2 May 2001


NEW YORK, 30 April (UN Headquarters) -- Following is the text, as delivered, of the address made by Secretary-General Kofi Annan today to the Annual Conference of the Council on Foundations in Philadelphia, Pennsylvania:

It is, indeed, an honour for me to address this meeting. I see several old friends here. More important, I see many good friends of the United Nations. If this is the State of Philanthropy, I think we can declare it a very healthy state indeed!

What is especially encouraging for me, of course, is that every year you are giving more and more, and bigger, grants for international causes. That shows you have understood the nature of our times: an age when the global and the local can no longer be separated; and when governments can no longer tackle global challenges alone. They need new partners.

In these partnerships, you have a central role. You are a link, both between the local and global, and between market forces and social needs. That role is spelt out in the theme of this Conference: "Responsible use of private wealth for the public good".

Nowhere is that theme more relevant than in the area of public health. In today's world, there are no health sanctuaries -- no separation between "foreign" and "domestic" infections; and no "us" and no "them".

Only through effective global partnerships can we beat back epidemic and endemic diseases. And only by bringing everyone together can we mount an effective response to the newest of these, which has become not only the world's biggest public health challenge, but in some countries the biggest single obstacle to development: HIV/AIDS.

Twenty years ago, few of us had even heard of AIDS.

Ten years ago, few of us had any notion of the scale of the disaster.

Even two years ago, most people in western countries still thought of AIDS as a mainly domestic problem, and believed they were getting it under control.

But now, for much of the international community, the magnitude of the crisis is beginning to sink in. More than 36 million people around the world are today living with HIV/AIDS -- the vast majority of them in sub-Saharan Africa, but the pandemic is now spreading at an alarming rate in Asia and Eastern Europe, too. Last year alone, 3 million people died from the virus -- the highest annual total to date -- and 5 million people became infected: an average of 13,000 people per day. It is as though the whole population of two cities the size of Philadelphia had been wiped out in a single year.

This is, indeed, a catastrophe. But we are not powerless before it. Something can be done, and -- what is more -- people are beginning to do it.

I have just come back from an important meeting in Abuja, Nigeria, where African leaders came together and collectively declared AIDS a state of emergency for the whole continent. They pledged a major increase in the share of their budgets they devote to health, and promised to use tax exemptions and other incentives to reduce the price of drugs and other health service inputs. Equally important, they promised to remove all the tariff and other economic barriers which currently prevent funds from reaching those involved in the struggle against AIDS. But even more impressive, to me, was the commitment and energy of the young African activists I met, including some who are themselves living with HIV/AIDS. I felt that African men, women and young people are really rising up against the disease and the suffering. Their strength filled me with hope even in the midst of tragedy.

But they desperately need more help, and we must see do whatever we can to get it to them.

For some time now, I have made the battle against HIV/AIDS one of my personal priorities. And from Abuja last week I issued a rallying call to the whole world -- setting out five clear objectives, which I believe the many heroic groups and individuals engaged in the battle can all accept.

The first objective is prevention: to halt and reverse the spread of the virus, notably by mobilizing young people -- those at greatest risk of infection -- in their own defence.

The second is to stop the transmission of HIV from mother to child -- the cruellest, most unjust infection of all.

The third is to put care and treatment within everyone's reach.

Until recently, this seemed a hopeless dream. But in the last few months there has been a dramatic fall in the prices at which key drugs are offered to developing countries -- driven partly by a revolt of world public opinion, and partly by competition from "generic" manufacturers. Price cuts alone will not be enough, and in any case it will take time for their impact to be felt. But they do, for the first time, make the ideal of treatment for all a real possibility. We no longer have to choose between prevention and treatment. We can and must do both.

The fourth objective, of course, is to deliver scientific breakthroughs: a cure for HIV/AIDS (which none of the present drugs are) and also a vaccine against it. The latter, especially, should be given higher priority. Those who would benefit from it do not form a powerful lobby, because most of them live in poor countries and don't even know they are at risk. In fact, most of them are not yet born. It is our job to lobby on their behalf!

And the fifth objective is to protect those made most vulnerable by the epidemic, especially the AIDS orphans, of whom there are already more than 13 million worldwide -- more than all the children in Pennsylvania, New York, New Jersey, Connecticut, Maryland, Virginia and North Carolina combined.

So those are the five objectives. If we are to reach them, a lot of things need to happen.

First, national leaders in all countries must show real leadership, committing themselves to a strategy and giving it priority in their budgets. The Abuja summit was a welcome beginning. But there is still a long way to go in Africa, and even further in much of Asia and eastern Europe.

Second, it is vital to involve local communities. Young people need the support of their families and communities if they are to succeed in changing their behaviour and protecting themselves. And those already living with HIV/AIDS must be seen as a major resource in this struggle. After all, they are the "ultimate experts".

Third, we must give more power to women, so that they can protect themselves and their children. It is a truly shocking fact, of which I as an African man feel ashamed, that at present in sub-Saharan Africa adolescent girls are six times more likely to be infected with HIV than boys. That has to change.

Fourthly, if we are going to make care and treatment available to all, we need much stronger public health-care systems in developing countries.

And finally, yes, we need a great deal of new money. While much responsibility does lie with governments in the countries concerned, where the disease is spreading fastest, clearly they need help from outside. The more fortunate countries can, and must, provide that help.

At a minimum, we need to be able to spend an additional $7 billion to $10 billion dollars a year for all aspects of the worldwide struggle against HIV/AIDS, over an extended period of time. It sounds a lot of money -- at least, it did sound a lot when I said it last week in Nigeria. But in this gathering it should not sound so much. It is actually less than you, the charitable foundations of a single country, are giving away each year. And the world's governments spend more than a hundred times that amount each year on their military forces.

So let's be in no doubt. The world has the resources to defeat this epidemic, if it really wants to. Is the will there? We will find out soon enough. But at present, there is a lot of confusion about how the money should be raised, where it should be directed, and who can ensure that it's well spent.

In the past few months, there has been a flurry of initiatives -- from governments, from distinguished scholars, and from you, the foundations. Some have been specifically directed at HIV/AIDS. Others have been broader and more ambitious in their aim, aiming to raise the general standard of health in developing countries and to defeat all major infectious diseases.

Many people have asked me to try to pull these initiatives together into one clear proposal. Accordingly, I have engaged in intensive consultations, and I believe we are now close to an agreed agenda.

What I propose is a Global Fund, dedicated to the battle against HIV/AIDS and other diseases. Clearly, it must be organized in a way that corresponds to the needs of the affected countries and people. And equally clearly, it must draw on the best expertise wherever it is to be found, whether in the United Nations system, in national institutions, or among non-governmental organizations -- especially those that represent people living with HIV/AIDS or directly affected by it.

The Fund must be able to deliver money quickly where it is most needed. Its decision-making must be open and transparent. It should give support to all kinds of organizations that are really working to fight the epidemic and help those affected by it, and which are willing to work within a common country framework.

Each country or community receiving support from the Fund would have to show that it is actually bringing results to those most at risk. These results would be independently monitored.

More work is needed on the details. I intend to pursue the idea actively with all concerned over the next few weeks. But I hope that in the very near future the Fund will be up and running, and that before the special session of the General Assembly on HIV/AIDS in late June we shall have some firm commitments of serious money.

Where is that money going to come from?

Undoubtedly, the heavy lifting, given the amounts involved, will have to be done by the governments and taxpayers of the industrialized world. They have long committed themselves, on paper, to spending 0.7 per cent of their gross national product (GNP) on aid to developing countries. Very few countries have lived up to that pledge, and the industrialized world as a whole has reached only 0.2 per cent. All governments should realise that, unless they take that commitment more seriously, they will have little chance of meeting the new commitments they made at last year's Millennium Summit in New York.

One of those Millennium pledges, let me remind you, was to halt and begin to reverse the spread of HIV/AIDS, malaria and other diseases by 2015.

Another was to provide special assistance to children orphaned by AIDS.

And a third was to help Africa build up the capacity to tackle the spread of HIV/AIDS and other infectious diseases.

Were the heads of State and government serious when they made these commitments last year? If they were, then a major, long-term commitment to the Fund I am proposing would be an excellent way for them to show it.

Of course, we in the United Nations family also have a vital role to play. We must organize ourselves better, and step up the tempo of our work on this issue, so that no one who has dealings with us can fail to see the importance we attach to it.

It is our job to coordinate the struggle, and to be its most eloquent and passionate advocates. All of us must play our parts within a coherent framework, laying aside turf battles and doctrinal disputes.

In that work, non-governmental organizations will be vital partners. They are our partners on the ground in developing countries -- where often it is local non-governmental organizations who actually deliver health services and run prevention campaigns, as well as raising their voice against stigma and discrimination. And they are also our partners in the donor countries, both as advocates of the cause and as creative contributors to policy-making.

Next, the corporate sector has a big responsibility. Two years ago, I engaged them. For two years I have been calling on it to play a bigger role in this battle. And I am glad to say my entreaties have been heard, but there is still much, much more that the private sector could do.

As you know, the big pharmaceutical companies have lately been in the spotlight. I myself held talks with the leaders of the six largest pharmaceutical companies earlier this month. They agreed to accelerate the reduction of AIDS drug prices in the least developed countries, especially those in Africa, and to cut prices in other developing countries too.

But pharmaceutical companies cannot do it alone. They are not the only ones with responsibilities. Every company doing business in a developing country should be making a major effort to inform its own employees, and the wider community, about the dangers of HIV/AIDS and the best ways to protect themselves against it. Every company should provide voluntary testing and counselling for its workforce and their dependants, and should give both material and moral support to those who have to live with the disease.

And every company should lend its marketing skills to support local and national education campaigns, aimed both at halting the spread of HIV/AIDS and at overcoming prejudice against those who have it.

Beyond that direct responsibility, corporations in general have a role to play, as public benefactors and donors to the global war chest. Some choose to play that role directly, others by creating and supporting foundations like yours.

I have saved your role for the last, but, of course, it is no accident that I am making this speech to this audience!

Several American foundations have already shown real leadership in the battle against AIDS. Last night, some of you heard Tim Wirth explain why girls' education is a key weapon in that battle, and how you can work as partners with the United Nations in forging and wielding that weapon. Many others among you are also making imaginative and generous contributions, both financial and intellectual. The Bill and Melinda Gates Foundation, especially, is doing very exciting things in the vital area of prevention, including the search for a vaccine.

Those contributions are desperately needed. And I’m here to urge you to increase and multiply them. You have the flexibility to provide funds quickly, and to use them to plug gaps, where other institutions may be held back by political considerations, or by terms of their mandates.

As voluntary contributors, you also have great moral authority. You can act as levers and advocates, and by mobilizing public opinion to prise open the public coffers. If you make the fight against AIDS a top priority, I wager that governments and the general public will not be far behind.

So that is the challenge I give you.

And many of you have great expertise on the issues involved. You can and do contribute actively to policy discussions, and to decisions about the kind of research that is worth investing in.

In short, my friends, from every point of view you are essential members of the Strategic Partnership against HIV/AIDS that I’m trying to forge. In Africa, that partnership has been working for over a year. The time has come to extend it to the whole world.

In less than two months, on 25 June, delegates from all over the world will gather at United Nations Headquarters for the special session on HIV/AIDS. My hope is that by then we will be ready to agree on a global strategy for defeating this global scourge, and will have firm commitments of money to finance it. But we cannot do it without your help. So I look forward to seeing you there -– and I mean all of you!

Thank you very much.

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