Preventing HIV/AIDS ‘Unfinished Business’, Say Speakers as General Assembly Quantifies Notable Progress in Some Regions, Backsliding in Others
With great strides made in reversing the global HIV epidemic since the dawn of the new millennium, the international community must build upon that progress — and avoid complacency — as it set out a new, post-2015 development agenda, speakers told the General Assembly this morning.
The global AIDS response had been highly successful in reversing, and in some cases even stopping, the spread of the virus, said Lyutha Sultan al-Mughairy (Oman), who spoke on behalf of General Assembly President Sam Kutesa (Uganda). New infections and AIDS-related deaths were falling globally and risk-taking behaviour had declined, as had mother-to-child transmission rates. Access to life-saving anti-retroviral therapy had vastly improved.
Nevertheless, she said, worldwide, 2.1 million people became newly infected with HIV in 2013 and 1.6 million had lost their lives to the disease. There were 36 million people living with HIV today, and 19 million did not know they were infected. Meanwhile, social and economic inequality and gender-based violence continued to put women and girls at an unacceptably high risk of infection.
Welcoming the target to end the AIDS epidemic by 2030 within the proposed sustainable development goals, she said that progress in the AIDS response was closely intertwined with other objectives outlined across the Millennium Development Goals, including those related to health, gender equality, human rights and development as a whole. Significant value lay in the lessons learned from the AIDS response.
Many delegations, describing national efforts to reduce HIV prevalence rates and to support people living with the disease, noted sharp declines in HIV infection rates and success in preventing mother-to-child transmission.
The representative of Rwanda, speaking on behalf of the African Group, said new infections and deaths continued to decline in sub-Saharan African. African Governments had shared responsibility and strengthened accountability and partnerships in building long-term and sustainable solutions. He urged innovative funding sources, as well as tailored services to ensure no one was left behind.
Kenya’s speaker said the Secretary-General’s report on the matter highlighted the extraordinary gains, but also reminded the world that “the task is far from over”. Of great concern was the slow progress and backsliding in some countries and regions. “We all recognize that there is unfinished business,” she said of the Millennium Development Goals.
Speaking on behalf of the Southern African Development Community (SADC), the representative of Zimbabwe said that there were lags in access to HIV treatment, notably for adolescents and children. It was important to expand proven prevention programmes to include women and young girls, who remained vulnerable.
The representative of the European Union said, despite remarkable achievements made in reducing global HIV infection and AIDS-related deaths, much remained to be done, and the fight against HIV/AIDS would remain an urgent international challenge in the post-2105 development agenda. At the country level, there was a need to invest strategically in tailored responses in order to ensure that resources and programming were targeted to the needs on the ground and made available to populations with a rise in new infections.
While the target of 15 million people receiving life-saving anti-retroviral treatment by 2015 had nearly been met, said India’s representative, the remaining 22 million people infected persons must also be reached. “The challenge before us is not of unavailability of medical treatment, but of accessibility arising from its high cost in developing countries,” he said.
In other business today, the Assembly declared the Czech Republic was elected a member of the United Nations Commission on International Trade Law for a term of office beginning on the first day of the forty-eighth session of the Commission in July 2015 and expiring on the last day prior to the beginning of the forty-ninth session of the that body in 2016. Earlier, Georgia, elected in June 2011, had informed the Assembly that it was relinquishing the remainder of its term in favour of the Czech Republic, in line with the Eastern European States rotation.
The Assembly also adopted without a vote the resolution contained in the “Comprehensive review of the whole question of peacekeeping operations in all their aspects: report of the Special Political and Decolonization Committee (Fourth Committee)” (document A/69/455/Add.1). In a separate decision, it approved an updated proposed programme of work and timetable of the Fourth Committee for its seventieth session, from 5 October to 17 November.
Also without a vote, the Assembly adopted the draft resolution, titled “Comprehensive review of United Nations system support for small island developing States” (document A/69/L.73). Introducing the text on behalf of the Group of 77 developing countries and China, the representative of South Africa noted that the “SAMOA Pathway” had tasked the Joint Inspection Unit to establish the parameters of the review, which it published earlier this year. By the text, the Assembly requested the Joint Inspection Unit to conduct a comprehensive review of United Nations system support for small island developing States, in the most efficient and cost-effective manner.
The Assembly also requested that the initial findings of the review and the recommendations thereon be included in the regular report of the Secretary-General to be submitted to the General Assembly at its seventieth session. The complete results, says the text, should be included as an addendum to the report before the end of that session.
The General Assembly will reconvene at 4 p.m. on Monday, 15 June, to elect the President and Vice-Presidents for its seventieth session.
Election
The General Assembly declared the Czech Republic was elected a member of the United Nations Commission on International Trade Law for a term of office beginning on the first day of the forty-eighth session of the Commission in July 2015 and expiring on the last day prior to the beginning of the forty-ninth session of the that body in 2016. Earlier, Georgia, elected in June 2011, had informed the Assembly that it was relinquishing the remainder of its term in favour of the Czech Republic, in line with the Eastern European rotation of seats.
Action on Texts
The Assembly adopted without a vote the resolution contained in the “Comprehensive review of the whole question of peacekeeping operations in all their aspects: report of the Special Political and Decolonization Committee (Fourth Committee)” (document A/69/455/Add.1).
Noting the widespread interest in contributing to the work of the Special Committee on Peacekeeping Operations expressed by Member States, in particular troop- and police-contributing countries, the Assembly endorsed the proposals, recommendations and conclusions of the Special Committee contained in its report.
For further details on the text, see Press Release GA/SPD/577 of 29 May.
By a separate decision, the Assembly approved an updated proposed programme of work and timetable of the Fourth Committee for its seventieth session, from 5 October to 17 November (document A/69/463/Add.1).
Introducing the draft resolution (document A/69/L.73), titled “Comprehensive review of United Nations system support for small island developing States”, the representative of South Africa, speaking on behalf of the Group of 77 Developing Countries and China, said the “SAMOA Pathway” had tasked the Joint Inspection Unit to establish the parameters of the review, which it published earlier this year. The time was, therefore, ripe for a full review, he said, seeking consensus adoption of the text.
Adopting the resolution without a vote, the Assembly requested the Joint Inspection Unit, on the basis of the recommendations and findings outlined in its report, to conduct a comprehensive review of United Nations system support for small island developing States, with a view to enhancing the overall effectiveness of such support and respective roles in supporting the sustainable development of small island developing States. It emphasized that the review should be undertaken in the most efficient and cost-effective manner.
The Assembly also requested that the initial findings of the review and the recommendations thereon be included in the regular report of the Secretary-General to be submitted to the General Assembly at its seventieth session the complete results should be included as an addendum to the report before the end of the seventieth session.
Implementation of HIV/AIDS Outcome Documents
LYUTHA SULTAN AL-MUGHAIRY (Oman), speaking on behalf of General Assembly President Sam Kutesa (Uganda), said that today’s meeting came at a critical juncture, with the target date for the Millennium Development Goals approaching and the international community in the final stages of negotiations on a post-2015 development agenda. Regarding the Secretary-General’s report entitled, “Future of the AIDS response: building on past achievements and accelerating progress to end the AIDS epidemic by 2030” (document A/69/856), she said that it showed that the global AIDS response had been highly successful in reversing, and in some cases even stopping, the spread of the virus. New infections and AIDS-related deaths were falling globally and risk-taking behaviour had declined as had mother-to-child transmission rates; access to life-saving anti-retroviral therapy had vastly improved.
Despite those accomplishments, she warned against complacency, as worldwide, 2.1 million people became newly infected with HIV in 2013 and 1.6 million people had lost their lives to the disease. There were 36 million people living with HIV today, and 19 million did not know they were infected. Social and economic inequality and gender-based violence continued to put women and girls at an unacceptably high risk of infection. Given those realities, the Joint United Nations Programme on HIV/AIDS (UNAIDS) had developed “fast-track” targets to ensure that by 2020, 90 per cent of all people living with HIV would know their status, 90 per cent of all people diagnosed with the infection would receive sustained anti-retroviral therapy, and 90 per cent of all people receiving anti-retroviral therapy would achieve viral suppression.
Welcoming the target to end the AIDS epidemic by 2030 within the proposed sustainable development goals, she said that progress in the AIDS response was closely intertwined with other objectives outlined across the Goals, including targets related to health, gender equality, human rights and development as a whole. Significant value lay in the lessons learned from the AIDS response and the UNAIDS approach for delivering a post-2015 development agenda that was truly transformative. Partnerships with a wide range of stakeholders, collective action and adequate resourcing were also critical. “We should take these important lessons learned and seek to implement similar approaches across the post-2015 development agenda.”
JAN POULSEN, on behalf of the European Union delegation, said that the Secretary-General’s report underlined some of the remarkable achievements made in reducing the HIV infection and AIDS-related deaths. However, much remained to be done, and the fight against HIV/AIDS would remain an urgent international challenge in the post-2105 development agenda. At the country level, there was a need to invest strategically in tailored responses in order to ensure that resources and programming were targeted to the needs on the ground and made available to populations with a rise in new infections. A goal of zero discrimination must be vigorously pursued; countries must work to end the stigmatization of those living with the disease. As nations grew economically, they should increasingly take over the funding of their HIV-reduction programmes, he said, reminding Governments to urgently scale up efforts to make affordable and quality health services available to all.
JILL DERDERIAN (United States), commending the tremendous progress outlined in the Secretary-General’s report, said all partners needed to fast track the fight against HIV/AIDS. The “90-90-90” global targets were an essential part of United States-funded programmes, she said, adding that the Obama Administration was committed to partnering with countries through evidence-based interventions. His programmes had taken a data-driven approach towards effective prevention measures for neglected and hard-to-reach populations. The Government was particularly interested in addressing the concerns of girls and women. She stressed the importance of sustained global solidarity to end the HIV/AIDS challenge through access to services allowing people to survive, thrive and fulfil their dreams.
IRENE SUSAN BARREIRO NATIVIDAD (Philippines) said her country had seen a rise in HIV/AIDS infections, approximating around 20 cases per day this year. Accordingly, the Government had increased the budget for prevention and treatment programmes and had embarked on a multifaceted approach to addressing the epidemic. Important awareness programmes and legislative initiatives were under way, while local efforts were being coordinated with national-level efforts. The country was also expanding universal access to health care as part of the post-2015 development agenda, through a people-centred strategy focusing on vulnerable populations. To end the AIDS epidemic as a public health threat required sustained international cooperation.
BERNADETTE NTABA (Zimbabwe), speaking on behalf of the Southern African Development Community (SADC) and associating with the African Group, said the ravages of the AIDS epidemic in the region had destroyed health systems and reversed social and economic progress. As a result, there had been an unprecedented rise in the proportion of children who were orphans. SADC member States had adopted a multifaceted approach in recognition of the fact that there was no one model, which, on its own, could yield sustainable results. Among other initiatives, SADC member States had prioritized abstinence and promoted prevention and protection through improving condom promotion and distribution, behavioural change programmes, increasing HIV testing and counselling, and ensuring safe medical circumcision. There had also been an unprecedented mobilization of international cooperation around those goals.
Nevertheless, she said, care must be taken to ensure that the lessons learned from the HIV response were “deliberately applied towards comprehensively strengthening health systems so that they are resilient and developed enough to address the general health needs of the population”. There were lags in access to HIV treatment, notably in relation to adolescents and children, she said, stressing that the HIV response could never be labelled a success if children continued to receive insufficient access to treatment. Emphasizing that the drivers of the HIV epidemic differed in various settings, she said that countries must have the flexibility to tailor their interventions according to the specifics of the epidemic. For example, in many places, it was important to expand proven prevention programmes to include women and young girls, who remained a vulnerable group. Also, international assistance must be sustained and possibly increased to assist those countries whose domestic capacity was unable to cope with the demands of containing the epidemic.
MESBAH ANSARI DOGAHEH (Iran) said that, 15 years ago, when the red ribbon was placed at the heart of Goal 6 of the Millennium Development Goals, a glimmer of hope had arisen. However, despite significant global progress, there were gaps and challenges, which must be faced appropriately, including by the international community. His country had put forth a robust response to the HIV epidemic, rapidly developing prevention, care and treatment measures. Its goals were zero new infections, zero discrimination and zero AIDS-related deaths, he said, noting that a number of national reports submitted to the United Nations demonstrated Iran’s concrete response to the epidemic. Tens of non-governmental organizations country-wide were engaged in a variety of activities, from awareness-raising to drop-in counselling. All people living with HIV in Iran benefitted from triangular clinics and enjoyed free health insurance. At the community level, positive prevention and other services were provided, despite the “illegal and unfair” sanctions levied against Iran, which made such progress more difficult.
GEORGE TALBOT (Guyana), speaking for the Caribbean Community (CARICOM), said the epidemic was far from over and required intensified efforts to build on the impressive gains made so far. Several of the Millennium Development Goals, especially those related to health and HIV would not be achieved, he said, adding that the existing AIDS-related commitments and goals must be reconfigured and redirected to defeating AIDS and advancing global health. The Caribbean had made significant progress towards achieving the goals of the Political Declaration, which was due in no small measure to the fact that the region had pursued cooperation across sectors. Nevertheless, considerable challenges remained. The region had a mixed HIV epidemic, consisting of a low-level, HIV prevalence generalized epidemic in the adult population, and unacceptably higher epidemic rates among vulnerable and marginalized populations. Linkages in the AIDS response should be promoted across the new development agenda, particularly in the areas of poverty eradication, employment creation and the empowerment of women and girls.
MABONEZA SANA (Rwanda), speaking on behalf of the African Group, said new infections and deaths continued to decline in sub-Saharan African. African Governments had shared responsibility and strengthened accountability and partnerships in building long-term and sustainable solutions. The African Union laid out clear pathways and demonstrated strong political will. Significant progress had also been made towards universal access to health-care services and to HIV/AIDS in particular. Despite the gains, the Group was concerned at the rise in infections in North Africa. Meeting established targets required focused investment in the interventions with the highest impact, as well as increased access to tailored services for those left behind.
The Group also called for increased resources and stressed the importance of complementary innovative funding sources. It reaffirmed the importance of guaranteeing access to affordable treatments, vaccines, medicines and indigenous knowledge. Prevention, diagnosis, treatment, strong surveillance systems and universal access must be at the core of efforts. The Group was disturbed by the continuous use of certain terms in the Secretary-General’s report and stressed the need to maintain joint ownership of the international human rights agenda and to consider human rights issues in an objective and non-confrontational manner. It was important to refrain from notions falling outside the internationally agreed human rights framework, as such attempts flouted the universality of human rights.
BHAGWANT S. BISHNOI (India) said that his country had undertaken targeted interventions for people living with HIV and high-risk groups. A strategy for 2012-2017 was in place, aiming to accelerate the reversal. At the international level, there was concern about uneven progress in the priority areas of the Political Declaration, as well as the rise in infections in new regions. There was a need for scaled up anti-retroviral therapy to extend lives and improve the quality of life. Global efforts had ensured that the target of 15 million people receiving those drugs by 2015 had nearly been met. Nevertheless, he said, the remaining 22 million people infected with HIV must also be reached.
“The challenge before us is not of unavailability of medical treatment, but of accessibility arising from its high cost in developing countries,” he said, adding that “we need to bridge the North-South divide if we are to achieve the 2030 target”. The Indian pharmaceutical industry had been plugging that critical gap by producing high-quality affordable drugs for use in his and other developing countries. India was committed to using all flexibilities under the Trade-Related Aspects of Intellectual Property Rights Agreement of the World Trade Organization (WTO) to ensure the availability of affordable and quality medicine to all people living with HIV. It was regrettable, however, that those Agreement flexibilities were being questioned in some quarters.
KOKI MULI GRIGNON (Kenya), associating with the African Group, said that the Secretary-General’s report highlighted extraordinary gains made towards halting and reversing the course of the HIV epidemic. However, it also reminded the world that “the task is far from over”. Of great concern was the slow progress and backsliding in some countries and regions even as the majority reported good progress towards the targets of the Political Declaration and the Millennium Development Goals. “We all recognize that there is unfinished business in achieving the [Millennium Development Goals]”, she said, adding that “the onus is upon us, the international community, with the impending dawn of a new development paradigm, to make the achievement of the end of HIV/AIDS a reality”.
He said Kenya remained steadfast in efforts to stem the tide of the deadly scourge, both nationally and as part of a dynamic African region. Progress had been made with HIV prevalence dropping from a high of about 14 per cent in the 1990s to a stable current rate of 6 per cent among adults. The Kenya AIDS Strategic Framework, in place through 2019, exemplified the firm commitment by key stakeholders to support national and county Governments to deliver better health for all. Kenya’s new and progressive Constitution asserted the duty of the Government to meet the needs of vulnerable groups within society through the provision of safety-net programmes, and the country had enacted the HIV/AIDS Prevention and Control Act. In line with the call in the Secretary-General’s report for increased investment and leadership, Kenya’s HIV Strategic Framework underscored the need to increase domestic and sustainable financing for HIV as a priority. The country had reduced the number of new infections by at least 50 per cent and reduced AIDS-related deaths by 25 per cent. It had also put in place a comprehensive strategy to prevent mother-to-child transmission.
ANTHONY BOSAH (Nigeria), associating with the African Group, said the international community, in addressing the HIV/AIDS epidemic, had waged an unprecedented war on the disease. As a result, HIV/AIDS was better understood and was no longer a death sentence for those living with it. However, challenges persisted, which required the continued attention and involvement of the international community. In sub-Saharan Africa, women and girls continued to be affected at a higher rate than males because of their biological make-up. Cortical action was needed to ensure that their access to education, health, legal rights and justice in order to enable them to make decisions about their health. A large segment of Nigeria’s population continued to lack access to services. The country had been spearheading initiatives, including legislative ones, against stigma and violence. Prevention remained a major concern as there was limited access in rural areas, he said, stressing that insufficient funding undermined efforts to ensure national ownership of policies and programmes. Those needed to be complemented by South-South cooperation and regional and international partnerships.
DIMITRY MAKSIMYCHEV (Russian Federation), reaffirming his Government’s full commitment to the goals and objectives of fighting HIV/AIDS, said national legislation guaranteed all citizens access to testing, and if needed, treatment. The country had virtually halted the vertical transmission of HIV/AIDS infections, through a sustained focus on harm-reduction and risk-prevention efforts, and was prepared to share its experiences with other countries. Since 2013, UNAIDS, together with Russian donor participation, had engaged in advanced diagnostic support and training in several countries, while working to harness all stakeholders in a broad partnership towards eliminating infections, transmission and deaths. Combating the spread of infectious diseases would remain a central part of his country’s international development assistance, he stressed.