SG/SM/7808
18 May 2001

POVERTY BIGGEST ENEMY OF HEALTH IN DEVELOPING WORLD, SECRETARY-GENERAL TELLS WORLD HEALTH ASSEMBLY

NEW YORK, 17 May (UN Headquarters) -- Following is the statement made today by the Secretary-General of the United Nations, Kofi Annan, to the fifty-fourth World Health Assembly held in Geneva:

It is a pleasure and an honour for me, as Secretary-General of the United Nations, to appear before this Assembly.

I have accepted Dr. Brundtland's invitation with particular pleasure at this time, because I greatly value the leadership she is giving to the World Health Organization (WHO), and because I can think of no Assembly whose wisdom and support is more acutely needed for what has become my personal priority -- the global struggle against HIV/AIDS.

Of course I know well that your concerns go far beyond any one disease. The health of humanity is under attack from many different causes, and you are rightly concerned about all of them.

The biggest enemy of health in the developing world is poverty, and the struggle for health is part and parcel of the struggle for development.

We shall not finally defeat AIDS, tuberculosis, malaria, or any of the other infectious diseases that plague the developing world until we have also won the battle for safe drinking water, sanitation and basic health care.

We shall not defeat them until we have also defeated malnutrition, and overcome the ignorance of basic precautions which leaves so many poor people exposed to infection.

The best cure for all these ills is economic growth and broad-based development.

And yet the devastation wrought by HIV/AIDS is now so acute that it has itself become one of the main obstacles to development.

That is patently true in southern Africa, where average life expectancy had risen to 59 years by the late 1980s -- but in the years ahead, thanks to HIV, it will fall back again to below 45, where it was in the early 1950s.

AIDS has become the primary cause of death in Africa. But let no one imagine it is only an African problem. Parts of the Caribbean and South-East Asia are not much better off. And we may well be about to see an explosion of new infections in South Asia and Eastern Europe.

As I told the African summit in Abuja three weeks ago, we can no longer afford to treat the emergency of HIV/AIDS as just another aspect of the battle for development, because it will not wait for that battle to be won.

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 the challenge head on.

In Abuja, I issued a call to action against HIV/AIDS, with five clear objectives:

-- First, to ensure that people everywhere, particularly young people, know what to do to avoid infection;

-- Second, to stop perhaps the most tragic form of HIV transmission, which is from mother to child;

-- Third, to provide care and treatment for all those infected;

-- Fourth, to redouble the search both for a vaccine and for a cure; and

-- Fifth, to care for all those whose lives have been devastated by HIV/AIDS, particularly the orphans. There are an estimated 13 million of them in the world today, and their numbers are growing.

To achieve those five objectives we need two things: leadership and resources.

We need leadership at every level, from the family through local communities to national governments and international institutions. All of us must be open about HIV, and raise our voices against stigma and discrimination.

At the local level, leadership is coming from heroic activists and civil society organizations, some of them representing those who live with HIV and AIDS.

At the national level it is coming from a small but growing band of courageous, far-sighted leaders on each continent, who have clearly made it their priority and spoken frankly on the subject to their peoples, in defiance of ancient taboos and deep-rooted inhibitions.

At the international level, we in the United Nations system are doing our best to provide leadership, through our joint programme, UNAIDS. For the last five years, ably led by Peter Piot, UNAIDS has played a crucial role in focusing and coordinating the combined efforts of the United Nations family, and indeed of other agencies outside it.

But the United Nations can achieve little by itself. Our leadership is only useful to the extent that others respond to it.

A little more than a year ago, I called together five constituencies -- African governments, the United Nations, donors, non-governmental organizations and the private sector -- to form an International Partnership against AIDS in Africa. It is now up and running, and has built a formidable framework for action, which is already showing results.

Now, we need similar partnerships in every region of the world. The Caribbean Community (CARICOM) has set a good example, with the pan-Caribbean partnership against AIDS that was formed earlier this year. And we need partnerships at every level: local alliances in every community, joined together -- loosely but effectively -- in a global alliance to beat AIDS.

And of course, that alliance must include those able to provide resources -- especially the governments of the developed world, but also private companies, foundations and individuals.

The UNAIDS has calculated that total spending on AIDS prevention and care in low and middle income countries needs to rise to something between $7 billion and $10 billion each year. That is at least five times the amount that citizens, national governments and international donors are currently spending.

I have called for a Global Aids and Health Fund to be established, as a mechanism for mobilizing some of this extra money.

The Fund would be governed by an independent Board, on which all significant stakeholders would be represented -- including, of course, the governments of the developing countries. In addition, there would be a small secretariat, to do the day-to-day administration, and a strong advisory board, on which the best international experts would be asked to serve.

Broad policies would be set by the Board, which would use the money to support national programmes and strategies, decided by national leaders. But it would insist on transparency and accountability, so that we can be sure the money is being spent in ways that are effective, and to ensure that it is reaching the people who need it most.

The Fund must be additional to existing funds and mechanisms, not just a new way of channelling money that is already earmarked for development.

Its first priority would be to support a comprehensive strategy for dealing with the unprecedented threat of HIV-AIDS, including all the five objectives I have just outlined. But one crucial element in that strategy must of course allow for an overall strengthening of the healthcare sector. And the Fund would also target other infectious diseases that blight the prospects of many developing countries -- starting with TB and malaria.

I am glad to say, Mr. President, that this proposal has been generally welcomed. I was particularly heartened by the support that President Bush gave to it, when he welcomed President Obasanjo and myself at the White House last Friday.

Let me now appeal to all here present to join this great global alliance.

Let us rise above turf battles and doctrinal disputes. The battle against AIDS is too important for us to risk sidetracking it by championing one institution or project at the expense of others.

Only results should count. And the only acceptable result is that we replace suffering with hope.

We must give hope to those infected with HIV, enabling them to plan for life instead of preparing for death.

And we must give hope to humanity -- hope that the spread of the disease can indeed be halted and reversed, and that future generations will not have to live under its shadow.

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