Progress on HIV/AIDS significant but insufficient

Jun 3 2005

United Nations Secretary-General Kofi Annan shared his hope with a gathering of senior world officials at Headquarters that the 2001 Declaration of Commitment on HIV/AIDS would have heralded a response that matched the epidemic’s scale, yet progress had been “significant but insufficient”.

Citing achievements in the core areas of political leadership, funding, the intensity and reach of prevention programmes, and the availability of drug therapies, he said, however, that last year saw more new infections and more AIDS-related deaths than ever before. With the epidemic expanding at an accelerating rate and on every continent, treatment and prevention efforts were “nowhere near enough”. For example, only 12 per cent of the people in need of antiretroviral therapies in low- and middle-income countries were receiving them.

He called for increased resources, better planning, better and more vocal leadership, and real investment in the empowerment of women and girls. Women now accounted for about half of all people living with HIV worldwide, but they were also the most courageous and creative champions in that fight. How the international community fared in the fight was crucial; only by meeting the challenge could it succeed in its efforts to build a humane, healthy and equitable world.

General Assembly President Jean Ping (Gabon) said that the HIV/AIDS threat in 2005 was much greater than when the Assembly met here four years ago. In every way, that threat had attained alarming proportions. In fact, he said, in 2004, the number of infected people had grown to about 5 million, and the number who had died had also grown, to 3.1 million in 2004, much more than for the four preceding years. The pandemic had also grown disturbingly worldwide, affecting new countries and new populations within countries, particularly women and girls, and 95 per cent of those infected were in low- and medium-income countries.

Given the quantum worsening in the epidemic’s trajectory, Joint United Nations Programme on HIV/AIDS (UNAIDS) Executive Director Peter Piot said the gap between need and action remained enormously wide. Unless AIDS was controlled, the epidemic would expand for decades, killing large numbers and wrecking entire societies. The global response required that several milestones be met: world leaders should give AIDS the same level of attention as they gave to global security; universal access to prevention and treatment must be ensured; money must be made to work for people on the ground; long-term strategies must be incorporated into planning and actions; and the United Nations system should maximize collective effectiveness by pooling efforts in every country.

Round tables were also convened, as follows: on prevention, chaired by Anna Marzec-Boguslawska, Head of the National Centre for HIV/AIDS of Poland; on HIV/AIDS and Human Rights with an emphasis on gender, chaired by Marcus Bethel, Minister of Health of the Bahamas; on resources, chaired by Jean-Louis Schlitz, Minister of Cooperation and Humanitarian Action of Luxembourg; on treatment, care and support, chaired by Anupong Chitwarakorn, Senior Expert, Preventive Medicine, Ministry of Public Health of Thailand; and on orphaned children, chaired by Paulette Missambo, Minister of Public Health and Population of Gabon.

Wrapping up those discussions this afternoon, Assembly President Ping said that the debates had raised certain essential questions and recommendations. On resources, it appeared that they had grown considerably, but they were still not commensurate with the problem, and efforts to improve services were encountering difficulties in the health and other sectors. Among the recommendations, apart from the need for governments to increase their national budgets, it was necessary to ensure that commitments and pledges made at the global level were honoured.

In the round-table discussion on orphans, it had been emphasized that efforts undertaken thus far had not been sufficiently matched with the scope of the problem. Recommendations included redoubling efforts at the national level and stepping up programmes for children at risk, including by eliminating the cost of schooling and broadening nutritional programmes in schools, and strengthening prevention of mother-to-child transmission.

In the round table concerning human rights with an emphasis on gender, it was stressed that human rights violations and inequality between men and women continued to increase the transmission of HIV/AIDS and undermine access to prevention and treatment. The growing feminization of the epidemic had made it ever more necessary to establish programmes to attack the vulnerability of women and girls. Among the recommendations was the need to strengthen measures to combat discrimination against people with AIDS, to draw up special programmes for women and girls, and to enhance efforts to eliminate violence against women and educate men and boys.

Prevention was reaffirmed as the pillar in combating AIDS in another round-table discussion, but coverage of prevention programmes was still low. Globally, fewer than one person in five had access to services to prevent AIDS, owing to the hesitation of leaders and to persistent taboos relating to sexuality and high-risk behaviour. The main recommendations included targeting prevention efforts in countries where the epidemic was concentrated among very vulnerable populations, and tightening the bonds between sex, hygiene and procreation programmes.

The round table devoted to treatment had reaffirmed the urgent need to expand treatment programmes, he said. Considerable difficulties still hampered the attainment of that objective, including the lack of public health infrastructure and qualified health staff. The main recommendation included reviewing national testing policies to, among other things, increase financial aid from donors for testing initiatives; continuing to reduce the cost of antiretroviral treatment, making such treatment more accessible, in particular for children; and strengthening monitoring mechanisms and ensuring maximum recourse to health-care workers.