E-DRUG: Kofi Annan Speech in Abuja OAU AIDS conference
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[crossposted from Pharm-Policy with thanks; NN]
Below is the text of Kofi Anan's speech being delivered today at the OAU
meeting in Abuja. Unlike the garbage we are hearing from the Bush
Administration, this is a pretty good speech.
The Secretary General declares strongly speaks for treatment AND prevention:
"We must do both." He makes reference to generic manufacturers. His
prevention measures include Tx for MTCT. He talks about the creation of a
7-10 billion/yr US$ fund (perhaps a modified incarnation of the World Bank
AIDS Trust Fund). It is specific and has specific policy recommendations,
instead of the empty drone of the UNGASS document.
There is an overstressing of the development of drug resistance. The use of
funds in the 'global war chest' for coordinated drug purchase is only hinted
at.
In spite of this, the speech is a ground breaking statement. I hope that it
adjusts the backwards sliding of the USG's efforts to prevent a UN-agency
drug purchase and distribution system.
Paul Davis
pdavis@critpath.org
Health GAP Coalition
ACT UP Philadelphia
+1.215.731.1844 ACT UP tel.
+1.215.731.1845 fax
+1.215 474.6886 direct
THE SECRETARY-GENERAL
--
ADDRESS TO THE AFRICAN SUMMIT ON HIV/AIDS, TUBERCULOSIS AND OTHER INFECTIOUS
DISEASES
Abuja, 26 April 2001
Excellencies,
Dear friends,
This is a conference about Africa's future.
The incidence of HIV/AIDS, tuberculosis and other infectious diseases is
higher on this continent than on any other.
Of course, this fact is connected to Africa�s other problems.
Africans are vulnerable to these diseases because they are poor,
undernourished, and too often uninformed of basic precautions, or unwilling
to take them.
Many are vulnerable because they have neither safe drinking water nor access
to basic health care.
They are vulnerable, in short, because their countries are underdeveloped.
And therefore the best cure for all these diseases is economic growth and
broad-based development.
We all know that.
But we also know that, in the best of cases, development is going to take
time. And we know that disease, like war, is not only a product of
underdevelopment. It is also one of the biggest obstacles preventing our
societies from developing as they should.
That is especially true of HIV/AIDS, which takes its biggest toll among
young adults - the age group that normally produces most, and has the main
responsibility for rearing the next generation. That is why AIDS has become
not only the primary cause of death on this continent, but our biggest
development challenge. And that is why I have made the battle against it my
personal priority.
In short, my friends, we are here to face a continent-wide emergency. We
cannot afford to treat it as just one aspect of the battle for development,
because it will not wait for us to win that battle. The cost - whether
measured in human misery today, or in loss of hope for tomorrow - is simply
too high. We have to turn and face it head on.
First, let us be clear what our objectives are. I believe they can be put
very simply, under five headings:
Number One: Prevention.
Our first objective must be to halt and reverse the spread of the virus - as
all world leaders resolved to do at last year's Millennium Summit - and so
to save succeeding generations from this scourge. Prevention can save many
millions of lives, and in several African countries it has been shown to
work.
Everyone who is not yet infected must know what they need to do to avoid
infection. We must give young people the knowledge and power to protect
themselves. We need to inform, inspire and mobilise them, through an
awareness campaign such as the world has never seen - using radio,
television and professional marketing techniques, as well as more
conventional tools of education.
That campaign must reach girls as well as boys. At present, in sub-Saharan
Africa, adolescent girls are six times more likely to be infected than boys.
That is something which should make all of us African men deeply ashamed and
angry.
And once they know what they need to do, young people must have the means to
do it. That means they must have support from their families and
communities, as well as access to voluntary counselling and testing and -
when appropriate - to condoms.
Number Two: We must prevent the cruellest, most unjust infections of all -
those that pass from mother to child.
All mothers must be able to find out whether they are HIV-positive or not.
And those who are must have access to short-term anti-retroviral therapy,
which has been shown to halve the risk of transmission.
In some cases, the risk can also be reduced by alternatives to
breast-feeding. But these must be approached with caution, since
breast-feeding is the best protection against many other diseases.
Number Three: we must put Care and Treatment within everyone's reach.
Even a year ago few people thought that effective treatment could be brought
within reach of poor people in developing countries. Those already infected
with HIV were condemned to be treated like lepers in earlier times � as
people from whom the healthy had to be protected, but for whom nothing could
be done.
Now, however, there has been a world-wide revolt of public opinion. People
no longer accept that the sick and dying, simply because they are poor,
should be denied drugs which have transformed the lives of others who are
better off.
Earlier this month I met the leaders of six of the world's biggest
pharmaceutical companies. They now accept the need to combine incentives
for research with access to medication for the poor. They are ready to sell
drugs to those countries at greatly reduced prices.
This crisis is so grave that developing countries must face it by exploiting
all options to the full - including the production and importation of
"generic" drugs under licence, within the terms of international trade
agreements.
Everyone who is infected should have access to medicine and medical care.
Now we know that that is possible, it is surely an ethical imperative. It
is also essential to any successful prevention strategy - because, so long
as testing positive is a death sentence without hope, many people will not
even want to know their HIV status.
In short, we cannot and should not choose between prevention and treatment.
We must do both.
Number Four: we must deliver Scientific Breakthroughs.
We are still a long way from finding a cure for HIV/AIDS, and a long way
from finding a vaccine against it. We must make sure that the search is
given the highest priority in scientific budgets, and be ready, as soon as
it produces results, to make them available where they are most needed --
not only to those who can afford them.
And finally, Number Five: we must protect those made most vulnerable by the
epidemic, especially orphans.
Millions of children, because they have lost one or both parents to AIDS,
are growing up malnourished, under-educated, marginalised, and at risk of
being infected themselves. We must break this cycle of death. And we must
not wait for parents to die before we intervene. We must help them secure
their children's future while they are still fit enough to do so.
Agreeing on those five objectives should not be difficult. But what are the
means we need to achieve those ends?
First of all, we need leadership. And my friends, that must start with you,
the leaders of Africa. Only you can mobilise your fellow-citizens for this
great battle. Only you can give it the priority in deserves in your
national budgets.
Above all, you must take the lead in breaking the wall of silence and
embarrassment that still surrounds this issue in too many African societies,
and in removing the abuse, discrimination and stigma that still attach to
those infected. The epidemic can be stopped, if people are not afraid to
talk about it.
Secondly, we need to involve local communities. It is ultimately at that
level that the battle will be fought and won. It is only with the fullest
support of their families and communities that young people will be able to
change their behaviour and protect themselves. Above all, we must involve
those already living with HIV-AIDS in the struggle against it. They, after
all, are the ultimate experts.
Thirdly, we need a deep social revolution that will give more power to
women, and transform relations between women and men at all levels of
society. It is only when women can speak up, and have a full say in
decisions affecting their lives, that they will be able to truly protect
themselves - and their children - against HIV.
Fourth, we need stronger healthcare systems. This should be obvious, but
both governments and development agencies often lose sight of it when
setting their budgets and priorities. If our aim is to make care and
treatment available to all those infected, we need a far more efficient and
extensive system of public health than most African countries even begin to
provide at present.
Cheaper anti-retroviral drugs, however vital, will not by themselves provide
the answer. Without proper health care, they may even do more harm than
good - for example, if potentially life-threatening side effects are not
addressed, or if the therapy is interrupted, leading to drug-resistant forms
of HIV. And too many patients still do not have access even to relatively
cheap antibiotics and other effective drugs for the many illnesses that prey
on their weakened immune systems.
Finally, we need money. The war on AIDS will not be won without a war
chest, of a size far beyond what is available so far.
Money is needed for education and awareness campaigns, for HIV tests, for
condoms, for drugs, for scientific research, to provide care for orphans,
and of course to improve our healthcare systems. At a minimum, we need to
be able to spend an additional seven-to-ten billion dollars a year on the
struggle against HIV/AIDS in the world as a whole, over an extended period
of time.
It sounds a lot, and it is a lot. Somehow we have to bring about a quantum
leap in the scale of resources available. But it is not at all impossible,
given the amount of wealth in the world. In fact it is little more than one
per cent of the world's annual military spending. We just have to convince
those with the power to spend - public and private donors alike - that this
would be money well spent.
We need to mobilise the widest possible range of donors -- who must all
agree on the same broad objectives -- and we need to win their commitment
for the long haul.
Over the past few weeks and months, there have been several exciting
suggestions for a new fund or funds from a variety of people -- Governments,
private foundations and academics. All these initiatives must now converge
towards a common vision of what we are trying to achieve.
I propose the creation of a Global Fund, dedicated to the battle against
HIV/AIDS and other infectious diseases. This Fund must be structured in
such a way as to ensure that it responds to the needs of the affected
countries and people. And it must be able to count on the advice of the
best experts in the world - whether they are found in the United Nations
system, in civil society organisations, or among those who live with
HIV/AIDS or are directly affected by it.
I intend to pursue this idea with all concerned over the next few weeks, and
I hope that in the very near future the Fund will be up and running.
My dear friends and colleagues,
The ideas I have put to you today are the fruit of extensive
consultations within the United Nations system, with member states, with
philanthropic foundations, with private companies, and with civil society.
I believe we can all agree on them, and that they can be the foundations of
a common strategy.
I certainly hope so, because this battle can be won only if we mobilise
and focus the efforts of a wide range of stakeholders: national leaders like
yourselves, donor governments, the United Nations system, pharmaceutical and
other companies, foundations, and voluntary groups - especially those that
represent people living with HIV. In other words, we need a complete
mobilisation of society at large.
Everyone has his or her part to play. Let us now lay aside all turf
battles and doctrinal disputes. The battle against HIV/AIDS is far more
important than any one institution or project. Our success will not be
measured by resolutions passed, appointments made, or even funds raised. It
will be measured in the lives of succeeding generations.
In the last year or so the world has begun to realise that HIV/AIDS is
indeed a world-scale pandemic, which has spread fastest and furthest in
Africa.
So this is a moment of hope, and potentially a turning point. Africa is no
longer being left to face this disaster alone. Its plight has caught the
attention, and the conscience, of the whole world.
I believe the world is ready to come to our aid. But it will do so only if
we convince the world that we ourselves are making the war against AIDS our
personal priority, and have a clear strategy for waging it.
In two months' time, delegates from all over the world will gather in New
York for a Special Session of the United Nations General Assembly on
HIV/AIDS. They will draw up a global strategy for the war against this
global scourge, and I hope by then we shall have firm commitments for our
war chest.
Will that strategy respond to the needs of Africa? It depends, in large
part, on the signal that goes out to the world from this conference.
For my part, I promise you the full support of the United Nations family.
Working together, my friends, we can defeat the scourge of HIV/AIDS. For
the sake of Africa's future, we must.
Thank you very much.