Press conference on OAU meeting on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases (unofficial transcript)
Press events | Kofi Annan, Former Secretary-General
Q: My area of concern is the proposed creation of the Global Fund. One, we would want you to expand more, the practicability of this. We know that when an idea like this comes, initially, most of our countries might say, it's OK, they would like to embrace it. But the practicability, and in the long run, they might not be forthcoming. One would want to know the structure that you have put in place already so as to ensure that this fund is effective, I mean practicable, because we all know that there is no money anywhere now for AIDS. So, we want to know this structure you will have on the ground, Sir.
SG: Well, I hope we all do not know that there is no money anywhere for AIDS. Quite frankly, if I shared the view that there is no money anywhere for AIDS, I don't think I would have embarked on this idea on trying to set up a Global Fund and encourage donor governments, private foundations corporations and individuals to pay money into the Fund. We have had a series of discussions, not just within the UN family but with other donor governments, foundations and the World Bank, about the need of establishing this fund and we are all working together. We realize that it is going to require substantial amounts of resources and it has to be sustained, it has to be over the long hall. The Fund that will be set up will have two windows: it will deal with HIV/AIDS and other infectious diseases. So, it will be applied to AIDS and other infectious diseases. Governments and others should be encourages to put in money and I hope that by the time we open the UN Special Session of the General Assembly, Governments and others would have already made announcements of how much money they are going to put into the Fund. The Fund will be governed by stakeholders which will be made of donors, the UN system and groups dealing with people infected by HIV/AIDS and the funds will be applied at the community level to national programmes at the country level and the emphasis will be on action at the country and community level. And I think from what I have said this morning it is clear that while I expect the African Governments and the leaders of the developing world to do a lot, the major donors and the developing countries also have a role to play, and I think there are indications that quite a few of them are ready to play that role.
Q: Thank you for the substantive speech today, it was quite detailed. I have a question to follow up the first question. First of all, have you won any commitment from any of the donor nations to put money into this Fund? And two, don't you run the risk now of creating such high expectations that If the Fund does not get even into the billions that there will be a devastating backlash here in Africa.
SG: Let me say that there are indications. We have indications from several sources that are ready to put money onto the Fund, but I will leave them to announce it themselves. Secondly, as to the second part of your question where you indicated that if we do not meet the targets, if there wouldn't be a backlash. I made it clear that the sums we are asking for is large, but we should also be conscious of the magnitude of the problem we are tackling. I think we have to be realistic and put the right dollar figure that we require. I hope we will achieve it but a least we know what it is that is required to get the job done. You are probably right that if we don't raise the money people will be disappointed. But do you think it would have been correct for me to ask for 150 million when I know it wouldn't do the job? To raise it and also disappoint people. I think it is much more realistic to let the world know the nature of the problem we are dealing with, the magnitude of it, and what resources are required and how we have to mobilize ourselves to get it done. It may be, some would say it's a dream. But first to dream, without that you don't get anything done.
Q: Sir, I would like to know what the UN is doing to strengthen the care systems of member countries, especially in areas of primary health care.
SG: I think the UN agencies, particularly World Health Organization, UNICEF and the UNAIDS are working with Governments at a national level to strengthen their health systems. But let me be clear. The basic responsibility for health systems and improvement of health systems, and setting the right priorities in applying the budgetary resources belongs to the governments. The international community and the UN can help, but the responsibility belongs to each and every one of our governments. And I think once we have our priorities right and even where we need help to draw the plans I think we should ask for their help and the UN agencies are working with some governments in doing that and we will. And, in fact the Fund that we are setting up, part of that money will also be used to strengthen health care systems. But the governments have to have the right priorities and we will work with them and in some situations, not only have we work with them to develop plans but we assisted them in implementation. But we have to be clear who has the primary responsibility.
Q: You talk about this Global Fund. As regards to Africa, doesn't that put dependency on the developed world and not on Africans themselves. Past history has shown that there is donor fatigue around because a lot of the developed countries start thinking we are putting money into Africa and it just goes down the hole. Rather, shouldn't the emphasis be on African countries themselves? Uganda has had tremendous success. Shouldn't we encourage we Africans to look for our own solutions. Why still asking for some funds as well.
SG: I think that was the thrust of my statement this morning. I agree one hundred per cent with you that the outsiders can help but the primary responsibility is ours and this is my message everywhere. The primary responsibility is ours in terms of leadership, in terms of priority, in terms of how we allocate our resources, in terms of how we get the communities and the families to work with us, in terms of how we use our schools and educational systems to get the message around, in terms of how we use our own traditional communication methods to get the message around. But we need help. We cannot do it alone given the amount of resources and some of the inputs, whether it's in terms of health equipment, in terms of medication and other aspects that will help strengthen the system. And I think if we do our part, it would energize and encourage the others to join us. So you and I have no disagreement, at all.
Q: 70% of those afflicted with AIDS live in Africa. Sometimes, in 86, the majority of conflict suffering from the debt crisis were in Africa and the UN convened a Special Session on Africa. Why is the UN no doing that this time around? Secondly, you talked of a war chest of trillions of nairas needed. You said that over several years. Can you be a little exact over how many years? And then, how will you overcome the question of donor fatigue, which usually follows situations like this?
SG: On your first question, I indicated, I stated this morning very clearly that there is a Special Session of the UN General Assembly in June on AIDS. So there is a Special Session in June on AIDS to follow up what we are doing here and I hope African Governments will participate fully in that conference. On your second question, yes to some extent there is a donor fatigue. But I don' think that means we should throw up our arms and not try and challenge them to push them to develop their will to contribute. And we also have to very clear. AIDS is not an African problem alone. AIDS is a global problem. If we don not win here in Africa, we are not going to win it anywhere else. AIDS is posing a problem in Asia, in Central America and in Eastern Europe. And we need to come together to deal with this issue. And I think in today's world, when people travel and cross borders and we are in constant communication, what is limited to one continent does not stay there for long. And so, it's a challenge for all of us and I think it's in the self-interest of all governments, rich and poor to join this fight. And I hope that message will be clear and I think we are getting through. And I think we are getting the response that we need, and I am not as pessimistic as some of you in this audience are. We will continue the fight. We will push and will try and get every one engage, get every one to do their part. Otherwise, we will be defeated.
Q: Have you w any specific commitment form the pharmaceutical companies on the prices for the antiretroviral drugs, and would you be prepared to see the global fund used to acquire generic drugs like those Nigeria plans to buy from India?
SG: I think on your first question, you may recall that I invited the Chairmen, CEOs of the 7 large pharmaceutical companies to meet me in Amsterdam on the 5th of April. I think they all came except Merck that couldn't make it at the last minute. At that meeting, we agreed that they would reduce the prices quite considerably and some have cut it back by 80%-90%, and some of the drugs they are giving away, I mean they have are donating some of the drugs. We also agreed that they should look at the group, the group of 50 countries, the least developed countries as a group and not get into individual, national negotiations with them, look at them as group and make the affordable medication affordable to them. For other developing countries giving differences in purchasing power, there were going to deal on country by country basis, obviously using their preferential pricing as well as voluntary licensing where it could be done. We also agreed that in offering these medications at reduced prices, it should not only be offered to Governments, but it should also be offered to serious NGOs that are giving care in some of these countries, and to private companies that are giving care to their staff and communities so that you'll be able to reach many more people through that mechanism. So, the first decision is to offer it to 50 countries as a group, and then expand access to it from Governments to NGOs and private companies that are providing care to their staff and communities. I think that is an important development. On the question whether the Fund should be used t buy the sort of medication that the President indicated Nigeria will buy this morning, I am not in the position to go into that kind of detail at this stage.
Q: You talked this morning and President Clinton this morning, there is no infrastructure before the antiretroviral cold be delivered. There is no infrastructure. So, at what point do you think these more affordable drug could possibly be available to HIV/AIDS sufferers. That's one. And two quickly. What do you think the withdrawal of the pharmaceuticals from the South African case does in terms of these countries power to import generic drugs? Do they have to consult with the drug companies or can they just do nit if they deem it necessary?
SG: I think on your first question, let me say that I hope I did not create the impression that one has to wait to have the entire health system in place before these antiretroviral drugs could be used. What I said was that that alone is not enough. We need to do other things. We need to strengthen the health system. We need to work to improve education and understating of the disease to others. And that just focusing on the retroviral medication is not enough I think in fact we have seen situation where you may not have the perfect health system, but the governments have been able to create supportive systems to be able to offer medication to some of them. At this stage, very small number of those infected in Africa are getting the medication. And I expect it to grow as the prices have come down, but along with the prices, we should set up a mechanism, even if it's basic, to be able to monitor and ensure that we educate the patients on how to use these medications. We need not have to wait for a perfect medical health system to begin to give them this medication to extend their lives. And so I think we can do it: Senegal and Uganda and others have demonstrated that with effective programmes you can really arrest the spread of the diseases and also help expand the life of those infected. So I will say, try get let's try meet the medication available but at the same improve the health systems and talk about prevention, educate people to look after themselves. On the question of what happens after the settlement of the South African case, I think the pharmaceutical companies accept that whilst we need intellectual property to protect research and give incentive for research, we also have to make sure that the medication reaches the poor and that we leave in a world today where citizen in this robust civil society, global civil society we have, cannot accept that life-saving medication is available but it is only reserved for the rich and not for the poor. And they themselves realize that the have to work with governments to make the medication available. And so, we will se, in my judgment a much more understanding application of agreements and acceptance that generic medication can be produced where it is going to save lives. I think the pharmaceutical, the major pharmaceutical companies themselves will continue to do whatever they can do to reduce prices and make it affordable and I suspect some of them will perhaps even team up with some other generic producers or encourage that to be done. I think what has happened in South Africa is not just a lesson for South African alone but it has an impact, a much wider impact and I do not see the pharmaceutical companies going to court to sue other countries that easily. I think that they will find a way of working with the governments and I think that's what' right.
Q: Monsieur le Secretraire general, je voulais vous demander deux petites questions. Vous avez dit que vous avez rencontre les 6 grosses societes pharmaceutiques. Qu'est-ce que vous avez discute? La deuxieme question: vous avez parle de, il faut qu'il y ait beaucoup d'argent pour lutter contre le sida, et cet argent vient, quel est le systeme de coordination qui va etre mis en place par le systemne des Nations Unies ou encore quelle est la place des associations nationales dans les pays du tiers-monde qui luttent contre le |sida? Merci.
SG: Quand j'ai eu l'occasion de rencontrer les presidents, PDG des societes pharmaceutiques, on avait discute des prix. Je les avais encourage de reduire les prix des medicaments pour permetre aux pauvres de pouvoir les acheter et de pouvoir se faire soigner. On s'est mis d'accord. Je crois que plusieurs parmi elles ont reduit de 80 a 90 pour cent les prix pour permettre aux gens, les ressortissants des pays pauvres de pouvoir acheter ca. La deuxieme question, evidemment, il faut avoir un comite pour gerer les fonds. Et ce comite va nommer les gens representants les gouvernements, les gens des agences specialisees, de la societe civile, y compris les societes qui s'occupent des gens qui sont atteints par le sida. Donc, on va avoir un groupe qui va gerer les fonds, mais les fonds vont etre utilises sur le terrain dans les pays conernes mais pas sur le plan international.
Q: (inaudible) Women stand to be the most affected victims of the disease of every form of diseases. How are you going to get women involved from all the African countries and the world over? Thank you Secretary-General.
SG: Thank you for that question. I think women have a very important role to play because of their role in society and on this continent because of their vulnerable situation. I would want to see women play an important role at several levels. I think as government come up and draw up their strategies to fight the disease and to make a difference, women groups and women should be consulted and be involved in the elaboration of national plans. Not only should they be involved in the elaboration of national plans, we are also going to work with them and rely with them in the implementation of the plans, and those of us at the international levels who are dealing with the disease and are also coming up with the idea of the Fund must have participation of women at the decision making level. And I can tell you from the UN point of view, in fact, of the five UN agencies that are leading this fight, three of them are headed by women. I have Dr. Brundtland, I have Caroll Bellamy, and we have Thoraya Obaid who is head of the UNFPA. So, at our level, the women are very actively involved, and I hope we can do the same at the national level and I appeal to the governments to do that.
Q: My question, Sir, has to do with what you mentioned, about we need to combat this scourge in Africa, and you said the first thing is leadership. Mr. Secretary-General, don't you think it would have been better for you to wait for the outcome of this summit, the African leaders have gathered, before they part, because so far they haven't shown enough commitment...
SG: Who has not?
Q: ...African leaders, in respective countries. Don't you think you should have waited before to se how the action plan from this summit is implemented before you make such a big statement about this huge financial commitment? Thank you.
SG: I don't know what your point of reference is and your starting point is. If you indicate that we are now 2001 and you maintain that leadership has not been shown, and we knew ten years ago where we were heading, we knew a year ago what this disease is doing, we knew five years ago. How much time do you think I should give the leaders after this conference before I say we need to show leadership. It is now. It was yesterday. It's not tomorrow. I think you would agree with me. Thank you very much. *****