11 November 2002
Assembly Is Told Lack of Resources, High Cost of Medicines, Continuing Stigma Remain Obstacles in Global Fight Against HIV/AIDS
Day-Long Review of United Nations Efforts; Debate Is Concluded on Role of Information, Communication Technologies in Development
NEW YORK, 8 November (UN Headquarters) -- Lack of resources, the high costs of medicines and the continuing stigma associated with HIV/AIDS were all hindering efforts to combat the epidemic, the General Assembly was told at two meetings today, during a discussion of implementation of the Declaration of Commitment on HIV/AIDS, adopted at the Assembly's twenty-sixth special session, held in June 2001.
Although the cost of HIV/AIDS drugs had declined sharply during the past few years, said Norway's representative, it was still too high for it to be available to most of the people in developing countries. Efforts must be continued to ensure that the developing countries gained access to inexpensive drugs produced under a licence, and that the pharmaceutical industry took its share of the responsibility.
Jamaica's representative noted that the fight against HIV/AIDS could be successful only in the context of strengthened and effective partnerships. Progress would continue to be slow if serious constraints caused by excessive economic burdens continued to impede capacity to allocate sufficient resources to fight the disease. There was a clear need for enhanced partnerships to expand resources and human and technical capacity to ensure that the scale of country-level activities matched the gravity of the problem.
Taboo and stigma, said the representative of the United States, remained formidable obstacles to effective responses, despite increased education and public awareness. Political leadership was crucial in making a difference in combating the stigma and discrimination that had accompanied the epidemic worldwide. Parents and families were critical and religious and community leaders must be involved.
The results achieved by Brazil in its fight against HIV/AIDS rested on a balanced approach to prevention and treatment and the advocacy of human rights, that country's representative said. Prevention policies combined with free and universal access to medicines had led to a 50 per cent reduction in the death rate and 75 per cent drop in hospitalizations.
Statements were also made by the representatives of Poland, China, Cuba, Egypt, Brunei Darussalam, Mexico, India, Belarus, Denmark (on behalf of the European Union and associated States), Russian Federation, Philippines, Guatemala, Senegal (on behalf of the African Group), Fiji (on behalf of the Pacific Islands Forum), Guyana, Uganda, Myanmar, Japan, Thailand, Madagascar, Indonesia, United Republic of Tanzania, Australia and South Africa.
Also this morning, the Assembly concluded its discussion on information and communication technologies for development with statements by the representatives of Switzerland, Republic of Korea, Japan, Venezuela (on behalf of the "Group of 77" developing countries and China), Senegal, Armenia and India.
In addition, the representative of Pakistan introduced a draft resolution on religious and cultural understanding, harmony and cooperation.
The Assembly will meet again at 10 a.m. on Monday, 11 November, to take up the report of the International Atomic Energy Agency.
The General Assembly met this morning to continue its consideration of Information and communication technologies for development (ICT). It had before it the summary by the President of the fifty-sixth session of the Assembly of its meeting devoted to the subject (document A/57/280), which took place at Headquarters on 17 and 18 June. Responding to Assembly resolution 56/258 of 31 January, the meeting addressed the digital divide in the context of globalization and the development process, and recommended promoting coherence and synergies between various regional and international information and communication technologies initiatives.
Highlighting the main issues of the meeting, which aimed at fostering digital opportunities for all in the emerging information society, the President notes that the meeting was recognized as an important and timely initiative, especially in the light of a persistent digital divide between developed and developing countries, as well as within countries. A wide consensus had emerged on the potential of such technologies to promote sustainable growth; to combat poverty; to strengthen democratic governance; and to contribute to the empowerment of women in reducing gender inequalities. In short, ICT represented a strategic instrument for achieving the Millennium Development Goals. The United Nations and other international organizations were recognized as catalysts for fostering digital opportunities and putting such technologies at the service of development.
The meeting recognized the significance of multi-stakeholder partnerships for leveraging development with the use of ICT. It emphasized the importance of collaborative partnerships between governments and civil society and the private sector, in order to ensure that the benefits of such technologies became available to all. The private sector was said to have a key role in developing and disseminating ICT; governments were responsible for providing transparent regulatory and legal frameworks that integrated the specific needs of developing countries, and civil society could bring a broader, participatory and inclusive approach to ICT development.
At its meeting this morning the Assembly was also to consider follow-up to the outcome of the twenty-sixth special session: implementation of the Declaration of Commitment on HIV/AIDS. The Secretary-General's report on progress towards implementation of the Declaration (document A/57/227 and Corr.1) was based primarily on responses received to a questionnaire sent to Member States seeking to establish a baseline against which future progress would be measured, as well as to chart progress made since the adoption of the Declaration.
The Declaration, adopted in June 2001, establishes, for the first time ever, time-bound targets to which governments and the United Nations may be held accountable. It calls for an expanded global response, including prevention of new infections; access to care, support and treatment; protection of human rights and the empowerment of women; mitigation of the societal, household and individual impact of HIV/AIDS; and allocation of sufficient resources to support these initiatives. The Declaration reflects global recognition of the epidemic as the single greatest threat to the well-being of future generations.
Key findings indicate that the Declaration is an important framework and a critical tool for advocacy, according to the report. However, while political commitment continues to increase and additional resources are devoted to HIV/AIDS, the scale of country-level activities does not yet match the epidemic. The Declaration calls on the global community to reach, by 2005, a target of annual expenditures on the epidemic of approximately $10 billion. A comprehensive analysis by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and leading international economists suggests that at least $9.2 billion annually will be required by 2005 for an effective global response to the epidemic.
While most countries have developed national AIDS strategies, implementation of these is slow, largely due to a lack of resources and technical capacity. Commendable programmes fail to achieve full impact because they remain small and lack a comprehensive approach. Infection rates among young people continue to rise, particularly in Eastern Europe and Asia, where a critical opportunity to stem this rise may be missed.
While many countries report progress in putting into place measures aimed at combating stigma and discrimination, and reducing vulnerability, especially of women, effective efforts were still impeded by HIV-related stigma and the continued marginalization of vulnerable populations. People living with HIV/AIDS continued to be the most under-utilized resource in the response to the epidemic. Despite the dramatic increase in the number of children orphaned by HIV/AIDS, nearly one in two countries lacked a strategy for care and support of children orphaned or made vulnerable by the epidemic.
The potential impact of increased global commitment was underscored by new projections issued by UNAIDS in collaboration with the World Health Organization (WHO) and leading experts. In the absence of a substantial strengthening of the global response to HIV/AIDS, 45 million new infections were projected to occur between 2002 and 2010. If available, prevention efforts were scaled up to meet the global HIV/AIDS challenge, 28 million (or 63 per cent) of these projected infections could be averted. It was possible to halt the advance of the epidemic but this could be achieved only with the sustained mobilization of the global community.
The report puts forward a number of recommendations for priority action for consideration by the Assembly. Among other things, Member States are urged to develop and implement a national strategic plan on HIV/AIDS by 2003, and to integrate HIV/AIDS into their development plans and poverty reduction strategies. Also, to ensure an effective response to the epidemic, the international community is urged to increase assistance significantly to countries which do not have sufficient resources for interventions, or for the strengthening of sustainable human capacity, systems development and capacity-building.
Also before the Assembly today was a draft resolution on Religious and cultural understanding, harmony and cooperation (document A/57/L.12), which would denounce acts of intolerance, discrimination, stereotyping, racial profiling, bigotry and hate-mongering in all forms, shapes and manifestations, including those derogating a religion, projecting religious teachings incorrectly as advocating violence, desecrating religious sites and insulting revered religious personalities.
The draft would urge States and the international community to protect the rights of persons belonging to national or ethnic, as well as religious or linguistic minorities, including through the provision of adequate education and the facilitation of their participation in all aspects of the political, economic, social, religious and cultural life of society and in the economic progress and development of the country.
Moreover, the resolution would call upon States to exert utmost efforts, in accordance with their national legislation and in conformity with international human rights standards, to ensure that religious places, sites and shrines are fully respected and protected, and to take additional measures in cases where they are vulnerable to desecration or destruction.
Introduction of Draft
MUNIR AKRAM (Pakistan), introducing the draft resolution on religious and cultural understanding, harmony and cooperation, said that the mutual misunderstanding and suspicion between followers of different faiths and cultures had become significantly accentuated in the aftermath of the terrorist attacks of last September. Despite declarations by world leaders that the war against terrorism was not targeted against any religion or any religious or social group, discrimination, mistreatment and hate had proliferated. In recent months, some extremists had gone to the extent of attacking Islamic religious teachings and insulting revered religious personalities.
Religious and cultural diversity in the globalizing world needed to be used as a vehicle for complimentary creativity and dynamism, and not as the rationale for a new ideological and political confrontation, he said. Respect, acceptance and appreciation of the rich diversity of the world's cultures had to be fostered by openness, communication, freedom of thought and knowledge.
The Declaration contained in the draft drew on the considerable work which had already been done towards promoting mutual understanding, tolerance and dialogue among religions and cultures. The adoption of the Declaration would be a timely, authoritative and global rejection of the message of intolerance, hate and discrimination being purveyed by bigots and belligerents. Its adoption by the Assembly would also be an important contribution to advancing the goal of religious and cultural understanding and harmony, as well as promoting the goals of universal peace, security and prosperity.
Statements on Information Technologies
PIERRE HELG (Switzerland) said ICT had the potential to be a powerful tool for sustainable development and poverty alleviation, and to contribute to the realization of the Millennium Development Goals, but only if the right enabling environment was put in place and considerable effort made. In order to close the digital divide, particularly in the poorer countries of the South, it was necessary to find ways to include poor and marginalized communities.
Youth and women had important roles to play in multiplying the impact of all efforts undertaken in that regard. But no progress would be made without adequate and functioning financing mechanisms for projects aimed at bridging the digital divide. Appropriate policy and regulatory frameworks on global, regional, national and local levels would also enhance initiatives taken by governments and individuals, he said.
On the implementation side, he said, the task of creating digital dividends could not be left to governments, donor agencies and international organizations alone. It had to involve the civil society, private sector and academia or ICT professionals.
LEE HO-JIN (Republic of Korea) said he hoped the momentum created by the meeting of the General Assembly in June would be maintained until the World Summit on Information in 2003 and 2005. He also commended the ICT task force and the digital opportunities task force for their efforts to engage intergovernmental and international organizations, as well as the private sector and civil society, in promoting digital opportunities.
For all countries to enjoy equal opportunities, he said, there had to be an effective partnership between those countries with ICT infrastructure and those without. Korea itself had utilized digital opportunity to make itself the world's twelfth-largest economy and a global leader in information and communication technologies. It had also continuously implemented human resources development programmes to produce a generation of "ICT savvy" Koreans. In addition, it had actively pursued foreign direct investment which had led to an influx of capital, advanced technology, improved management skills and better jobs in the country.
His country was playing its part, he said, in helping to bridge the digital divide through such United Nations bodies as the Economic Commission for Africa (ECA) and the Economic and Social Commission for Asia and the Pacific (ESCAP). Since 1999, Korea had invited some 1,200 foreign trainees in the ICT field to participate in human resources development programmes in Korea, and had dispatched more than 600 Korean ICT experts and volunteers to implement programmes abroad. Korea also saw regional coordination and South-South cooperation as means by which developing countries would be able to share valuable communications technology experience and best practices. While promoting the ICT industry globally, the international community should also, he said, take steps to counter the misuse of such opportunity in the arena of "cybercrime".
MASASHI MIZUKAMI (Japan) said that it was important to create an information society in which everyone received the full benefit of information and communications technologies and used them as a basis for development.
On the issue of "cybersecurity", he said Japan had involved itself in the drafting of "the Guidelines for the Security of Information Systems and Networks Towards a Culture of Security" by the Organization for Economic Cooperation and Development (OECD). Japan also joined the United States in sponsoring the draft resolution introduced in the Second Committee, entitled "Creation of a global culture of cybersecurity", based on OECD guidelines.
He said Japan made bilateral and multilateral contributions emphasizing cooperation with international organizations, and cited the example of its 5 million contribution to the United Nations Development Programme (UNDP) Thematic Trust Fund for ICT.
Japan was determined, he said, to continue its support for the World Summit on Information Society, and next January would host the Asian Regional Conference for the summit. Japan welcomed the active cooperation of the United Nations system, especially the ESCAP, the International Telecommunications Union (ITU), the UNDP and the United Nations Educational, Scientific and Cultural Organization (UNESCO).
MILOS ALCALAY (Venezuela), speaking on behalf of the "Group of 77" developing countries and China, noted a recent Group meeting held in Dubai from 27 to 30 October, to deal with three themes for the developing world, namely ICT, biotechnology and the supply of drinking water. In the Dubai Declaration, countries had reaffirmed their commitment to apply specific plans of action at the national and international levels to promote and develop knowledge and technology in the developing world, as well as to promote the central role of the United Nations in removing barriers to developing countries in acquiring knowledge and technology.
The rapid technological progress in recent years should give impetus to efforts to achieve world economic and social development, especially for the poorest countries, he said. Information and communications technologies enabled the global community to provide millions of people with the possibilities to promote economic development and reduce the disparities between the developed and developing countries, so as to enable all individuals and communities to fulfil their potential. The majority of the world's population still lived in poverty.
He said hundreds of millions would benefit from ICT, the benefits of which were lost on many of those in developing countries. The question was how to reduce the giant digital divide so as to continue directing ICT for the benefit of the peoples and economies of the developing world. Urgent actions and concrete solutions were needed. It was essential to obtain concrete results with regard to the various international initiatives adopted to reap the benefits that such technologies offered. He welcomed the holding of the World Summit on the Information Society, to be held in 2003 in Geneva and in 2005 in Tunis.
PAPA LOUIS FALL (Senegal) said existing perverse trends suggested that the digital divide would grow wider. Technological illiterates would be relegated to the rearguard in the information revolution. Many Member States lacked the infrastructure to benefit from the revolution. African leaders, in approaching the challenge, felt the issue should occupy a privileged position in the New Partnership for Africa's Development (NEPAD).
With ICT, he said they would be able to work more effectively in the areas of trade and finance. But they recognized that they faced a titanic struggle to build up the literacy skills to bridge the gap. In that regard, they needed to ensure that proper policies and strategies were put in place to promote higher education, thus equipping the various social sectors that would be able to take advantage of ICT opportunities. Such a reality depended, however, on Africa being able to break the cycle of conflict affecting the continent.
He said the Government of Senegal realized the seriousness of the challenge and, consequently, it had promoted the establishment of cyber-cafes in urban centres and the provision of equipment in community centres in remote areas. It was also laying the links that would allow it to network with other African States. In addition, it had launched a technical park to facilitate ICT activities by businesses and young people. With the assistance of Microsoft, it had launched a programme to benefit children. Along the same lines, the University of Africa would set out to teach a large number of students in that field.
He said Senegal saw collaboration with developed partners as central to Africa's success in bridging the gap, through various ICT projects. As part of the preparation for the World Summit, it would, perhaps, be beneficial to have a meeting in Africa among the relevant heads of government, task forces, groups and development partners and pan-African leaders. He called on the United Nations to assume the leading role in ensuring that all States advance at the same speed.
MHER MARGARIAN (Armenia) said it was crucial to replace the bureaucratic systems of organization and management with new forms. The landlocked countries, in particular, needed to exploit the expanded opportunities of information and communications technologies.
He said Armenia expected the World Summit on the Information Society to find ways and means for bridging the digital divide, and to make the opportunities of information technologies available for all. International agreements relating to development of such technologies must be complemented by practical work to bridge the digital divide, with a commitment of technical assistance and capacity building for countries which had committed themselves to competition and market-based economies.
In December 2000 the Government of Armenia declared the development of information technologies as a priority, to foster the economy and to raise education standards. He announced that the Government had now launched an e-governance project, the flagship of which was an e-visa system.
One of the Government's strategic programmes was the preparation of specialists of a new generation. He said Armenia believed the spread of ICT could become "a consolidating factor for promoting stability and security in our region".
KRISHNA BOSE (India), said the United Nations had a crucial role to play in making ICT work for the promotion of the developmental efforts in developing countries. To that end, the holding of the special meeting of the General Assembly last June was significant in promoting awareness, and the United Nations system now had to work on concrete programmes that provided technical and financial support for capacity-building to developing countries.
The World Summit on Information Society, set for Switzerland and Tunisia in 2003 and 2005, respectively, should focus on how to achieve the objective of ICT for all. India hoped that the two-phase meeting would build a consensus at the global level on how to increase access to ICT and its use for development. There should be a commitment at the political level to act in concert, on the basis of mutual benefit. The involvement of major groups and relevant stakeholders would contribute greatly to efforts to achieve the goal of ICT for all.
She said that while India recognized the important role which such technologies could play in promoting development, it also was of the view that ICT alone could not solve the problems of poverty and underdevelopment. It would take a judicious blend of emphasis on provision of basic social, education and health services. She ascribed the growth of India's information technology industry to the availability of a large pool of skilled manpower.
KJERSTI RODSMOEN (Norway) said that too many of the efforts against HIV/AIDS were still being conducted as small-scale interventions. While many prevention programmes had been shown to work, they were still confined to small geographical areas. Good practices should now be applied on a much larger scale. The main reason that had not been done was reported to be lack of resources; many countries said their high debt burden prevented them from allocating sufficient resources to fight HIV/AIDS. The donor community should step up its funding to combat the epidemic, and all partners involved should ensure the effective implementation of the Heavily Indebted Poor Countries (HIPC) Debt Initiative.
She said education was the only known vaccine against HIV/AIDS -- at least for the time being. Respect for the right to information and reproductive health care was essential to halt the spread of the disease. Lack of knowledge killed thousands of people every single day. In the fight against HIV/AIDS, it was crucial to break down the walls of silence and denial. The price of not doing so had become too high. Prevention and care programmes were being hampered by the discrimination and stigmatization that surrounded the epidemic.
Although the cost of HIV/AIDS drugs had declined sharply during the past few years, it was still too high for it to be available to most of the people in developing countries. Efforts must be continued to ensure that the developing countries gained access to inexpensive drugs produced under a licence, and that the pharmaceutical industry took its share of the responsibility. At the same time, local health care systems must be strengthened so that they could offer an effective chain of health-related services designed to meet the needs of individuals, regardless of HIV status or the stage of infection.
ANNA MARZEC-BOGUSŁAWSKA (Poland) said her country's law lacked rules and regulations on HIV/AIDS in the context of human rights. Despite a number of cases of discriminatory reaction in the early years of HIV infections in Poland, that social pressure had not resulted in legislative changes. However, with increased social awareness and HIV/AIDS education there had been greater tolerance and less stigmatization at the workplace.
There was no compulsory testing of any kind in admission to schools, employment or immigration visa processing, and legislation policy was oriented towards solutions preventing any discrimination of persons living with HIV/AIDS. The national programme provided and supported the principle of full protection and promotion of human rights, based on the inalienable dignity of the individual. The issue of gender was similarly reflected in that national programme, which also included a number of education programmes carried out in schools.
She said that Poland contributed significantly to the efforts carried out by the international community on the issue of human rights in the context of HIV/AIDS, noting that since the beginning of the 1990s, and every two years since, the country had introduced the resolution on the protection of human rights in that context in the Commission on Human Rights.
BRUNO RODRÍGUEZ PARRILLA (Cuba) said that there were currently 40 million people infected with the virus, 3 million of them children and 29 million living in sub-Saharan Africa. More than 80 per cent of HIV/AIDS-related deaths occurred in Africa. The developing countries had made great efforts and created national programmes to combat HIV/AIDS. However, they could not cope with the insufficient resources available to them, which had to be used for debt servicing, among other things. Global action to combat HIV/AIDS required financial resources. The Global Fund had, thus far, collected more than $2 billion in pledges. It had approved subsidies for programmes in countries with low and medium incomes, amounting to $616 million for a five-year period. The world's response fell far short of the goal of $10 billion annually.
He said Cuba, despite the fact that it was poor and subjected to a blockade, was developing a programme to combat HIV/AIDS that guaranteed treatment, therapies and medical care, and was tirelessly combating the disease without discrimination. Also, it had zero transmission from mother to child since 1997. Furthermore, it had the lowest rates of the epidemic in the Americas and one of the lowest in the world, despite the fact that the country had no access to 50 per cent of the new medicines developed. Cuba had contained the epidemic and achieved a life expectancy rate of more than 76 years. It wanted to share its modest experience, particularly with those in Africa.
AMR ABOUL ATTA (Egypt) said that the HIV/AIDS report showed that the international community remained incompetent in dealing with the disease. It also showed that expenditures in combating HIV/AIDS were decreasing globally. International resources committed to the Global Fund did not exceed $2 billion. The UNAIDS should be given more emphasis. T
The continuation of the suffering of the millions affected by the disease represented the helplessness of the international community to deal with the disease. The presence of medicines with the inability of many to purchase them was a source of shame.
ZHANG YISHAN (China), noting that an additional 45 million people would be infected between 2002 and 2010, emphasized that the HIV/AIDS global crisis required a concerted response through global action. Major international conferences held recently, among them the Millennium Summit, had placed HIV/AIDS high on the international agenda. The fight against HIV/AIDS had received great attention from the Chinese Government, which formulated and began implementing a strategy in 1998.
He said the Declaration of Commitment which came out of the United Nations special session on HIV/AIDS held last year had set out the goals, tasks and responsibilities to deal with the crisis. Many countries had developed national prevention strategies in line with the Declaration. Of note was the fact that the Global Fund had attracted over $2 billion in pledges and approved the disbursement of $616 million of related relief funds to low- and middle-income countries for the next five years. That figure still fell short of the annual target of $10 billion.
To deal with the problem more effectively, China recommended that prevention and treatment should go hand in hand. There should be a two-pronged approach by making a concerted effort to push forward the targets and implement the tasks set forth in the Declaration for 2003 and 2005. It was also important to mobilize financial resources and provide access to drugs in fighting against HIV/AIDS. The relevant United Nations agencies and bodies, in particular UNAIDS, should encourage cooperation between governments and the private sector, exploring both traditional and innovative means in mobilizing financial resources and making HIV-related drugs widely available to those affected.
SHOFRY ABDUL GHAFOR (Brunei Darussalam), speaking on behalf of the Association of South-East Asian Nations (ASEAN), said that those countries had succeeded in adopting a declaration of commitment during the special session of the General Assembly on HIV/AIDS, held in June last year. The leaders' commitments had been translated to many encouraging developments in the efforts to fight HIV/AIDS.
He said an ASEAN Task Force on AIDS was established in 1993 to strengthen regional coordination, build regional capacity and address cross-border issues. With the assistance of the WHO, the ASEAN member States managed to develop the ASEAN Regional Programme on HIV/AIDS Prevention and Control for 1995-2000. HIV/AIDS was now "a national and regional priority" in South-East Asia, and ASEAN was strengthening its efforts in areas such as access to drugs for people with HIV/AIDS, improving HIV/AIDS surveillance and reducing vulnerability to HIV/AIDS transmission.
He said implementation of the second ASEAN work programme was under way. This included projects related to joint actions to increase affordable drugs and testing reagents, and mainstreaming HIV/AIDS into the development agenda.
MAURICIO ESCANERO (Mexico) said HIV threatened all countries. It needed an energetic collaborative response from the international community. The statistics were getting worse. According to UNAIDS, the social and economic consequences would be greatly felt in all affected countries.
In sub-Saharan Africa and Asia, where 86 per cent of victims lived, only a small fraction of people were getting appropriate antiretroviral treatment. Funds accumulated did not match established targets.
Despite the challenge in the short and long term, he said, the Secretary-General's report identified some bright spots. In the last 16 months there had been considerable progress on different fronts, especially in low- and middle-income countries. There were, for instance, 91 countries that had formulated multisectoral strategies to deal with the problem.
The Mexican Government supported the Millennium Declaration proposals, the work of UNAIDS and the Global Fund for the fight against AIDS, tuberculosis and malaria. It had put forward proposals to deal with the disease, focusing especially on women. For the Mexican Government, the seriousness of the crisis required the involvement of the private sector and civil society groups.
He said that, based on proposals coming out of the special session held by the General Assembly, Mexico had also adopted a plan of action for the prevention and control of HIV/AIDS, covering the period 2001-2006. In that plan, education and preventive measures were emphasized. The plan also supported discounts for retro-viral drugs. Mexico advocated international and regional cooperation to confront and deal with the pandemic; it had been working with governments of the Latin American/Caribbean region to deal with the problem.
DIGVIJAY SINGH, Minister of State for External Affairs for India, said the Declaration of Commitment on HIV/AIDS adopted by the special session of the Assembly represented a global compact bringing together all Member States -- both developed and developing. However, the compact would remain unfulfilled unless all parties met their commitments. In that regard, India called on UNAIDS to further refine the mechanisms that it proposed to use for the purpose of tracking progress.
Despite its resource constraints, India had been doing what was its due as a responsible member of the international community. The country's pharmaceutical industry had been responsible for the reduction in the cost of antiretrovirals by up to 90 per cent in most developing countries. He said India was now working on what could possibly be a "fairly tangible contribution" to the international response to the prevention of HIV/AIDS. There was ongoing research in India, both original and collaborative, in the area of vaccine development. Recent breakthroughs in genomic and related areas offered possibilities.
He said a variety of strategies was needed to address both the preventive and the care and support aspects of the pandemic. He called for the fulfilment -- by developed countries and developing ones -- of commitments undertaken by the international community as a whole in the special session on HIV/AIDS. Progress towards the fulfilment of those commitments should be monitored.
ALEG IVANOU (Belarus) said his country had developed State programmes for prevention of the disease, providing for a number of measures among different sectors of the population which were highly vulnerable. Care, support and treatment were provided free of charge at medical institutions. Research showed that Belarus was facing difficulties in providing therapies, because of the limited availability of medicines and the high costs associated with those medicines. Belarus had prepared a local product, whose use would make it possible to bring down costs and increase accessibility.
He said people living with the disease were guaranteed basic rights under the Constitution. Discrimination was prohibited and the principle of confidentiality was guaranteed. HIV/AIDS-related issues were included in programmes for medical workers and specialized training was provided. One of the main obstacles in carrying out national measures was the lack of resources and technology. Belarus was not in a position to increase financing for State programmes due to the transitional nature of its economy. The Eastern European region had the highest rate of increase of the pandemic. To mobilize international support, his country had initiated practical cooperation with the Global Fund. It also appreciated its interactions with the World Bank in combating HIV/AIDS in Belarus.
ELLEN MARGRETHE LØJ (Denmark), speaking on behalf of the European Union and associated States of Central and Eastern Europe, said that true commitment to halting and reversing the spread of HIV/AIDS must be shown through joint actions. She said there was an urgent need for a strengthened effort in the fight against it. Action was needed through all aspects of society, not just in the area of health. The efforts to fight HIV/AIDS must be an integral part of the work in all fields in relation to education, agriculture, industrial development, trade, human rights and social development. The capacity to coordinate a wide range of initiatives must be enhanced.
On the importance of national leadership in the fight against HIV/AIDS, she said that that HIV/AIDS must be spoken of openly, and the stigmatization and discrimination must be confronted. The European Union was committed to helping the Global Fund establish itself as an effective mechanism for delivery of essential support to those most in need, and spending on health and education must be increased.
She said the effectiveness in strategies to combat HIV/AIDS depended on improved coordination and coherence between all stakeholders, and the European Union looked forward to the debate on the findings of the evaluation at the Programme Coordinating Board of UNAIDS, to be held in Portugal this December.
She said the European Union was ready to intensify its efforts, also through the United Nations system, above all, UNAIDS. She stressed the role of UNAIDS in coordinating the United Nations response to the "scourge", and reaffirmed the importance attached to an enhanced, but balanced, approach to address all dimensions of the epidemic. The European Union was working to increase access to key pharmaceuticals, and to promote research and development of global public goods to confront HIV/AIDS.
When the Committee met again this afternoon, ANDREY KONDAKOV (Russian Federation) said that the HIV/AIDS pandemic seriously impeded the attainment of development goals, such as those contained in the Millennium Declaration. The problem was urgent for all countries, but particularly acute in sub-Saharan Africa and Eastern Europe. There were 200,000 infected persons in his country. The Government was taking serious comprehensive action, including the implementation of a special programme on prevention. Also, a programme to prevent mother-to-child transmission was being developed.
He said international cooperation was crucial in combating the pandemic. He commended cooperation within the United Nations system, as well as that involving other international institutions. It was necessary to step up efforts to mobilize resources for the Global Fund. The fight against HIV/AIDS was entering a new phase; what was needed now was to make the most effective use of the resources. There should be a balanced approach involving prevention and treatment, and a broad-based educational campaign. Education was the most important factor in preventing HIV/AIDS. In that regard, he saw great potential in the role to be played by the United Nations Children's Fund (UNICEF) and UNAIDS. It was also important to take into account the social and human rights aspects of the pandemic. He supported the conclusions and recommendations contained in the report.
ENRIQUE MANALO (Philippines) said there had been a deterioration in the HIV/AIDS crisis. In 45 of the most affected countries, there was a projection that 68 million people would die from the disease between 2000 and 2020, and there was no sign that the situation would level off in those countries.
Taking note of the time-bound targets of the Declaration of Commitment on HIV/AIDS -- to which, he said, governments should be held accountable -- he indicated his country's support for the framework for accelerated action on HIV/AIDS of the United Nations system in four key areas: advocacy, including promotion of the Declaration and its endorsement by the global and regional conferences; normative guidance and operational support with emphasis on guidance to United Nations country teams; communications and public information; and civil society support. In that regard, he said, the Philippines welcomed the efforts of the UNAIDS for its monitoring and evaluation framework, tailored to the Declaration's goals and targets at both the global and national levels.
He stated that his country had passed legislation embodying the principles articulated by the special session of the General Assembly. Based on its support for the goals of the Declaration of Commitment, the Philippines had submitted a $35 million proposal last September to the Global Fund for AIDS, TB and malaria, of which $13 million were for the HIV/AIDS component. As part of his country's effort to combat the disease, it had hosted a regional meeting in April 2001 and had joined the ASEAN Task Force on HIV/AIDS, which had been set up in the region.
JOSÉ ALBERTO BRIZ (Guatemala), speaking for the member States of the Central American Integration System (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama, as well as the Dominican Republic as an observer), said that recently provided data showed that the HIV/AIDS pandemic, far from stabilizing, continued to spread in the region.
He commended efforts being made in Africa and Asia where Uganda, Zambia, and Cambodia, among others, offered exemplary models on how to reverse the course of a generalized epidemic through firm political commitments and large-scale prevention programmes, carried out despite unfavourable socio-economic conditions.
He said that the mobility of the population in the Central American Integration System and the Dominican Republic was becoming a significant factor in the spread of the epidemic; recent investigations underscored the need for intervention at frontier posts and transit stations, with a view to the protection of migrant and sex workers. Protecting adolescent girls and young women was the focal point of a project established by the governments of Central America, Mexico and the United States. If the epidemic were allowed to continue at the present rate, it could significantly impair the productivity and development of the region.
For those reasons, he said, the governments of the Central American nations had launched national AIDS programmes. Many of them had had wide participation by non-governmental organizations (NGOs), people living with HIV/AIDS, relevant ministries, human rights ombudsmen, social security systems and even the armed forces. However, he added, those national, regional and even interregional efforts were still not sufficient, and the support of the international community was needed.
PAPA LOUIS FALL (Senegal), speaking for the African Group of Member States, said that HIV/AIDS would have infected 27 million Africans by this year, constituting 75 per cent of the global total. Children and young people were the majority of those affected. Poverty, malnutrition and illiteracy all helped to spread HIV/AIDS and seriously undermined the survival of Africans and others worldwide. The war on HIV/AIDS needed to be made more systematic and needed more resources. Over the last 12 years, African heads of State and government had adopted a wealth of resolutions and declarations, which had raised awareness of the vital need to control the scourge.
The Declaration of Commitment, adopted at the Assembly's special session, highlighted the lack of resources devoted to the pandemic, and the need for capacity-building and international cooperation. It also highlighted the need to forge strategic partnerships between various stakeholders. That Declaration also urged regional organizations and partners to participate actively in searching for solutions to the pandemic. The Declaration also stressed: prevention; care; support; treatment; human rights; protection for vulnerable persons; reducing the socio-economic impact of the disease; research and development; and HIV/AIDS in conflict situations.
He said the special session was held largely because the situation was getting so much worse in Africa, and also because the African Group had mobilized and brought its force to bear on the issue. The pandemic continued to gain ground in Africa. Among the reasons for that was the still difficult and costly access to antiretroviral drugs. He stressed the need for robust follow-up at the national level to reinforce the momentum created at the special session. Regional and subregional organizations must also play a part. There was an urgent need to see a substantial increase in the resources earmarked to combat HIV/AIDS. The resources of the Global Fund must be increased and impact studies should be carried out. He said heightened attention should also be given to the disease in regions or countries suffering from armed conflict. He stressed the African Group's support for the 12 recommendations contained in the Secretary-General's report.
AMRAIYA NAIDU (Fiji), speaking for the Pacific Island Forum countries, suggested that successes in various parts of the world gave encouragement in the struggle against AIDS. Despite those developments, however, the crisis remained the worst in the world. Its social and economic effects were enormous. With a continued infection rate of 5 million per year, urgent action was imperative. Because of their low rate of infection, the Pacific States ran the risk of developing a false sense of security. It remained a high-risk area, and recent findings showed that cases had been reported in countries previously unaffected. Education and awareness-building were important.
He took note of the Secretary-General's report indicating the huge task that still lay ahead. However, leadership at the global level had sensitized the world community about the problem. Much had been accomplished by recent international conferences. The Pacific Islands Forum had prioritized HIV/AIDS in its August 2002 political communiqué. Vulnerable small island States would, in his view, benefit from a more focused subregional approach. He called for international support in the struggle, because the small islands lacked the resources to implement regional initiatives. There had to be broad-based collective action.
He said young people should be mobilized as significant agents of positive change. In their region, they had started to look at improving media tools and perspectives as part of their strategy.
Contributions to the global fund were welcome. Its proposed disbursement of $3 billion next year represented a 50 per cent increase over the amount distributed last year. Such funding would help to arrest the development of the problem in their region. Important projects were dependent on the availability of funding. He commended United Nations bodies for the work they were doing in helping developing countries in combating the pandemic, but stressed that support had to be sustained in order to reach the 2005 objective of reducing the prevalence of the disease among young people aged 15 to 24, who were in the most-affected 25 per cent in the region, and would be 25 per cent of the global total by 2010.
GEORGE TALBOT (Guyana) said the fact that the HIV/AIDS infection rate was highest among 15 to 49 year-olds was of great concern to his country, because in addition to its heavy human toll the disease constituted a serious threat to the productive sector of the population, as well as to the country's efforts to promote economic and social development.
For those reasons, and the fact that Guyana was part of the Caribbean region, which had the world's second highest incidence of HIV/AIDS infection, the Government had redoubled its efforts to combat the spread of the disease. Since the convening of the United Nations special session on HIV/AIDS last year, significant progress had been made at the national level and HIV/AIDS had since been incorporated into Guyana's poverty reduction strategy. The country's 2002 budgetary allocation to address the pandemic had increased 100 per cent over that of the previous year.
Recalling his country's position as articulated during the special session on HIV/AIDS -- that national efforts to fight the disease could be stymied by a lack of resources -- he said Guyana remained convinced that many countries faced a grave threat, unless urgent action were taken to significantly increase the levels of investment in care, treatment and prevention of the disease.
HAROLD ACEMAH (Uganda) said that although the HIV/AIDS epidemic had had a devastating impact on medical facilities, the economy and social structures, the situation had not left Uganda in despair. People living with HIV/AIDS in Uganda had become an effective weapon against the pandemic. The Ugandan Network and Association of People living with HIV/AIDS had mounted effective advocacy and awareness-raising campaigns. Ugandans living with HIV/AIDS were cooperating and sharing experiences with those from other parts of the world. Public debate about the pandemic would be effective in sensitizing the masses while seeking solutions.
He said that openness, political support and commitment had been key to reducing HIV/AIDS cases, since the youth were getting educated about the problem. The President of Uganda had instituted a mechanism through which he would be frequently briefed about the education in schools regarding HIV/AIDS. Local leaders were taking on the President's example to address the grass-roots communities.
The representative of Uganda said that HIV/AIDS issues were "part and parcel" of Uganda's national programmes, including education, the Poverty Eradication Action Plan and debt relief. Also important to the Government was cooperation with the private sector, the business community and civil society. Uganda needed grants and other support measures to intensify its response. Assistance from the international community was welcomed.
KYAW TINT SWE (Myanmar) noted that the Secretary-General in his report had mentioned that young people could be effective HIV prevention messengers. The School-based Healthy HIV/AIDS Prevention Education, also known as SHAPE, had brought relevant education to some 1.2 million schoolchildren in more than 9,000 schools in Myanmar. Its "spiral curriculum" combined age-appropriate information about HIV/AIDS and healthy living with life skills and peer education components for children aged 7-15. The programme had been integrated into the national curriculum and implementation was steadily growing nationwide.
He said a Myanmar-language publication called "100 Frequently Asked Questions", which had been widely distributed since December 1999 and was still in great demand, dealt with the ABCs of HIV prevention and care, and also tackled complex moral questions. To further create awareness and reduce stigma against HIV/AIDS, the Government also used the most popular form of media -- television -- to reach the masses, through documentaries and films, with the active participation of film stars as dutiful members of civil society.
He said that by using a "grossly inflated estimate" of 500,000 living with HIV/AIDS, critics had attempted to project Myanmar as a country which had done little to combat the pandemic. A meeting held in March between Myanmar Ministry of Health officials and UNAIDS had put the estimate at 177,000 at the end of 2001. It was also concluded that HIV infection in Myanmar was concentrated in high-risk groups.
JOHN DAVISON (United States) said that the most laudable achievement since the special session was the rapid establishment of the Global Fund, which represented a new way of doing business. The Fund would soon be moving significant new resources to countries to help push back the impact of HIV/AIDS, tuberculosis and malaria, and the United States was the largest contributor. However, the new additional and complementary support from the Global Fund could not displace already existing efforts.
He said the United States continued to be the largest donor to international HIV/AIDS efforts, providing 44 per cent of bilateral assistance for such efforts, according to UNAIDS. United States monies supported bilateral and multilateral programmes that prevented new infections, reduced risky behaviour and provided treatment and care for those living with HIV. The United States was also the leader in the research necessary to develop a vaccine.
Despite efforts, the decades to come threatened to be far worse than the decades that had already passed, he noted. He urged States that had not already done so to work to meet the targets set by the special session. Despite increased education and public awareness, taboo and stigma remained formidable obstacles to effective responses. Political leadership was crucial in making a difference in combating the stigma and discrimination that had accompanied the epidemic worldwide. Parents and families were critical. Religious and community leaders must be involved. He believed that public-private partnerships were vital to combat HIV and AIDS. It was only through the combination of public and private efforts that the challenge ahead could be confronted.
KAZUYA SHIMMURA (Japan) said that, despite progress made in the three key areas of leadership, partnership and resources, there were still worrying signs that the HIV/AIDS epidemic continued to spread. The Asian region was experiencing a rapid increase in prevalence rates and because of the region's vast population, even a low prevalence meant a large number of infected and affected people.
He said that, while prevention was the mainstay of the international response, care and support, provided through basic health infrastructures, were closely linked to effective prevention. The provision of care and support in accordance with local conditions, including voluntary and confidential testing, must be promoted as an effective tool to combat the spread of HIV/AIDS.
Welcoming the establishment last January of the Global Fund to Fight AIDS, Tuberculosis and Malaria, he said Japan was making a contribution of $200 million to the Fund in the hope that it would strengthen global measures to combat infectious diseases.
CHUCHAI KASEMSARN (Thailand) said that an effective response to HIV/AIDS required a comprehensive approach in addressing the various aspects of the epidemic, such as prevention, treatment and research, as well as strategies to address the specific situations of vulnerable groups and the human rights of people with HIV/AIDS. Much of Thailand's success in curbing HIV/AIDS was a result of the contribution of civil society, NGOs and United Nations agencies. Thailand's national plans for the prevention and alleviation of HIV/AIDS had been developed and implemented in that spirit. The current plan, covering the period between 2002 and 2006, also adopted a human-centred approach and emphasized building community capacities as well as the administrative systems.
He said that national, provincial, district and community efforts by government agencies, NGOs and the private sector were implemented under the auspices of the National AIDS Prevention and Alleviation Committee. Regarding policy and implementation, he said that prevention remained the mainstay of Thailand's response, and the Government had set a target to reduce HIV/AIDS prevalence among people between 15 and 49 years-of-age to less than 1 per cent by 2006.
Stressing the need to address stigmatization and social exclusion, he said that Thailand's policy emphasized awareness-raising among families and communities, as well as providing support for organizations dealing with HIV/AIDS issues, including community activities involving people living with HIV/AIDS.
ZINA ANDRIANARIVELO-RAFAZY (Madagascar) described the AIDS pandemic as one of the greatest challenges facing mankind and noted that almost 14,000 children were susceptible to infection daily. Given the extent of the pandemic, current efforts to deal with it had proven insufficient so far, and although there had been commitment to fight the disease, implementation was lacking due to lack of resources.
Women and youth continued to be infected. he said, pointing out that there must be a better data collection system to facilitate preventive action. Work was also needed to deal with the stigma attached to the illness, and to strengthen the struggle against drug abuse and to protect children against sex crimes.
Madagascar welcomed the Global Fund to fight AIDS, but was disappointed that only $2 billion had been raised so far against the $10 billion required annually. He appealed to all donors to increase their contributions and called for debt relief in order to allow developing countries to fight the pandemic. Consideration should be given to the conversion of loans into grants, he said, noting that only 60,000 people in most affected developing countries were receiving antiretroviral treatment.
He hoped support for the Millennium Declaration would allow the achievement of its goals. For the problem to be effectively tackled all social sectors had to be involved, not only ministries. At home, Madagascar was taking steps to make resources available at the local and provincial levels. He asserted that although AIDS was an enemy to be feared, it could still be overcome.
DJAUHARI ORATMANGIN (Indonesia) said adoption of the Declaration of Commitment at the United Nations General Assembly special session on HIV/AIDS in June 2001 provided a new momentum for the international community to combat this devastating epidemic. In order to mount an effective global response to the HIV/AIDS epidemic, there must be concrete political commitment and genuine cooperation at all levels. A prerequisite for the international community to remove this "global curse" was strong leadership that would mobilize the necessary resources to eradicate HIV/AIDS.
He said that Indonesia, along with its ASEAN regional partners, made a joint declaration to cooperate in combating AIDS, including fighting drug use. In recent years, "the twin curses" of intravenous drug use and HIV/AIDS had been growing in Indonesia and throughout the region. As early as 1994, Indonesia initiated a national programme to combat the spread of HIV/AIDS, including the establishment of a national AIDS Prevention and Control Commission. The AIDS prevention program included AIDS education, prevention, testing, treatment, research and monitoring of the progress of the programme.
He said Indonesia also renewed its efforts to fight AIDS and drugs through presidential decrees, which included the launch of a national movement against AIDS, and efforts to fight drug abuse.
The national programme acknowledged the role of the community, especially the family, in the prevention of the disease, and the caring for those already infected. A third of those suffering from HIV/AIDS were in the 15 to 24 year-old range. The family played a key role in teaching young people to avoid unsafe activity, and, so, in prevention.
CHRISTINE KAPALATA (United Republic of Tanzania) said that, by the time the General Assembly adopted the Declaration of Commitment last year, it was already evident that the HIV/AIDS epidemic was getting worse, thereby suggesting that responses taken so far had been inadequate compared to the magnitude of the problem. Interventions had obviously been on a smaller scale than that demanded by the pandemic.
She said that, to paraphrase Peter Piot, the Executive Director of UNAIDS, unless the international community stepped up interventions, the pandemic would "not defeat itself". That grim picture notwithstanding, however, Tanzania remained committed to the war against the scourge, and reaffirmed its resolve to implement the Declaration of Commitment. Tanzania had identified rampant ignorance, fear of the disease, stigmatization and, most importantly, the prevalence of poverty, as obstacles in the war against the pandemic.
In that regard, she said Tanzania was concerned that without additional resources, most governments would achieve neither the Millennium Development Goals nor those contained in the Declaration of Commitment. For that reason, the country strongly supported the Secretary-General's recommendation for expanded support by United Nations agencies, funds and programmes to HIV/AIDS efforts in particular UNAIDS co-sponsoring agencies and the UNAIDS secretariat.
LAURIE BRERETON (Australia) predicted that HIV/AIDS would grow significantly through the coming decade. Australia's concern was the spread of the epidemic in Asia and the Pacific where, by the end of the decade, it would eclipse its growth in Africa. It was estimated, he said, that by 2010, China would have 10 to 15 million HIV/AIDS cases and India would have 20 to 25 million.
He said last year's special session represented a landmark in the development of global, regional and local responses to the pandemic. Australia looked forward to when the Global Fund to fight HIV/AIDS, tuberculosis and malaria would implement projects and achieve results on the ground. Also welcome was the reduction in the price of some treatments for HIV/AIDS. However, the cost of antiretroviral drugs remained too high. He expressed concern about the possible emergence of drug-resistant strains as a result of inconsistent use of antiretroviral therapies and the manufacture of sub-standard medications.
He noted that, in October last year, Australia had hosted the Asia-Pacific ministerial meeting to discuss the impact of the pandemic, and was working on a second meeting, to take place in 2003. The first meeting had led to the establishment of the Asia Pacific Leadership Forum on HIV/AIDS and Development. Widely supported by regional States, the Forum would commence its work next year. In addition, Australia continued to fund programmes in Asia and the Pacific to help countries respond directly to the pandemic through a six-year, $200 million global HIV/AIDS initiative.
NORMA TAYLOR ROBERTS (Jamaica) said the fight against HIV/AIDS could be successful only in the context of strengthened and effective partnerships. National governments had taken significant steps aimed at strengthening their responses. However, the implementation of national strategies had been slow. Progress would continue to be slow if serious constraints caused by excessive economic burdens continued to impede capacity to allocate sufficient resources to fight the disease. To increase the ability to address the problem, particularly in developing countries, there was a clear need for enhanced partnerships to expand resources and human and technical capacity, to ensure that the scale of country-level activities matched the gravity of the problem.
If the goals set in the Declaration of the Assembly's special session were to be met, she said, there should be greater support for national efforts to expand medical services. Expanded research into the development of a safe and effective vaccine should also be a priority. She was therefore concerned that only 1.6 per cent of all HIV/AIDS research was focused on the development of a vaccine suitable for use in sub-Saharan Africa -- the worst affected region. That clearly confirmed that global research priorities were not sufficiently oriented towards urgent health needs in resource-limited countries.
Since the adoption of the Declaration, her country had increased its efforts to combat the disease, through the adoption of a comprehensive national framework involving all sectors. In December 2001, the Cabinet approved the National Strategic Plan on HIV/AIDS for the period 2002-2006, which outlined an integrated national response across sectors, ensuring the implementation of programmes and policies aimed at advancing the human rights of people living with HIV/AIDS and the most vulnerable groups in society.
LUIZ TUPY CALDAS DE MOURA (Brazil) said the results his country had achieved in its fight against HIV/AIDS rested on a balanced approach to prevention and treatment, and the advocacy of human rights. The Government had pursued those policies since the beginning of the epidemic and had always counted on the strong cooperation of civil society. Prevention policies in Brazil included universal access to condoms, women's empowerment, the inclusion of issues relating to HIV/AIDS in the school curriculum, the implementation of programmes aimed at avoiding mother-to-child transmission and the development of strategies for the most vulnerable and high-risk groups.
As far as treatment was concerned, one of the main elements of the Brazilian response was the free and universal access to medicines, including antiretroviral therapy. That policy had borne fruit. The death rate was slashed by 50 per cent and hospitalizations dropped by 75 per cent. The positive consequences of that policy were far-reaching. The number of people with HIV/AIDS now was half what some studies had foreseen a decade ago.
That treatment policy would have been much more difficult to pursue if it were not for the local production of medicines, he added. Brazil now produced eight generic versions of non-patented antiretroviral drugs at low costs. Other important elements of Brazil's policy were the respect for human rights and the cooperation of civil society.
JEANETTE NDHLOVU (South Africa) reiterated her country's appeal to the international community to increase assistance to countries lacking sufficient resources. This was necessary if the war against HIV/AIDS was to be won. The global HIV/AIDS research programmes for a safe and effective preventive vaccine should also remain a global priority. In that connection, the South African Medical Research Council would initiate the country's first HIV/AIDS vaccine trials early next year in collaboration with Johns Hopkins University in the United States and other chosen sites.
She noted that one of the important outcomes of the special sessions on HIV/AIDS was the establishment of the Global Fund to fight HIV/AIDS, tuberculosis and malaria as a financing mechanism for additional resources. In order for progress to be made in the implementation of the special session's Declaration of Commitment there was need to strengthen the Fund, and the process and procedures for getting access to resources in the Global Fund should be accelerated.
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