UN general assembly special session on HIV/AIDS
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UN SECRETARY-GENERAL CALLS ON GOVERNMENTS TO TAKE UP AIDS CHALLENGE
Seeks Global Commitment to Reverse AIDS Spread
New York, 20 February 2001 - Declaring the HIV/AIDS epidemic "the
most formidable development challenge of our time", United Nations
Secretary-General Kofi Annan, in a report released today, calls on
governments to secure a global commitment for intensified and coordi-
nated action.
The report has been issued in preparation for the General Assembly
Special Session on HIV/AIDS, which will take place in New York from
25 to 27 June 2001. The first round of substantive negotiations for
the Special Session are set to take place the week of 26 February,
based on the report.
The report calls for intensified and broadened political and finan-
cial commitments by nations in their response to the AIDS crisis.
Alarmed by the accelerating epidemic and its global impact, the Gen-
eral Assembly decided in November 2000 to hold a Special Session on
HIV/AIDS at the highest political level. The Session follows calls
for concrete action made in the UN Millennium Declaration, adopted in
September 2000 by world leaders at the Millennium Summit.
More specifically, the report calls on governments worldwide to meet
a set of seven critical challenges that will help reverse the AIDS
epidemic:
- effective leadership and coordination,
- alleviating the social and economic impact of the epidemic,
- reducing the vulnerability of particular social groups to HIV in-
fection,
- achieving agreed targets for the prevention of HIV infection,
- ensuring that care and support is available to people infected and
affected by HIV/AIDS,
- developing relevant and effective international commodities,
- mobilizing the necessary level of financial resources.
"Leadership is fundamental to an effective response," said Mr Annan,
referring to one of the challenges highlighted in the report. "One of
the key issues facing the global community is developing and sustain-
ing such dedicated leadership, vital if the nature of the epidemic is
to be clearly understood throughout society and a national response
mobilized."
Another core challenge is to alleviate the epidemic's social and eco-
nomic impacts. In many countries, AIDS has significantly undermined
key sectors. Its negative impact is evident in economic development,
education, health and agriculture. In addition, conflict, war, eco-
nomic uncertainty, gender inequality and social exclusion have all
made people more vulnerable to HIV infection, according to the re-
port.
The report also states that an expanded prevention effort is vital to
containing the spread of the epidemic and spending on prevention
helps avert the future cost and impact of infection. A particularly
effective intervention is the prevention of mother-to-child transmis-
sion. A short course of antiretroviral treatment can cut the rate of
transmission to children by 20-50%.
As well as the need to strengthen health care systems, the afforda-
bility of medicines for opportunistic infections and antiretroviral
therapy - one of the greatest barriers to improving access to care -
must be dealt with.
Some progress in reducing the price of medicines has resulted from
the dialogue between the UN system and several research and develop-
ment based pharmaceutical companies, initiated in May 2000, as well
as through the increasing availability of generic versions of anti-
retroviral drugs. Despite these efforts, much more needs to be done
if access to care and treatment is not to remain out of reach for the
majority of people living with HIV and AIDS, according to the report.
The report says continuing inequalities in access to effective care
and treatment must be specifically addressed through all possible
means, including tiered pricing, competition between suppliers, re-
gional procurement, licensing agreements and the effective use of the
health safeguards in trade agreements.
In his report, the Secretary-General also calls for focussed interna-
tional research and development to produce microbicides and vaccines
for HIV/AIDS, and for greatly increased resources to meet the chal-
lenges of a growing epidemic.
One of the goals of the Special Session will be to call for a
strengthening of financial commitments in the response to AIDS, which
remains vastly underfunded.
Lessons Learned
Despite the dramatic and ongoing spread of the epidemic, much has
been learned since it surfaced two decades ago and the potential to
reverse AIDS has never been higher.
"Collective experience with HIV/AIDS has evolved to the point where
it is now possible to state with confidence that it is technically,
politically and financially feasible to contain HIV/AIDS and dramati-
cally reduce its spread and impact," Mr Annan said in his report.
By the end of 2000, 36.1 million men, women and children around the
world were living with HIV or AIDS and 21.8 million had died from the
disease.
The same year saw an estimated 5.3 million new infections globally
and 3 million deaths, the highest annual total of AIDS deaths ever.
However, an even greater epidemic can be prevented, according to the
report. Large-scale prevention programmes in virtually all settings
have clearly demonstrated that the spread of HIV can be reduced, es-
pecially among young people and hard-to-reach populations.
The report also said that successful responses have their roots in
communities, that empowering young people and women is essential, and
that people living with HIV or AIDS are central to the response. An
approach based on human rights is fundamental: combating stigma is a
human rights imperative on its own, as well as of instrumental value
in fighting denial and shame, both of which are major obstacles in
opening dialogue about HIV/AIDS.
A Complex Mosaic
A key lesson learned from the epidemic is that it is complex and must
be tackled on several fronts - by dealing with its risks, the factors
that affect vulnerability to it, and the epidemic's impact.
"AIDS has become a major development crisis. It kills millions of
adults in their prime. It fractures and impoverishes families, weak-
ens workforces, turns millions of children into orphans, and threat-
ens the social and economic fabric of communities and the political
stability of nations," said Mr Annan. It has become clear that sin-
gle, isolated activities do not yield sustained results, and that in-
terventions to reduce HIV risk and change behaviour are effective
only when a range of government ministries and partners in the so-
cial, economic and health fields are involved.
AIDS is now found everywhere in the world but has hit hardest in sub-
Saharan Africa. Africa is home to 70% of adults and 80% of children
living with HIV, and to three-quarters of the people worldwide who
have died of AIDS since the epidemic began. During 2000, an estimated
3.8 million people became infected with HIV in sub-Saharan Africa,
and 2.4 million people died. AIDS is now the primary cause of death
in Africa.
Asia has so far escaped the high infection rates registered in Af-
rica. Only three countries - Cambodia, Myanmar and Thailand - have
prevalence rates exceeding 1% among 15 to 49-year olds. But infec-
tions are rising. In South and Southeast Asia during the past year,
780,000 adults, almost two-thirds of them men, became infected. East
Asia and the Pacific registered 130,000 new infections.
The countries of Eastern Europe and the former Soviet Union present
some of the most dramatic trends in the worldwide AIDS epidemic. Pre-
viously characterized by very low prevalence rates, the region now
faces an extremely steep increase in the number of new infections, up
from 420,000 at end-1999 to at least 700,000 a year later.
In Latin America, an estimated 150,000 adults and children became in-
fected during 2000, bringing the total number of infected to 1.4 mil-
lion. The Caribbean has the highest rate of HIV infection in the
world after sub-Saharan Africa and AIDS is already the single great-
est cause of death among young men and women in this region.
High-income countries witnessed a major decline in AIDS-related
deaths in the late 1990s because effective antiretroviral therapy is
keeping people alive longer. However, this good news is tempered by a
stall in prevention efforts and by new infections which show no sign
of slowing. In 2000, despite years of awareness about AIDS, 30,000
people in Western Europe were infected and 45,000 in North America.
Visit the UNAIDS Home Page on the Internet for more information about
the programme:
http://www.unaids.org
Get the document at:
http://www.unaids.org/whatsnew/others/un_special/index.html
--
Claudio Schuftan
Hanoi, Vietnam
mailto:aviva@netnam.vn
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