General Assembly Plenary
Twenty-sixth Special Session
7th Meeting (AM)
KING OF SWAZILAND DESCRIBES A ‘NATION OF DYING’ AS GENERAL ASSEMBLY
MOVES TO CONCLUSION OF SPECIAL SESSION ON HIV/AIDS PANDEMIC
Many Speakers Echo Concern at Devastation of Disease,
Stressing Need for Adequate Funding of Massive Global Action
"My people are dying," King Mswati III of Swaziland told the special session of the General Assembly on HIV/AIDS this morning. "They are dying before their time, leaving behind their children as orphans, and a nation in a continuous state of mourning. A quarter of all Swazis are already infected with the virus that causes AIDS and we cannot avoid an escalating tragedy of truly frightening proportions."
As the Assembly continued its general debate on the last day of the session, the head of State of Swaziland said the success of the session, and the only justification for its substantial expense would be measured in terms of a reversal in the numbers of the dead and the dying. The survival of his own nation, and many others, hung in the balance.
The Minister of Public Health and Social Welfare of Paraguay agreed. He said economic, racial, political, cultural and religions differences should be set aside. The AIDS epidemic affected everyone, and only a joint effort would “allow us to win the fight against this terrible scourge".
Describing their efforts to overcome and prevent the pandemic, many speakers in the debate agreed that even countries with low incidence of the disease could not remain indifferent to the threat of HIV/AIDS because they, too, had risk factors for its spread. Agreeing that the situation in Africa required urgent attention, several representatives also called attention to other severely affected regions, including Asia and the Pacific, and the Caribbean.
The Minister of Health of Malaysia expressed disappointment that the Declaration of commitment, which was expected to be adopted at the closing of the session today, gave low profile to Asia and the Pacific. "The impending epidemic in Asia and the Pacific will far surpass anything previously seen if nothing is done today," he said. "It is our earnest hope that the proposed Global Fund on AIDS will be appropriately apportioned to ensure that this future disaster will be averted."
The Minister for Health, Human Resources, Family Affairs and Gender Relations of Saint Lucia said that while the proposed global health fund was a good supplement, it was not the solution to address the emergency the world faced.
Of paramount importance was the immediate and adequate adjustment of World Trade Organization (WTO) rules to allow countries to produce affordable drugs to deal with the crisis.
Guyana's Minister of Health said that his country was painfully aware that the Caribbean was now ranked as the second most affected region in the world, with Guyana being its most affected country. It did not, however, have the resources to protect itself against the pandemic. The scourge of HIV/AIDS had begun to erode the significant social progress his country had made in the last decade, offsetting the advantages of debt relief which it had received.
The representative of Andorra announced her country’s intention to contribute $100,000 to the Global Fund established by the Secretary-General.
Also speaking this morning were the Prime Ministers of Belize and Viet Nam; Ministers and high-level Government officials from Togo, Micronesia, Guinea, Turkey, Luxembourg, Cyprus, Mauritania, Bangladesh, Czech Republic, Vanuatu,
El Salvador, Moldova, Saudi Arabia, Mongolia, and Argentina, as well as representatives of Fiji, Uzbekistan, Turkmenistan, Maldives, Marshall Islands, Lebanon, Sierra Leone, and Democratic Republic of the Congo. The Assembly also heard representatives of the Observers for the Holy See and Palestine.
Also this morning, the Assembly adopted, without a vote, a resolution, approving the report of its Credentials Committee concerning the participation of representatives of Member States in the current special session.
The Assembly is expected to hold the last meeting of its special session at 3 p.m. today.
The General Assembly met this morning to continue its special session on the review of the problem of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in all its aspects. (For background, please see press release AIDS/22 issued on 21 June.)
KING MSWATI III, Head of State of Swaziland: My people are dying. They are dying before their time, leaving behind their children as orphans, and a nation in a continuous state of mourning. A quarter of all Swazis are already infected with the virus that causes AIDS, and we cannot avoid an escalating tragedy of truly frightening proportions. We are all agreed that this meeting addresses the biggest risk to global security. It requires the total commitment of all nations, because no country will escape the effects of this catastrophe. There must be a truly global effort to meet the challenge. The effort must not be undermined by political considerations, nor through a belief that the crisis is confined only to certain areas of the world.
Every source in Swaziland is strained to the limit, to help our people in the areas of prevention, education, care and treatment. We are grateful for support in our efforts from the United Nations agencies and from our international partners. But our combined strength is as nothing in the face of the tidal wave that has broken over us. We need much, much more.
The tradition of the extended family and of community spirit is the basis for our approach to providing care and support for the needy. We depend increasingly on the traditions and culture of the past for guidance, especially in the promotion of abstinence. Our traditional healers have much to offer in research partnership with modern day techniques and effective medicines.
We are looking to raise funds by targeting the huge reserves of good will and compassion among the communities of the world. Inspired by the example of the global response to the Live Aid event “We are the World”, we are launching later this year an album of music by international artists, called “Songs for Life”. Its title carries the message of hope, in the global language of music, and the proceeds will go directly to HIV/AIDS programmes throughout southern Africa.
SAID W. MUSA, Prime Minister and Minister of Finance and Foreign Affairs, Belize: My country is both witness and subject to the ravages of HIV/AIDS in Latin America and the Caribbean. In Belize, the 4.01 per cent prevalence rate ranks as one of the highest in the region. With a population of 250,000 people who live in small communities, the tragedy of HIV/AIDS directly affects many Belizean families, our human resources and productive capacities. The stigma associated with the disease encourages a culture of silence, resulting in under-reporting and increasing attempts to deny and hide its existence.
We have established a National AIDS Commission, whose primary responsibility is to coordinate, facilitate, and monitor implementation of the National Strategic Plan, which aims to change attitudes and practices, implement inter-sectoral coordination and provide support services to persons with HIV/AIDS. To be effective in the long-term, we must learn from the experience of those caught in the centre of this whirlwind pandemic. This means working harder to equalize the balance of power between men and women. Gender equality is a critical component in the process of changing sexual behaviour. Only when a woman is free to choose how she lives her life will she possess the capacity to best protect herself from HIV/AIDS.
There is no longer an excuse to shy away from our collective responsibility. An effective national response cannot be successful in isolation. There is need for global solidarity and support. If we are to lift the death sentence from the thousands of our fellow human beings who fall prey to HIV/AIDS, we must act together.
PHAM GIA KHIEM, Deputy Prime Minister of Viet Nam: Since 1990, we have detected more than 36,000 cases of infection, of whom more than 3,000 have been fatal. We have been focusing our efforts on communication and education, and on prevention measures for all, especially for groups with high-risk behaviour. In addition, we have been strengthening our health-care services, trying to mobilize the maximum available resources. However, the number of infected persons still increases rapidly.
Poverty, unemployment, drug abuse, ignorance, and unsafe sexual behaviour are the main factors leading to the spread of HIV. In fighting it, our experience shows that strong commitment on the part of leaders is crucial, along with a multi-sectoral approach, and the integration of the fight against HIV/AIDS into the fight against unsafe behaviors, especially among adolescents.
Viet Nam calls upon developed countries to increase technical and financial assistance to developing countries, and appeals to pharmaceutical companies to adopt policies aimed at making the necessary drugs available at low prices to the poor. We commit ourselves to regional and international cooperation in the fight against HIV/AIDS and sincerely thank the United Nations, various countries and international organizations for their cooperation and assistance.
ELIUEL PRETRICK, Minister of Health, Education and Social Services of Micronesia: I cannot over-emphasize the negative impact a spread of HIV/AIDS would cause to my country, with its small and fragile population. The first case was confirmed in 1989, having been contracted abroad, but recently the first new case, locally acquired, was discovered on a remote atoll, causing great alarm.
This issue requires discussion of many sensitive issues, and it requires a focus on prevention along with a multi-faceted approach. My Government, with assistance from the United States and the World Health Organization, has developed short and medium term preventive, educational and monitoring systems. Donor partners have also assisted with programmes for high-risk individuals.
As a small nation, we cannot sustain these programs for long, nor would we be able to combat a full-blown epidemic. We have other health needs and few resources. We therefore express appreciation to those countries that have already contributed to the Global Fund, and urge others to do so. It is important that agreements reached at the end of this forum are within a country’s means, in order to be implemented effectively.
SALIOV DIALLO, Minister of Health of Guinea: In the Millennium Declaration, leaders from around the world made a solemn commitment to fight the spread of HIV/AIDS. They set the goal of reversing the rising trend of infection by 2015. In that connection, the international community must help Africa, the continent most heavily hit by the virus. Africa, the continent which is paying the heaviest price due to the pandemic, is fully cognizant of its responsibilities.
Their efforts need to be supported and coordinated in a genuine spirit of cooperation. We highly appreciate the initiative of the Secretary-General to establish a Global Fund to fight HIV/AIDS and other infectious diseases. We are satisfied to learn of the pledges already made, and appeal to all members of the international community to assist in that regard.
My Government has undertaken a broad programme of social and economic reforms aiming at reducing and stabilizing the number of virus carriers and obtaining a full grasp of the pandemic. The recently adopted national health plan lays special stress on the strategic plan for HIV/AIDS prevention. It is intended that 70 per cent of resources which result from the alleviation of the debt burden should go to the social sector. The situation in Africa is such today that the efforts of its governments and peoples will be of no avail unless the substantial support of the international community was forthcoming.
OSMAN DURMUS, Minister of Health, Turkey: My country is still among the least-affected by HIV/AIDS with 1,141 cases reported between 1985 and 2000. The majority are in the 25-35 age group, and although the majority of infected are males, the number is rising among females. We have taken measures to provide healthcare for all HIV/AIDS patients. The State also covers the expense of those patients who for some reason are not covered within the existing healthcare system.
Efforts aimed at changing social behaviour and educational measures to improve consciousness, as well as improvements in self-protection, are bearing fruit. We are well aware, however, that unless effective and extensive prevention measures are taken, HIV/AIDS may become a serious threat in Turkey. Efforts must be made to prevent AIDS from disrupting, through prejudice and discrimination, the very structure of families and society as a whole. Problems related to this disease should be openly discussed in all related forums, while attempts are made to overcome secretiveness as well as other cultural and traditional restraints that prevail in society.
AIDS patients and their families should receive counselling so that they do not isolate themselves and risk falling into depression. More international assistance is necessary to support the struggle against the disease. While Turkey appreciates the willingness of the developed countries to contribute generously, the need to tailor specific programmes to recognize the social, cultural and economic realities of recipient countries must be kept in mind, rather than imposing standardized programmes on them.
SARAH FLOOD-BEAUBRUN, Minister for Health, Human Resources, Family Affairs and Gender Relations, Saint Lucia: Based on projections, HIV/AIDS will consume approximately 4 per cent of the gross domestic product of the Caribbean territories in the next 10 years. We therefore call for an adequate allocation of UNAIDS funding to my region as the second hardest hit area after sub-Saharan Africa. We would also like to propose that any international funds made available to combat the epidemic should be provided on a grant basis, and should be made accessible to small countries such as mine.
While the proposed Global Health Fund is a good supplement, it is not the solution to address the emergency we face. Of paramount importance is the immediate and adequate adjustment of World Trade Organization (WTO) rules to allow countries to produce affordable drugs to deal with this crisis. It has been estimated that the cost of a comprehensive response by the Caribbean countries to the HIV/AIDS epidemic is $260 million per annum for the next five years. Several donors have already committed to funding the Regional Strategic Plan for the disease.
Treatment and care continues to be the most under-represented and under-addressed issue in our region. This applies not only to the issue of medication but also access to care. The most fundamental and critical component of AIDS treatment is access to affordable medication. Sadly, because of lack of access to anti-retroviral therapy, those diagnosed with HIV/AIDS continue to suffer as a result of the prohibitive costs of treatment and anti-retroviral drugs. In addressing access, we would like to reiterate the importance of the development dimension of this epidemic, and the need for financial and trading institutions to grant access to concessional financing and assistance to small, structurally weak and vulnerable economies.
In the Saint Lucian scenario, despite significant efforts, the epidemic shows no sign of abating. We still need to strengthen our surveillance and testing capacity. This continues to pose a major public health challenge. As it stands, we do not have a true picture of the prevalence of the disease.
CHARLES GUERENS, Minister for Cooperation, Humanitarian Action and Defence of Luxembourg: Twenty years ago when HIV/AIDS was diagnosed clearly for the first time, it was an unknown disease killing thousands of people. Now it is a major threat to the future of humanity. Luxembourg had its first case of HIV/AIDS in 1984. Since then, it has diagnosed a total of 470 infections. The most common form of transmission is through sexual activity. All segments of our society are affected. As the Secretary-General has stated, the four priorities should be prevention, mother-to-child prevention, access to treatment and care, and special attention on the most vulnerable groups. Political commitment is crucial to achieving those commitments. The role of women must be reinforced, as should medical structures. Without the necessary financial resources, the fight will not be won.
Luxembourg has reacted in the area of international cooperation. In 2000, we went beyond the prescribed official development assistance (ODA) level of
0.7 per cent of GDP. We hope to reach one per cent by 2005. Bilateral programmes for target countries are included in our cooperation strategy, and we have participated in the UNAIDS Coordination Council. The concept of tiered pricing would make medicines accessible to those groups for whom they were not already available. Reducing prices will not be the miracle solution. For the past four years, we have been involved in a major prevention project in Niger and have set up a blood transfusion centre in Rwanda. My country is at the head of the list with regard to its expenditure in relation to GDP. The prevention and treatment of AIDS requires a new level of openness and frankness.
FRIXOS SAVVIDES, Minister of Health of Cyprus: The countries most affected by HIV/AIDS have found themselves in a state of emergency, requiring urgent measures to reverse the spread of the epidemic and its disastrous impact on social and economic stability, food security and the life expectancy of their populations. Communities with weak economies are gradually deprived by the epidemic of the very means needed for effective responses to it. The countries least affected nonetheless face the risk of sudden outbreaks of the epidemic, especially among high-risk groups and people suffering from the effects of armed conflict, violence and sexual exploitation. Many women, even in societies with institutionally protected human rights, are often placed in situations of vulnerability regarding their sexual safety and freedom of choice. The global nature of the epidemic calls for urgent and concerted action, since no country can bring about the necessary changes alone.
The role of the United Nations is central to such efforts. And we agree with the Federation of International Civil Servants Associations on the need for the United Nations personnel policy on HIV/AIDS to be strictly enforced. Where appropriate medications are not available locally, they must be supplied to staff members through the United Nations medical service.
Cyprus has faced the HIV/AIDS problem since 1986, but remains a low-prevalence country. The epidemic has been addressed as a priority issue through a strategic plan in cooperation with the WHO and through the establishment of a national committee with wide participation at all levels. Financing and funding mechanisms were quickly put in place to support the infected, and implement educational campaigns among the population and special-risk groups. Medical treatment, hospital care, testing and counseling have been offered free of charge. Though encouraging, these facts do not warrant complacency or relaxation of measures to tackle the epidemic. Time-bound targets set by the declaration of commitment to be adopted at the special session will be strictly respected and actively promoted by Cyprus.
BOYDIEL OULD HOUMEID, Minister of Health and Social Affairs of Mauritania: Humanity is now taking the full measure of the HIV/AIDS epidemic. Africa is by far the most affected continent. We have seen that there is a direct correlation between the spread of HIV/AIDS and a country’s economic condition. The prevention of poverty and underdevelopment are the most effective ways to combat the disease. Resources for prevention and treatment are also crucial. Therefore, we support the Global Fund.
Mauritania has not been spared by the epidemic with 6,000 reported cases of infection so far. This number is increasing. A decentralized, multi-sectoral approach has been adopted to combat the spread. Our goal is to implement a national strategic plan to integrate activities at the national and international level. At this meeting, the commitment of the entire international community is being expressed. It is our hope that ensuing actions will be strong and effective.
MONICA CODINA TORT, Minister of Health and Welfare of the Principality of Andorra: After this meeting, the taboos surrounding HIV/AIDS must disappear. Those affected have the right to healthcare, and everyone has the right to respect. Prevention, however, is paramount to us, targeting first the young population through schools and special events. Women have also received information in the work place.
A basic element in the entire discussion is access to medications. We would like to encourage pharmaceutical companies to continue to make changes in their policy to increase that access to all sectors of the population. We are much concerned about the magnitude of HIV/AIDS epidemic in Africa, which has destroyed the structure of society in many areas. The firm will of every country is needed to provide assistance to its own people, with the support of the international community.
The priority is financial assistance. In that light, I wish to announce that my country intends to contribute $100,000 to the Global Fund, and hopes all countries will respond generously. The courage shown by thousands of people who are ill should be the best lesson to enable us to face a future full of hope.
SHEIKH FAZLUL KARIM SELIM, Minister for Health and Family Welfare of Bangladesh: Learning from our experience and success in family planning, our prevention programme on HIV/AIDS has been mobilized taking into account our religious practices, traditional family values and cultural ethics. Accordingly, we have involved our religious leaders, students and community leaders in advocating prevention programmes. Because of our positive measures, the prevalence of HIV/AIDS in Bangladesh is very low -- only 157 cases. However, given the wider perspective and magnitude of the problem, we urgently require financial and technical assistance from the Global Fund for HIV/AIDS and from the international community, to safeguard our people from this devastating public health problem.
Our cabinet has recently approved legislation on safe blood transfusion and initiated a massive programme to screen blood for safe transfusion in 97 centers across the country. This will be further expanded to cover the entire country through the establishment of a full-fledged National Blood Transfusion Service for which we also need special support. In spite of our achievements, we believe we have a long way to go and cannot be complacent. Our big challenges now are building institutional capacity in order to be able to make optimum use of the resources we have mobilized. We require a range of assistance from technical to managerial, in Government and in civil society, to stay ahead of the epidemic.
BOHUMIL FISER, Minister of Health of the Czech Republic: There is no doubt that the epidemic is now a global crisis, and one of the most serious destabilizing factors of development and social progress. From the very beginning, my country has taken part in the global programme on AIDS and in the work of UNAIDS. For many years, we have been closely cooperating with neighbouring European countries in the medical, social and economic areas.
So far, our country has not been affected by the spread of the disease. It still ranks among the countries with the lowest HIV/AIDS incidence. Our Government closely collaborates with civil society actors, including NGOs, economic and research institutions, and people living with the disease. Our programme against HIV/AIDS is based on prevention. We focus on young people by enhancing sexual and family education in our schools. Clear and open dialogue with all vulnerable groups is fundamental.
Effective prevention is based on widely accessible voluntary HIV testing and counselling. High priority is given to prevention of mother-to-child transmission. As of January 2001, HIV tests for pregnant women are mandatory. We also pay close attention to care availability and quality of treatment in our clinical AIDS centres. Therapy and prophylaxis are covered by health insurance and by a national HIV/AIDS subsidy.
We recognize that the epidemic has outgrown the control of individual countries, however rich or large. The only possible way out of this situation is to mobilize the reserves in the area of international cooperation, science and preventive activities. I fully agree with Secretary-General Kofi Annan that "we cannot deal with AIDS by making moral judgments or refusing to face unpleasant facts.
CLEMENT LEO, Minister of Health of Vanuatu: Vanuatu, like Tuvalu, reports zero confirmed cases of HIV/AIDS. Despite this clear success story, we have not been complacent. The Government is deeply concerned about the challenges and burdens this epidemic has placed on human development and global security. Vanuatu, in several respects, is vulnerable to this deadly disease.
As a least developed country (LDC), Vanuatu already faces many social, economic and environmental problems. Among the risk indicators for AIDS are high population mobility, increasing levels of unemployment and the alarming incidence of traditional STDs. All this, coupled with cultural factors and the lack of sophisticated technology for screening and testing, may well point to under-reporting or a lack of detection capacity. LDCs and small island developing States like Vanuatu stand to lose a lot if they allow the pandemic to take hold of their small populations.
We endorse the strengthening of human rights in our global fight against HIV/AIDS, especially for vulnerable groups. Our prevailing cultural and religious prejudices urgently need to be revisited. Vanuatu hails the creation of the Global Fund for health and its emphasis on prevention strategies. We acknowledge the contributing countries, sectors and agencies, and look forward to meeting the targets set by the United Nations.
LESLIE RAMSAMMY, Minister of Health, Guyana: My country is truly under siege. HIV/AIDS threatens to decimate large numbers of our productive population. Unprecedented numbers of our children are being orphaned while the fabric of our society is being relentlessly torn apart. In addition, our socio-economic development, already lagging behind most countries in the Americas, is threatened with destruction. We are also painfully aware that the Caribbean is now ranked as the second most affected region in the world, with Guyana ranked as its most affected country.
The prevalence rate of 5.5 per cent may well reflect significant under-reporting of those affected in Guyana. The prevalence rate of 45 and 29 per cent respectively among sex workers and persons with sexually transmitted infections (STIs) are not unlike prevalence rates in many African countries. Nevertheless, we have established a strategic plan that embraces partnerships with civil society organizations and persons with HIV/AIDS. Guyana is committed to the reduction of mother-to-child transmission and to addressing gender inequalities, stigmatization, discrimination and human rights violations. We also believe that treatment and care are inseparable from prevention efforts.
We do not have the resources to protect ourselves against the pandemic. We recognize however that this is not just our business -- it is also the world's fight. We are impatient with more talk, nice-sounding rhetoric and declarations. We want action. The hesitancy and slowness debt relief is not merely the reduction of debt, but debt forgiveness. Despite the debt relief received by Guyana, which resulted in substantial investment in the social sector, HIV/AIDS has begun to erode the significant social progress my country has made in the last decade. Unless Guyana can urgently access additional funds, our capacity to sustain programmes for surveillance, voluntary testing, capacity and infrastructure building and treatment will continue to be severely limited. Pharmaceutical companies too must further significantly reduce the price for anti-retroviral drugs. Cutting of prices to approximately $1,000 per person per annum still excludes countries like mine. We salute countries like Brazil and India for their efforts to produce drugs at affordable prices. The knowledge and experience should be fostered, particularly in the context of South-South cooperation. While we welcome the Global Health Fund, we hope it does not become another window to place conditionalities on developing countries.
FRANCISCO LOPEZ BELTRAN, Minister of Health of El Salvador: HIV/AIDS has become one of the most formidable challenges to human life. El Salvador is the most densely populated country in Central America, and one of those most seriously affected by natural disasters. We are also vulnerable to external economic conditions, such as the international prices of oil and coffee.
El Salvador recognized that the HIV/AIDS pandemic has the full potential to become a serious limiting factor to our development. Given its social roots, the disease deserved a robust reply in which all actors of society have a role to play. We are unifying our efforts together with civil society and UNAIDS to face the pandemic.
The Government of El Salvador has established alliances with all interest groups on the issue. A strategic prevention plan for HIV/AIDS and infectious disease has been established. We have trained our health staff in pre- and post-test counselling and have already begun treatment for adults, children and pregnant women with anti-retrovirals to reduce transmission. Our programmes place particular emphasis on young girls and boys to promote values and healthy life practices.
Within the Central American context El Salvador hopes to achieve a greater impact in its programmes, given the enormous exchange of citizens and goods and services between our countries. We support the declaration which the Assembly will be adopting, particularly the setting up of a Global Fund, which will contribute to containing the pandemic and promoting prevention and appropriate treatment. Because this is a global crisis, it requires a broad and global response from the international community.
MARTIN CHIOLA VILLAGRA, Minister of Public Health and Social Welfare of Paraguay: As of last month, 655 cases of AIDS had been officially recorded in Paraguay. In 1988, the Government established the national AIDS control programme and initiated measures related to prevention and assistance. The problem of HIV/AIDS has become an issue of State policy. Academic reform in the country has allowed educational institutions to take action in terms of prevention, aimed at children and young people. Preventive measures are also being taken aimed at prison inmates and drug users. Since 1996, the Ministry of Public Health and Social Welfare has provided free medical attention to infected persons, including laboratory testing, follow-up monitoring and the supply of anti-retroviral medication.
Paraguay proposes to support the immediate implementation of a common fund for the fight against AIDS, within the context of prevention and assistance. The fund should be applied to reduce inequality in investments between countries with low and high prevalence; to mobilize international assistance agencies to provide non-refundable resources for the fight against AIDS; to recognize AIDS as an economic problem that affects the security of countries; and to accept that the HIV/AIDS epidemic further affects the vicious circle of poverty. Immediate action is needed to reduce the cost of medication and to consider the reduction of foreign debt for the poor countries affected by the epidemic. Economic, racial, political, cultural and religious differences should be set aside. The epidemic does not respect anything or anyone. It affects us all, and only a joint effort will allow us to win the fight against this terrible scourge.
ANDREI GHERMAN, Minister for Health of Moldova: Moldova is working at a national level in cooperation with international organizations. We have developed a strategy through 2005 to prevent the spread of the infection, especially in the young population, in the blood supply, and among drug users. We became drawn into the epidemic in the mid-1990s and have a relatively low level of infection, with somewhat over 1,100 cases registered. Migration, prostitution (including the trade in women for that purpose) and drug addiction are major factors in the spread of the disease.
We fully support the report of the Secretary-General on the issue, along with its recommendations. Measures at the international level are following United Nations guidelines. With the support of international organizations, we have implemented programmes to aid vulnerable groups that are at risk. In this effort it is important to enhance coordination. I am certain that this session will provide stimulus for effective efforts at the national, regional and international levels.
YACOUB BIN YOUSSOUF AL-MASRUWAH, Deputy Minister of Health for Preventive Medicine of Saudi Arabia: In the absence of an effective vaccination or remedy for HIV/AIDS, humankind should concentrate on fighting this health hazard through effective preventive measures. Coordination and cooperation among all countries are especially important in this regard.
My Government shares with other governments the responsibility of stemming the spread of the epidemic. We are committed to international recommendations and strategies that are in conformity with the teachings of Islam. The Government of Saudi Arabia provides all preventive and curative services to its citizens and residents. It closely follows international efforts, including those of the United Nations.
My Government has set up a national anti-AIDS programme at the level of the Ministry of Health and regional health directorates. A scientific consulting committee has been established to assist the executive branch in dealing with the technical aspects related to AIDS, such as selecting the medications and laboratory activities for health providers and national coordinators. It also plans awareness strategies. The programme executes preventive measures and reviews and records lists of cures discovered, ensures follow-up procedures for the patients and their partners. On the local level, coordinators have been appointed to combat AIDS around the country.
The reason for the low prevalence of AIDS in Saudi Arabia is adherence to Islam, which prohibits sexual relations outside the confines of marriage. In spite of this, an awareness campaign has begun in the country, directed at all groups, especially the young, who are the highest risk group. The programme emphasizes adherence to Islamic teachings and explaining the dangers of the disease.
NATSAG UDVAL, Deputy Minister for Health of Mongolia: Even though Mongolia has only two reported cases of HIV infection, we are all in the same boat of risk. A sense of solidarity and compassion compels us all to commit ourselves to a global response to the crisis. That response requires a comprehensive, holistic approach that takes into account a wide range of issues, from good governance to respect for human and reproductive rights, along with leadership, community empowerment, and multi-sector partnership.
Momentum in all these areas is building, but, in the developing world, it needs to be supported by financial assistance. Contributions to the Global Fund are therefore appreciated. As the Fund becomes operational, it should be directed to strengthening the health systems of developing countries, to enable risk reduction, preventive action and national capacity building.
Mongolia is committed at the highest political levels to fight the disease, as it is extremely vulnerable, with a struggling healthcare system. Phases of a national strategic plan are being completed, along with the implementation of an information and prevention strategy. The Government is working closely, in these efforts, with non-governmental organizations, the private sector and United Nations agencies, and is building regional cooperation. To implement other necessary activities, the Government needs further support from the international community and civil society.
DATO'SERI SULEIMAN MOHAMAD, Deputy Minister of Health of Malaysia: The special session signifies the urgent nature of the pandemic. Malaysia has not been spared. More than 40,000 HIV/AIDS cases have been reported in the country, and almost 4,000 have died. A multi-sectoral approach to prevention, treatment, care and support is essential. For instance, in the area of prevention the Government has limitations in reaching vulnerable communities. In this regard, we support programmes undertaken by NGOs and community-based groups. We encourage private sector involvement both in providing financial support and in incorporating HIV/AIDS education in the workplace. Several Government agencies have ongoing programmes that address HIV/AIDS issues in their own spheres of work.
Among the major barriers to prevention in Malaysia are gender inequities, stigma and discrimination. As more women are becoming infected, many by their own husbands, the need to empower them to protect themselves is urgent. Recognizing the risk of mother-to-child transmission, Malaysia has, since 1998, instituted a voluntary antenatal screening programme and provides zidovudine to HIV-positive mothers and their babies. The Government has also started to provide free anti-retroviral therapy to the mothers as part of the continuum of care. We recognize that more needs to be done to prevent discrimination against vulnerable groups and people living with AIDS, and we support non-governmental organization efforts in this area.
In terms of access to care, Malaysia is very concerned about the disparities between the North and the South, largely due to the prohibitive prices. Access to life-prolonging drugs should not be restricted by trade and patent related issues. We hope that the declaration of Commitment will redress this inequity. Although we are in agreement with much of the declaration, Malaysia is disappointed at the very low profile given to Asia and the Pacific, where 60 per cent of the world's population lives. While recognizing the magnitude of the African problem, the impeding epidemic in Asia and the Pacific will far surpass anything previously seen, if nothing is done today. It is our earnest hope that the proposed Global Health Fund will be appropriately apportioned to ensure that this future disaster is averted.
ARNOLDO VICTOR CASTILLO, National Secretary for Health Care, Ministry of Health, Argentina: It is indispensable that the magnitude of the HIV/AIDS epidemic be made widely known so that not only policy makers but the whole society is aware of it. We are convinced that the disease will only be controlled if society as a whole works together in a common direction. It is impossible to believe that governments alone can successfully respond to the pandemic, or that isolated individuals and organized groups from civil society will be able to do so as well. This year my Government is developing a massive prevention campaign aimed at informing and raising awareness among the whole population. Argentina believes that as far as HIV/AIDS is concerned, prevention cannot be separated from care, support and treatment. This is why we advocate that infected people act as multiplying agents for prevention and care.
Our legislation guarantees free access to medication and integral care for those who need it and those without medical insurance. Since 1997, and thanks to the mobilization of civil society, the number of beneficiaries has increased. This has led to a 20 per cent reduction in the number of AIDS related deaths. The greater survival rate was accompanied by a better quality of life -- the main goal of the Government’s actions to address HIV/AIDS.
We are worried about the high vulnerability of young women and its consequences on mother-to-child transmission. A better enforcement of the current legislation led, in 2001, to a significant reduction of the HIV incidence rate in children born from mothers who received AZT treatment. These first achievements strengthen our commitment because thousands of women, girls and young men are being infected. We must increase our efforts to avoid this. Argentina hopes the commitment reached today will be a step forward in the fight against the pandemic. If every country acts more effectively against AIDS, within similar frameworks for the defence of human rights and personal dignity, the results will be effective.
AMRAIYA NAIDU (Fiji): By global standards, the number of HIV/AIDS cases reported in Fiji may be insignificant. But, it is alarming for our small population. Sixty-eight HIV/AIDS cases were confirmed between 1989 and 2000. More alarming is the high number of traditional sexually transmitted infections, which may indicate an under-estimation of unreported infection. Of the
68 reported cases, over 40 per cent are between the ages of 20 and 29. Fiji’s Strategic Plan for combating HIV/AIDS was designed with a rights-based approach, which ensures, without judgement, the rights of individuals to information and free voluntary screening.
Most importantly, we can begin to win this battle if we successfully reverse attitudes and behaviour, and instill a stronger sense of belonging and community values. Stigmatization continues to prevent our people from accessing the prevention and care services they need. It undermines confidentiality, especially in small Pacific island countries like Fiji, which also leads to underreporting.
Fiji seeks to promote a supportive and enabling environment for women, children and other vulnerable groups, including men who have sex with men and sex workers, by addressing underlying prejudices and inequalities through community and multi-sectoral dialogue. Appropriate policy and legislative reforms are also in order to strengthen the privacy, confidentiality and non-discrimination of people living with HIV/AIDS. Prevention programmes are being developed in consultation with all stakeholders, particularly NGOs and civil society. Inroads will need to be made in the corporate and private spheres, especially in developing research and in resource mobilization.
ALISHER VOHIDOV (Uzbekistan): This special session is evidence that the international community has finally recognized its global character and the need to act in solidarity. While Uzbekistan has only 230 people infected with HIV/AIDS, our Government is determined to resolve the problem by stabilizing the epidemiological situation and preventing the spread of the disease, especially among the youth.
We have created a Programme on the Strategic Planning of National Measures to Counter the AIDS Epidemic. We also aim to enact favourable legislative conditions for vulnerable groups, and to ensure that medical help as well as social support is available for HIV/AIDS patients.
Unfortunately, opportunities for anonymous treatment are still limited, and there is a shortage of appropriate medication. Sex workers and intravenous drug users are most at risk, and they have to be reached. We are also trying to prevent in-hospital transmission of HIV and ensure the safety of donor blood. Considerable assistance and support is received from the United Nations system. This is particularly significant at a time when the pandemic is beginning to spread in my country.
ASKOLTAN ATAEVA (Turkmenistan): The problem of AIDS, which has been steadily growing in the last decades, has touched upon almost all countries of the world and has become global. It is especially worrisome that the disease has spread to the children, rendering this vulnerable group the most wounded and helpless in the face of the catastrophe of the twenty-first century.
Irrespective of how many cases are found in each particular country, the danger of the spread of disease presents the same threat to everyone, since there is no absolute barrier against it.
Management at the global and national levels, and the mobilization and coordination of all means in the fight against the epidemic are essential, and should be undertaken with adequate financing. We realize serious socio-economic consequences of the spread of HIV/AIDS and fully support the initiative of the Secretary-General to create the Global Fund to fight AIDS.
Turkmenistan is among countries with a low level of AIDS, but measures to prevent the spread of the disease are among the priorities of our health programme. The efforts are focused on prevention aimed at the risk groups. Within the framework of the joint project of the Government of Turkmenistan and UNAIDS, the national capacities have expanded, and an inter-agency committee has been established to confront the problem. The national prevention strategy is being implemented through integration of various State, civil and international efforts. Measures are being taken to prevent drug addiction, improve access to medical and consulting services, and to assist the population in forming healthy life habits. An information and communications network on AIDS prevention has been established, and training seminars are being carried out to educate the people.
Although the multifaceted prevention programme being carried out in the country is producing positive results, we understand that quickly spreading drug abuse can seriously influence the situation. We are counting on practical assistance from the United Nations in this respect.
HUSSAIN SHIHAB (Maldives): The first case of HIV/AIDS was confirmed in the country in 1991. Since then, a total of 11 cases have been traced, of whom six have died. Although the number of cases may be relatively small when compared to other countries, the potential threat that looms over us cannot be overemphasized. The rapid advances in economic and social development in our country, enabling our people to travel and interact frequently with the rest of the world, have also exposed us to a wide range of infectious diseases, including HIV/AIDS.
Moreover, the increased inflow of tourists and the growing presence of a large number of expatriate workers in the country have contributed to the exposure of locals to the risk factors. Another high-risk group includes those locals working as seamen in various parts of the world. However, a recent study cited drug-abuse-associated sexual behaviour among youth as the single most obvious risk factor for infection in the country.
Several measures have been taken by the Government to prevent and control the spread of the disease. A National AIDS Council and a National AIDS Control Programme were established in 1987 to facilitate full commitment in preventing and controlling the disease. Steps being taken include awareness programmes conducted for health workers, to enable them to generate accurate information on HIV/AIDS and on training of peer educators at schools. Distribution and availability of condoms at all health facilities and pharmacies are also carried out as a major preventive measure.
JACKEO RELANG (Marshall Islands): While we respect each other’s beliefs, traditions and other concerns, the destructive force of HIV/AIDS respects no national borders. Given the limited resources of the Marshall Islands, the lack of adequate infrastructure, the high percentage of vulnerable youth and the high cost of drugs, one case of HIV/AIDS is one too many. The disease could have a devastating impact on our sustainable economic development.
Traditional cultural barriers make it difficult to talk openly about such issues as sexual behaviour. However, we must be ready to implement prevention and health services and engage all segments of our society in efforts to prevent the disease from gaining a foothold in our country and to reduce vulnerability factors. In recent years, we have focused on surveillance systems, infectious diseases, training of clinical staff and awareness programmes, as well as plans to reduce the socio-economic impact of HIV/AIDS.
Our efforts have been carried out in partnership with the specialized agencies of the United Nations, the United States and Japan. The establishment of a global fund is also most welcome, and we have confidence that it will be effectively utilized through partnership and collaborative efforts. The Marshall Islands stands committed to contributing to global efforts to fight the pandemic, and welcomes the adoption of an effective declaration during this special session.
SELIM TADMOURY (Lebanon): The extremely negative impact of HIV/AIDS on the development of countries, particularly those in sub-Saharan Africa, must be kept in mind. The first case of HIV/AIDS in Lebanon was reported in 1984 and we have over 600 cases up till now. The first reported case drew the attention of the Government to the need to adopt a national prevention and treatment approach, which then led to the establishment of a national body to address AIDS. Among the primary tasks of that body is prevention, and the provision of the necessary means to combat the disease.
Our Government assumes all costs associated with the disease. The problem we are facing at the present time is the lack of adequate resources to provide hundreds of thousands of migrant workers with AIDS tests. We call for greater support for such efforts.
Lebanon appreciates the efforts of the Secretary-General to combat the epidemic, and attaches the utmost importance to devising an effective strategy to tackle it. We consider that the establishment of the Global Fund to mobilize between $7 and 10 billion is crucial to combat AIDS in poor countries, which are in need of support. At the same time, we must allow these countries the necessary drugs at a modest cost. Today, we have the opportunity to prove our solidarity as peoples and States to fight the greatest tragedy to have affected mankind.
ALLIEU IBRAHIM KANU (Sierra Leone): Although numerous studies to determine the magnitude of the HIV/AIDS situation in Sierra Leone have been inconclusive, there has definitely been an increase in its prevalence. Many of the predisposing factors exist, all as a result of the 10 year-long war -- including the breakdown of civil society, massive displacement and the presence of troops from many countries where the disease has already reached epidemic proportions.
Economic and socio-cultural characteristics are also factors, such as poverty and the concentration of wealth, gender inequalities and traditional practices that include skin piercing and contact with blood. Efforts so far, in partnership with the World Bank, United Nations agencies and other stakeholders, focus on containing or reducing the epidemic, mitigating its effects and increasing access to prevention services, as well as care and support for those already infected and otherwise affected. Extensive structures have also been created in the national Government to pursue those goals.
In addition to breaking the poverty cycle, a major breakthrough is needed in treatment of HIV/AIDS. Even if they were provided free, the cost of administering existing drug cocktails would be prohibitive in rural Africa. What is needed is an easily administered vaccine. It is imperative to promote clinical trials of such drugs. The Global Fund is also essential and Sierra Leone, even though its economy has been devastated, will make a contribution symbolic of our strong determination to control this disease.
ATOKI ILEKA (Democratic Republic of the Congo): My country was one of the first African countries to recognize, in 1983, the reality of HIV/AIDS. We have therefore cooperated with international scientific research to contribute to a better knowledge of this new epidemic. But the fight against the disease has been severely hampered by armed conflict, and other factors have allowed infection rates to increase to over 5 per cent of the population, with great disparities between rural and urban areas and various provinces. For example, the rate has increased from 4 per cent to 20 per cent in Goma. 730,000 children in the country have lost their parents to HIV/AIDS.
The full picture in my country is even more alarming than those figures would suggest. Conditions of life, the continuing war, and the occupation by foreign troops is exacerbating the situation. There is systematic rape of women and young girls and evidence of the use of HIV-positive soldiers as instruments of war.
Despite such obstacles, the DRC has developed, with its international partners, strategies for effective response to the epidemic. We would like to take advantage of all approaches and participate in partnerships at all levels. Resources must be mobilized, especially to increase health spending, and we welcome the establishment of the Global Fund for this purpose. We must take up the challenges together, so that there will be rigorous implementation of the points of the Declaration of Commitment. My Government supports it without reservation.
ARCHBISHOP JAVIER LOZANO BARRAGÁN, President of the Pontifical Council for Pastoral Assistance to Health Care Workers, Observer for the Holy See, on behalf of His Holiness Pope John Paul II: Two responses are required in the face of this evil scourge -- prevention and cure. Prevention of this disease calls for an honest assessment of its real nature as a reality which affects the whole person. In many cases, HIV/AIDS also implies problems of existential values; it is a true pathology of the spirit which harms not only the body but the whole person, interpersonal relationships and social life, and is often accompanied by a crisis of moral values.
Regarding the sexual transmission of the disease, the best and most effective prevention is training in the authentic values of life, love and sexuality. No one can deny that sexual license increases the danger of contracting the disease. It is in this context that the values of matrimonial fidelity, chastity and abstinence can better be understood. Prevention, and the education which fosters it, are realized in respecting human dignity and the
person's transcendent destiny, and in excluding campaigns associated with models of behaviour that destroy life and spread the evil in question.
In many countries it is impossible to care for infected people due to the high cost of patented medicines. The Pope reminds us that the Church has consistently taught that there is a 'social mortgage' on all private property, and that this concept must also be applied to 'intellectual property'. The law of profit alone cannot be applied to essential elements in the fight against hunger, disease and poverty. The Pope also invites industrialized countries to avoid any semblance of colonialism and assist needy nations in their campaigns to combat AIDS. To secure greater effectiveness in the fight against the disease, the Holy See also supports plans for global coordination in combating the epidemic and encourages governments to make maximum use of the power and authority of the State in responding to HIV/AIDS.
NASSER AL-KIDWA, Observer for Palestine: Poverty, discrimination, stigma, crises and conflict are among the most prominent factors which contribute to the exacerbation of the spread of HIV/AIDS. Thus, these factors should be addressed in a serious and thorough manner. It is clear that respect for human rights and for international humanitarian law would contribute significantly to promoting conditions for reducing vulnerability to HIV/AIDS within societies.
A strong commitment with appropriate and urgent action is required to combat and prevent the fast spread of the epidemic. The development of effective preventive strategies and an increase in the availability of resources, whether human, medical, financial or technical, is needed.
In Palestine, we have registered a relatively small number of HIV cases. Nevertheless, we have been giving the necessary attention in dealing with this serious disease. The Palestinian Ministry of Health has instituted policies and measures to combat and prevent the spread of the virus, including treatment consisting of full free care for the sick. In the area of preventive measures, the Ministry has conducted health education and has created awareness in schools, universities, labs and dental clinics as well as for doctors working in both the governmental and private sectors.
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