UN Secretary-General Calls on Governments to Take Up AIDS Challenge
New York, 20 February 2001 – Declaring the HIV/AIDS epidemic "the most formidable development challenge of our time", United Nations Secretary-General Kofi Annan, in a report released today, calls on governments to secure a global commitment for intensified and coordinated action.
The report has been issued in preparation for the General Assembly Special Session on HIV/AIDS, which will take place in New York from 25 to 27 June 2001. The first round of substantive negotiations for the Special Session are set to take place the week of 26 February, based on the report.
The report calls for intensified and broadened political and financial commitments by nations in their response to the AIDS crisis. Alarmed by the accelerating epidemic and its global impact, the General Assembly decided in November 2000 to hold a Special Session on HIV/AIDS at the highest political level. The Session follows calls for concrete action made in the UN Millennium Declaration, adopted in September 2000 by world leaders at the Millennium Summit.
More specifically, the report calls on governments worldwide to meet a set of seven critical challenges that will help reverse the AIDS epidemic:
"Leadership is fundamental to an effective response," said Mr Annan, referring to one of the challenges highlighted in the report. "One of the key issues facing the global community is developing and sustaining such dedicated leadership, vital if the nature of the epidemic is to be clearly understood throughout society and a national response mobilized."
Another core challenge is to alleviate the epidemic’s social and economic impacts. In many countries, AIDS has significantly undermined key sectors. Its negative impact is evident in economic development, education, health and agriculture. In addition, conflict, war, economic uncertainty, gender inequality and social exclusion have all made people more vulnerable to HIV infection, according to the report.
The report also states that an expanded prevention effort is vital to containing the spread of the epidemic and spending on prevention helps avert the future cost and impact of infection. A particularly effective intervention is the prevention of mother-to-child transmission. A short course of antiretroviral treatment can cut the rate of transmission to children by 20-50%.
As well as the need to strengthen health care systems, the affordability of medicines for opportunistic infections and antiretroviral therapy – one of the greatest barriers to improving access to care – must be dealt with. Some progress in reducing the price of medicines has resulted from the dialogue between the UN system and several research and development based pharmaceutical companies, initiated in May 2000, as well as through the increasing availability of generic versions of antiretroviral drugs. Despite these efforts, much more needs to be done if access to care and treatment is not to remain out of reach for the majority of people living with HIV and AIDS, according to the report.
The report says continuing inequalities in access to effective care and treatment must be specifically addressed through all possible means, including tiered pricing, competition between suppliers, regional procurement, licensing agreements and the effective use of the health safeguards in trade agreements.
In his report, the Secretary-General also calls for focussed international research and development to produce microbicides and vaccines for HIV/AIDS, and for greatly increased resources to meet the challenges of a growing epidemic.
One of the goals of the Special Session will be to call for a strengthening of financial commitments in the response to AIDS, which remains vastly underfunded.
Despite the dramatic and ongoing spread of the epidemic, much has been learned since it surfaced two decades ago and the potential to reverse AIDS has never been higher.
"Collective experience with HIV/AIDS has evolved to the point where it is now possible to state with confidence that it is technically, politically and financially feasible to contain HIV/AIDS and dramatically reduce its spread and impact," Mr Annan said in his report.
By the end of 2000, 36.1 million men, women and children around the world were living with HIV or AIDS and 21.8 million had died from the disease. The same year saw an estimated 5.3 million new infections globally and 3 million deaths, the highest annual total of AIDS deaths ever.
However, an even greater epidemic can be prevented, according to the report. Large-scale prevention programmes in virtually all settings have clearly demonstrated that the spread of HIV can be reduced, especially among young people and hard-to-reach populations.
The report also said that successful responses have their roots in communities, that empowering young people and women is essential, and that people living with HIV or AIDS are central to the response. An approach based on human rights is fundamental: combating stigma is a human rights imperative on its own, as well as of instrumental value in fighting denial and shame, both of which are major obstacles in opening dialogue about HIV/AIDS.
A Complex Mosaic
A key lesson learned from the epidemic is that it is complex and must be tackled on several fronts – by dealing with its risks, the factors that affect vulnerability to it, and the epidemic’s impact.
"AIDS has become a major development crisis. It kills millions of adults in their prime. It fractures and impoverishes families, weakens workforces, turns millions of children into orphans, and threatens the social and economic fabric of communities and the political stability of nations," said Mr Annan. It has become clear that single, isolated activities do not yield sustained results, and that interventions to reduce HIV risk and change behaviour are effective only when a range of government ministries and partners in the social, economic and health fields are involved.
AIDS is now found everywhere in the world but has hit hardest in sub-Saharan Africa. Africa is home to 70% of adults and 80% of children living with HIV, and to three-quarters of the people worldwide who have died of AIDS since the epidemic began. During 2000, an estimated 3.8 million people became infected with HIV in sub-Saharan Africa, and 2.4 million people died. AIDS is now the primary cause of death in Africa.
Asia has so far escaped the high infection rates registered in Africa. Only three countries – Cambodia, Myanmar and Thailand – have prevalence rates exceeding 1% among 15 to 49-year olds. But infections are rising. In South and Southeast Asia during the past year, 780,000 adults, almost two-thirds of them men, became infected. East Asia and the Pacific registered 130,000 new infections.
The countries of Eastern Europe and the former Soviet Union present some of the most dramatic trends in the worldwide AIDS epidemic. Previously characterized by very low prevalence rates, the region now faces an extremely steep increase in the number of new infections, up from 420,000 at end-1999 to at least 700,000 a year later.
In Latin America, an estimated 150,000 adults and children became infected during 2000, bringing the total number of infected to 1.4 million. The Caribbean has the highest rate of HIV infection in the world after sub-Saharan Africa and AIDS is already the single greatest cause of death among young men and women in this region.
High-income countries witnessed a major decline in AIDS-related deaths in the late 1990s because effective antiretroviral therapy is keeping people alive longer. However, this good news is tempered by a stall in prevention efforts and by new infections which show no sign of slowing. In 2000, despite years of awareness about AIDS, 30,000 people in Western Europe were infected and 45,000 in North America.
For more information, please contact Anne Winter, UNAIDS, New York, (+41 79) 213 4312, Dominique de Santis, UNAIDS, Geneva, (+41 22) 791 4509), Andrew Shih, UNAIDS, New York, (+ 1 212) 584 5024 or Pragati Pascale, UN Department of Public Information, New York (+1 212) 963 6870. You may also visit the UNAIDS Home Page on the Internet for more information about the programme (http://www.unaids.org).
Note: The Joint United Nations Programme on HIV/AIDS (UNAIDS) brings together the efforts and resources of seven UN system organizations to help the world prevent new HIV infections, care for those already infected, and mitigate the impact of the epidemic. Its aim is to help mount and support an expanded response – one that engages the efforts of many sectors and partners from government and civil society.