAMBO ( Kenya) said that the world was at a crossroads: with 2015 rapidly approaching and the deadline for myriad health-relate and other development goals looming, HIV/AIDS was still devastating large segments of the population in many countries. African countries were at different stages of addressing the pandemic, with mixed results. Indeed, while several nations had registered some successes over the past two decades, “the situation is still grave.” With two years left to make good on Millennium commitments, the prospects did not look good, she said, stressing that much work remained to be done and the international community could not waiver. The deep challenges were not insurmountable, and some African countries, including Kenya, had shown that the epidemic could be contained through the adoption of coordinated, aggressive and comprehensive strategies. Such measures must be community-based and community-drive, and be backed by high-level political support.
She said that Kenya had stabilized its infection rate at about 6 per cent and new infections had reduced considerably. Sadly, women made up the largest group of HIV-positive persons in the country. At the same time, Kenya was working to raise awareness about prevention and treatment methods, which the Government believed had helped save the lives of some 300,000 people. Kenya’s national AIDS strategy, through 2013, had been adopted in the wake of new evidence on the key drivers of new infections. The hope was that, by the strategy’s deadline, the number of new infections would be reduced by half, AIDS-related deaths by 25 per cent and that the socio-economic impacts of HIV/AIDS at the household and community-levels would be reduced. Finally, and speaking more broadly, she said that providing universal treatment, prevention and support services required more than access to antiretroviral drugs; it required trained healthcare workers, suitable facilities, up-to-date information and scaled-up funding, all integrated within full-functioning healthcare systems. “It is incumbent upon us to act in order to help our people. Our inaction is making this world a more dangerous place to live in,” she said.
OSCAR LEON GONZALEZ ( Cuba) said the world was very unequal and the lopsided distribution of resources meant that the poor were disproportionately impacted by HIV/AIDS. People in poor and middle-income countries also faced difficulties in gaining access to medicines and other forms of care and treatment. Despite a political commitment to achieve the globally agreed goals on HIV/AIDS, the inequitable international environment meant that the efforts of low and middle-income countries to achieve them “are all but cancelled out.” Cuba supported measures to ensure that all its citizens achieved the highest standards of physical health and well-being. It had continued to work towards that goal, despite the unjust embargo imposed on his country by the United States, which hampered access to some life-saving treatment.
He said that Cuba had a strong health and medial sector and it produced six antiretroviral medications and was continuing its research, including towards the creation of a vaccine. He said that HIV prevalence was low in the 15-49 age group, as well as among women and young people. Civil society had played a major role in mobilizing the nation against the pandemic. Cuba was also lending its medical expertise with other countries. With just three years to go, it was urgent to renew political commitment to decrease the spread of the virus. Unity solidarity and international cooperation were the only ways to tackle shared challenges in the world, he said.
JAKKRIT SRIVAL ( Thailand), aligning with ASEAN, said HIV/AIDS was much more than a health challenge. “The international community must unite for universal access” to comprehensive prevention programmes, treatment, care and support, he stressed, a goal that would continue to be the foundation of Thailand’s national response. Thailand had pledged to achieve zero new HIV infections, zero discrimination and zero HIV-related deaths. Progress had been made in preventing mother-to-child transmission.
Over the next five years, key at-risk populations would account for 90 per cent of new infections, he said, including men who have sex with men, drug users, and people in relationships with an HIV-positive partner. Thailand would do more to address the legal, social and environmental factors hindering access to care, and maintain a rights-based and gender-sensitive approach, which was integral to providing treatment.
Going forward, it would be important for ASEAN States to work together, he said, and Thailand had worked to improve cooperation beyond its borders, including with a view to providing care for migrant workers. It planned to scale up lifesaving programmes. TRIPS flexibilities would be an essential contributing factor in efforts to achieve universal access. Such flexibilities were critical in helping those with HIV have access to care and treatment, and that a critical understanding must be reiterated again and again. Thailand was pleased that the Secretary-General’s report urged making maximum use of flexibilities to lower the costs of medicines and avoid measures that limited them.
AMIT KUMAR ( India) said the national AIDS Control Programme had yielded encouraging outcomes in prevention and control over HIV in the last decade, a fact recognized at last year’s High-level meeting where India was identified for its success. In the last decade, the number of new HIV infections in India each year had dropped by more than 50 per cent. The focus had been on high-risk groups, expansion of services and improving access to antiretroviral therapy. Prevention was a focus and strategies targeted female sex workers, men who have sex with men, the transgender population and drug users.
Intervention measures included the promotion of free condoms and peer education, he said, which ensured community participation in planning, implementing and monitoring of the programme. Regarding mother-to-child transmission, India was working to enhance coverage to 14 million pregnancies by 2017, and planning to “graduate” from the single drug nevirapine prophylaxis to the more effective multi-drug antiretroviral regimen for preventing such transmission. India was fully committed to providing access to antiretroviral treatment to 15 million people by 2015.
He said the international community must dismantle barriers to universal access to treatment, including the high cost of antiretroviral medicines. India was meeting 80 per cent of antiretroviral drug demand and was committed to using all TRIPS flexibilities, to ensure the availability of affordable and quality medicine to all people living with HIV.
BYRGANMYN AITIMOVA ( Kazakhstan) said that while the international community had had some successes in its combat against HIV/AIDS in the years between the 2001 special session of the Assembly and the adoption of last year’s Political Declaration, the disease continued to adversely impact the efforts of many countries to achieve sustainable development. Since 2001, Kazakhstan, following a path of prevention, diagnosis and treatment, had been able to stabilize its HIV infection rate, including a 14 per cent drop in HIV prevalence between 2008 and 2011. Kazakhstan had also focused its efforts on populations at higher risk of infection and, for example, had seen transmission rates through intravenous drug use decline by one-third between 2006 and 2011.
She said that, in keeping with the national strategy to eliminate stigma and discrimination against HIV-positive people, including violence against women with HIV, the Government had partnered with nearly 100 civil society groups combating social exclusion. She said that her delegation supported the recommendations in the Secretary-General’s report, especially those regarding the decisive role of raising the required funds, improving accountability and eliminating duplicative processes. She encouraged all partners in the battle against HIV/AIDS to continue exploring ways to ensure readily available and affordable medicines, including through building regional and local capacities to scale up production of antiretroviral drugs in regions most affected by the pandemic.
MIRIAM BIBACOU ( Gabon) said the Assembly’s adoption of the Political Declaration in 2011 had allowed Member States to set the course for continued combat against HIV/AIDS. It had underlined the magnitude of the pandemic, including its impact on broader development. In its effort to implement the goals of the Declaration, the Gabonese Government had set out an updated strategy that aimed to mitigate the impact of the disease on families, individuals and communities. The Government had also strengthened its public awareness campaigns and had enlisted the help of civil society to join such efforts. A major campaign had been launched during African World Cup qualifying games in Libreville and Franceville, where thousands of people had been tested for HIV and had participated in activities to raise awareness about the virus.
YANERIT MORGAN ( Mexico) said the Political Declaration contained notable advances in establishing goals for universal access and commitments for the prevention of HIV and provision of financial resources. For Mexico, that had led to progress in eliminating stigma and incorporating a code of human rights in the fight against HIV. There were 33.3 million people living with HIV around the world; new infections had fallen by 20 per cent over the last decade. Global antiretroviral coverage was 36 per cent in 2009. Today, Latin America had the greatest coverage among all global regions, with 51 per cent coverage.
There was still much to be done, she said, urging countries to establish regional and global partnerships, especially with civil society, people living with HIV, and the scientific and academic communities, with a view to providing a joint response to HIV and meeting the goals of the Political Declaration. To bolster the HIV response, “we need to work in harmony as much as possible”, she said. It was crucial that all countries have as soon as possible sustainable mechanisms to permanently offer free antiretroviral treatment to all those in need. The costs of such treatment in low- and middle-income countries must be reduced and working together would provide a sound response.
MOURAD BEN MEHIDI ( Algeria), aligning with the African Group, said the Secretary-General’s report pointed to mixed progress in combating HIV/AIDS. On the positive side, it said an estimated 2.5 million deaths had been averted due to increased access to antiretroviral treatment. HIV infections also were at their lowest levels. The report also warned that more than 34 million people were still living with HIV/AIDS. Algeria shared the concern at the dire situation in sub-Saharan Africa, which accounted for 65 per cent of people living with HIV, and 70 per cent of those newly affected in 2010.
He was pleased with the report’s recommendation to integrate prevention measures with those aimed at enhancing socioeconomic development. Partnerships and investment were needed. For its part, Algeria was committed to preventing AIDS. Since 1989, it had implemented a plan that took a multisectoral approach to the epidemic. It focused on prevention measures and provision of free voluntary counselling. In addition, Algeria had mainstreamed HIV prevention, care, treatment in all Government initiatives, with the understanding that the fight against HIV/AIDS had socioeconomic dimensions.
Generally, funding for the HIV response was insufficient, he said. Prevention should be emphasized, notably by developing countries, whose resources were inadequate. Access to affordable medicines should be increased and options for producing HIV/AIDS medicines in the regions where they could be produced most effectively should be explored. Indeed, HIV/AIDS medicines, treatment and care were costly. International cooperation must be strengthened to help developing countries, especially those in sub-Saharan Africa.
MORTEN WETLAND ( Norway) said “we need to work smarter to ensure that funds available are spent in the best possible way,” which meant investing where the needs were greatest. The investment framework developed by UNAIDS was an important tool for doing so. In such work, emphasis must be placed on reaching high-risk groups, such as migrant workers, persons who sell sex, men who have sex with men, injecting drug users and prisoners. Working smarter also meant ensuring that HIV was not addressed in isolation. Linkages with reproductive health services were important in that regard. Efforts to prevent mother-to-child HIV transmission must be well connected to other health services for women and babies.
Sexuality and HIV education in schools was also important, he said, as was the provision of youth-friendly access to sexual and reproductive health services. Condoms were indispensable to HIV prevention and it was discouraging they were still hard to find in many places. More also must be done to develop new generations of female condoms. Efforts to reduce the harm of negative behaviour must also be pursued.
Moreover, syringe programmes and medically assisted therapy aimed at injecting drug users could be seen as “low hanging fruit” to be implemented regardless of the legal framework for drug use, he said. Gender-based violence correlated with HIV infection and it was important to work with men and boys to change negative notions of masculinity. Norway contributed $75 million annually to the Global Fund. Some recipient countries still spent little of their own budgets funding for HIV and it was time for them to enter an active partnership as a way to develop more sustainable responses to HIV.
( El Salvador) said combating HIV/AIDS was a collective challenge of enormous scope. In his country, the epidemic was prevalent among sex workers, men who have sex with men, and transgender persons. To address the problem, El Salvador had adopted a “Reaching Zero” strategy, which reaffirmed its commitment to the 2011 Political Declaration. It also was working to combat stigma, notably with the 2010 adoption of a presidential decree. In December 2011, on the Global Day to Fight AIDS, El Salvador launched the “Don’t Label Me” campaign to reduce stigma and discrimination towards lesbian, gay, bisexual and transgender persons, and to promote health services. Progress had also been made in ensuring the human rights of persons living with HIV.
Also in 2011, El Salvador had launched the National Day for HIV Testing, he said, with 88,000 tests taken. Screenings were available in all prisons and detainees received treatment. A secretariat for sexual diversity was created and the Government had redoubled efforts to include sexual education in school curricula. In the area of mother-to-child transmission, training had helped to prevent the problem. Diagnosis and early detection had helped to reduce AIDS prevalence. El Salvador provided free antiretroviral treatment for mothers and breast milk was provided to children of HIV positive mothers for a full year. On regional and international levels, El Salvador had focused its energies towards South-South cooperation. El Salvador also had presided over a regional coordination mechanism, which allowed it to work with the region’s ministers of health, and those living with HIV.
SHEILA N. MWEEMBA ( Zambia), aligning with the African Group and the Southern African Development Community (SADC), said treatment was essential to prolonging the lives of people living with AIDS. The discussion of HIV also must emphasize prevention and Zambia had worked to reposition prevention at the centre of fighting the epidemic. Several prevention symposia had been held across the country, starting in 2010, with a high-level event attended by the President and Vice President.
In the race to halve the sexual transmission of HIV and eliminate new paediatric infections, she urged finding synergies with the post-Rio sustainable development agenda. In that context, she reiterated calls for enhanced research for a multi-protection product with high public health efficiency. More funding for prevention research was needed. She also drew attention to the issue of orphans. While the number of children orphaned by HIV appeared to have peaked in 2009 at 17 million, caution should be exercised, as vulnerability and gender violence were key determinants of HIV acquisition. No effort should be spared in cushioning the impact of abject poverty by providing social protection services.
LE HOAI TRUNG (Viet Nam), aligning himself with ASEAN, said his Government was pleased, as reported by the Secretary-General, that there was cause for hope and optimism, with increased access to essential treatment and prevention and a decline in new infections and AIDS-related deaths. The world was, however, still far from meeting the targets set out in the Political Declaration on HIV/AIDS, when substantial access gaps still persisted in key services. His country had joined efforts towards universal access to comprehensive prevention programs, treatment and support and towards halting and reversing the spread of the pandemic by 2015. All stakeholders, especially developing countries, should fulfil their commitments to support national efforts to strengthen their responses to the problem.
At the high-level meeting on HIV/AIDS in New York last June, Viet Nam had renewed its determination in the fight against HIV/AIDS and adopted new targets by signing the Declaration, he said. The country took those commitments seriously and had adopted concrete measures. Recently, the nation had finalized the National Strategy on HIV/AIDS Prevention and Control to 2020, with a vision to 2030. The strategy contained ambitious targets echoing those of the Declaration. The country’s Assembly had passed a programme on HIV/AIDS 2011-2015, securing more funding for HIV activities.
As a result, Viet Nam had initially been able to contain the rise of HIV infection, with HIV-infected people currently accounting for about 0.26 per cent of the population, he noted. In concrete terms, the prevalence rate among injection drug users had declined from 30 per cent in 2001 and 2002 to 17 per cent in 2010; the number of HIV/AIDS-related deaths had gone down from more than 6,000 a year to some 2,500 a year for the last two years. In 2001, 49 of 63 provinces had carried out community outreach activities for injection drug users and female sex workers; 60 provinces had implemented some level of needle and syringe programs and 57 provinces had distributed condoms free of charge. In addition, the National Methadone Maintenance Therapy program had been expanded to 11 provinces and had treated more than 6,900 people in 41 clinics, with an adherence rate of 96 per cent. That service was planned to expand to 245 clinics in 30 provinces and 80,000 patients by 2015. He, however, drew attention to challenges still remaining and hindering the implementation of HIV interventions, such as overlapping policies and measures: a lack of personnel, health facilities, equipment and laboratories, and limited resources for sustainable programs.
RAZA BASHIR TARAR (Pakistan) said that while the thrust of the Secretary-General’s report had been positive, especially regarding the worldwide drop in new HIV infections, it had also made clear that progress varied considerably among nations and regions and that HIV remained the leading cause of death among women of child-bearing age. It was also clear that at the current level, the international responses to the pandemic fell short of what would be required to achieve the aims of the Political Declaration by 2015. “This is a worrisome situation,” he said, expressing the hope that after more than 30 years fighting the virus, the international community was better informed and better equipped to deal with it on all fronts.
Noting that Pakistan was until recently a “low prevalence” country, it now found itself in a “concentrated phase” of the epidemic. Among the key affected populations, intravenous drug users had the highest prevalence rates at some 27.2 per cent in 2011. The most recent estimates had suggested that there were some 98,000 HIV-positive people in Pakistan, and while geographic trends showed the disease spreading from cities to small towns, it was clear that the disease was not impacting the general population, where prevalence rates remained below .01 per cent. He said the Government’s response to the disease had incorporated partnerships with bilateral and multilateral donors, United Nations agencies and civil society. The national strategy was based on three five-year plans between 1987 and 2010. In addition, starting last year, the provinces had begun developing their own site-specific health strategies. A final document, Pakistan AIDS Strategy 2012-2016 would aim to prevent new infections and improve health nation wide, would consolidate provincial guidelines and national health and development priorities.
MUSTAFIZUR RAHMAN ( Bangladesh) said the rate of decrease in new HIV infections was still too low to meet the HIV-related Millennium Development Goal, which aimed to reduce new infections 50 per cent by 2015. More than 34 million people were still living with AIDS. Moreover, the achievements were disproportionate throughout the world. The Secretary-General’s report had documented declines in new infections in sub-Saharan Africa and the Caribbean, but reported increases of HIV incidence in Eastern Europe and Central Asia, in the Middle East and North Africa and in certain Asian countries.
Bangladesh boasted one of the lowest HIV/AIDS prevalence rates, at less than 0.1 per cent, which was still below an epidemic level, he said. The Government had, from the very beginning, taken an evidence-based approach towards HIV programming. The nation had included HIV/AIDS education in the national curriculum of grade sixth to seventh classes. A number of well-developed strategies and guidelines had been adopted, including the adoption last year of the National Strategic Plan for HIV/AIDS 2011-2015, which provided a framework for the national response to the HIV epidemic towards 2015.
However, a survey outcome showed a trend that could fuel the spread of HIV from Most At Risk Populations (MARPs) to the general population, he noted. High levels of HIV infection had been found among injecting drug uses. Bangladesh, despite its low prevalence rate, remained extremely vulnerable to an HIV epidemic, given its dire poverty, overpopulation, high mobility of population, emigration and other factors. Migrant workers remained at great risk of HIV infection and, thus, could be a source for an AIDS epidemic in the country. Traditional development partners, emerging economies, the private sector as well as corporate society should come up with more financial and technical support to the developing countries. Barriers like intellectual property rights should be eliminated to make life saving medicines affordable. Family members, teachers and community leaders also had constructive roles in setting norms for responsible behaviour, and in advocating for the full range of services needed for young people to stay healthy. Only through the concerted efforts of all stakeholders would the rhetoric of zero new AIDS infections come to be realized.
ROFINA CHIKAVA ( Zimbabwe) said that her country had made progress in achieving the universal access commitments over the past five years. By identifying specific targets and indicators, Zimbabwe had seen a dramatic decline in HIV prevalence rates and in new infections. The twin decline was underpinned by the expansion of access to prevention services, including male and female condoms, HIV testing and counselling and awareness-raising campaigns. She said that the country had also added male circumcision to its programmes, in the wake of compelling evidence that such measures offered potential benefits in HIV prevention. She said that, following the Assembly’s adoption of the 2006 Political Declaration, Zimbabwe had been perhaps the first country in the world to develop and implement an evidence-based behavioural change strategy. That strategy had yielded key benefits, including increased demand for, and participation in, HIV prevention services.
Continuing, she said that, despite perennial funding challenges, Zimbabwe had logged significant progress in providing treatment and care services, and, by the end of 2010, the country had attained 77 per cent coverage towards its universal access target. Nevertheless, she acknowledged that some people in need of antiretroviral treatment were forced to delay their courses of treatment because the demand for the drugs was outstripping the supply. Zimbabwe was, however, continuing to press ahead with its effort to expand services to all districts and rural health centres. Finally, she stressed that Zimbabwe’s modest progress was being threatened because some donors were withdrawing funding. “As we speak here, there was [a fear] that at least 66,000 people risk losing their drug allocations if steps are not taken to redress this funding gap”, she said, appealing to all donors to have a “change of heart”. The withdrawal of funding would lead to “untold suffering” among people living with HIV.
At the conclusion of the debate, the Assembly adopted without vote, a draft decision on Implementation of the Declaration of Commitment on HIV/AIDS and the Political Declarations on HIV/AIDS (document A/66/L.49).
After action on the text, the representative of Iran, speaking in explanation of position, said his Government was committed to providing access, treatment and care, without stigma and discrimination, to all those requiring such interventions. At the same time, Iran had reservations regarding some of the language in the relevant report of the Secretary-General on implementation of the Political Declaration. All HIV/AIDS interventions must be grounded in the cultural and political systems in which they were being carried out and Iran had yet to be convinced of the link between revising or eliminating the laws cited in the report and the goals of the Political Declaration on AIDS.
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