1 June 2006

Involving People Living with HIV in Policymaking, Addressing Stigma, Dealing with Marginalized Groups Among Issues at Civil Society Hearing on AIDS

Secretary-General Tells Gathering Fight against HIV/AIDS Can Be Won Only if Civil Society at Heart of Efforts

NEW YORK, 31 May (UN Headquarters) -- After 25 long and hard years, the international community had learned that it could win the fight against AIDS only if civil society was at the heart of its efforts, Secretary-General Kofi Annan said to the representatives of civil society today, as the 2006 High-Level Meeting on HIV/AIDS, aimed at assessing the international response to the epidemic, opened at Headquarters.

Today's informal interactive civil society hearing, which directly followed the opening plenary, was part of a series of meetings, round tables and panel discussions being held to identify common challenges to sustaining and scaling up national and international AIDS responses. Building on those discussions, a political declaration will be adopted at the close of the meeting on 2 June.

The hearing provided an opportunity for civil society members to exchange views with Member States on the progress achieved in realizing the targets agreed in the Declaration of Commitment on HIV/AIDS, which was adopted in 2001 at the General Assembly special session. Almost 800 civil society groups have been granted special accreditation to the meeting, an unprecedented number for such a gathering, and many more are expected to attend as part of organizations already accredited to the United Nations, or as part of national delegations.

"I am delighted that we have such a wide spectrum represented in this room, including from the private sector," Mr. Annan said. "One of the absolute musts in this effort is greater and more meaningful involvement of people living with HIV. Their perspectives are needed to make sense of programmes, planning and policy-making for HIV prevention, care and treatment. Their engagement is the key to stamping out stigma and discrimination. Their voice is the surest way to sustain the passion and compassion we need to win against the pandemic."

The need to develop more effective partnerships with civil society and people living with HIV was also emphasized by the President of the General Assembly, Jan Eliasson (Sweden), who said that the fight against AIDS required all stakeholders to work together. An integral part of the three-day meeting, the hearing gave civil society an opportunity to speak to the world Governments at the very moment that decisions were being taken that could and should shape the next stage of the global response to AIDS.

"The presence of many of you will help to ensure that the realities of AIDS are brought into these halls over these three days," said the Assembly President. "AIDS kills people, kills development, kills hope, kills dreams, kills aspirations, kills the future, but it need not be this way. Beating the disease is entirely within our reach."

Encouraged by Mr. Eliasson to "tell the story as it is, hold us to account", and challenge the international community to hold its promises, 12 panellists and numerous other speakers at the hearing focused on: the need to ensure greater involvement in decision-making of people living with HIV and AIDS; the situation of marginalized groups; girls' and women's rights in the context of AIDS; sexual and reproductive health issues; research and development; and the role of the private sector, trade and labour organizations in response to AIDS. Also addressed were the issues of financing a scaled-up AIDS response, overcoming stigma and discrimination, children and AIDS, the role of religion, and human rights, as well as the importance of access to sterile injection equipment and condoms.

Among the participants in the interactive discussion were those who, in the words of the Secretary-General, had been "too often marginalized -- sex workers, injecting drug users, and men who have sex with men". A speaker said that Governments should not be afraid to deal with those groups, which wanted to participate in the anti-HIV efforts and whose voices were very important. It was also pointed out that stigma and discrimination needed to be urgently addressed, along with other causes that hindered the implementation of agreed goals.

Speaking as part of the Global Network of People living with HIV/AIDS delegation, Martine Ago of the BLETY organization from Côte d'Ivoire opened the discussion, saying that it was the first time a sex workers' representative had been given an opportunity to address the United Nations. Her organization wanted to give a face to the disease, show solidarity and provide support to people living with HIV. She stressed that, if Member States wanted the pandemic resolved, they must stop criminalizing sex workers' activities. "We are not a problem, but we are part of a solution," she said. Among other things, sex workers needed access to preventive measures, treatments and condoms.

Considering the means of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it, speakers stressed the need to promote a human rights-based approach and scale up HIV prevention, care and support. Noted in the debate was the fact that, while much had been accomplished, the epidemic continued to outpace the global response. In 2005, there had been more new infections and more AIDS deaths than ever before. Despite recent gains, only one in five people in need of antiretroviral drugs from low- and middle-income countries were currently obtaining them. Such prevention activities as behaviour change programmes for highly vulnerable and at-risk populations and services to prevent mother-to-child transmission, currently reached fewer than 10 per cent of those in need.

Among the experiences shared today were lessons learned from the implementation of a workplace AIDS initiative at a massive mining conglomerate, which was introduced by Brian Brink of the Anglo American/International Women's Health Coalition from South Africa. He said that the private sector had tremendous potential for helping Governments in their efforts to stop the disease. Among the great achievements of the programme was the fact that some 3,000 employees were now on anti-retroviral therapy. It was also a great economic success, resulting in an increase in retention of skilled employees and increased productivity. Also important was HIV counselling and testing, zero tolerance of discrimination, confidentiality and a human-rights approach.

Lilian Mworeko of the International Community of Women Living with AIDS from Uganda was among the speakers who stressed the need to ensure predictable and sustainable financing, at both national and international levels for treatment of HIV/AIDS and other infectious diseases. She called for financing of health services for all, through an inclusive decision-making process and introduction of concrete targets and benchmarks. In fact, there were sufficient resources to stop the epidemic, she said. What was missing was the commitment of Governments and international donors. It was time to ensure it was in place.

Children were particularly vulnerable, and by not protecting them, the international community was jeopardizing its future, Musimbi Kanyoro of the World YWCA from Kenya said. Urgent attention should be given to access to treatment for children. Youth- and HIV-positive-friendly policies were needed, as well as access to information and education. She also focused on the need to: put an end to sexual exploitation and violence against children; bring the offenders to justice; and promote children's rights. "Today, we call on you to ensure that all HIV-positive mothers receive treatment when they are pregnant and when the child is born," she said, insisting that the children of the world needed to stay alive and to have their parents alive. Other speakers on the issue of children pointed out the need for social support services for orphans and to protect their inheritance rights.

Recalling the phrase "AIDS is God's punishment for sins", as part of the faith community's initial response to the epidemic, Johannes Petrus Heath of the African Network of Religious Leaders Living with and Personally Affected by HIV and AIDS from Namibia said that the religious community needed to make changes in its attitude and seek to address the stigma and discrimination associated with HIV. In a move to openness and acceptance, it had a role to play in helping people make informed decisions about their lives. The obvious, but frequently overlooked, fact was that HIV was a virus and not a moral condition. "Until we have done everything possible to stop it, we have not done enough," he said.

Several speakers stressed the need to link the efforts to stop the epidemic with the programmes to address poverty and discrimination, defend human rights of people living with HIV, and introduce reproductive-rights education. Also emphasized was the importance of the removal of barriers in pricing, tariffs, trade, regulatory policy and research, to speed up access to affordable HIV-prevention medicines and diagnostics. National Governments needed to set ambitious AIDS targets and, with support from international partners, prioritize funding for social mobilization and treatment programmes.

"As we know, some 8,000 people die of AIDS every day, and now we have to hold ourselves accountable, both individually and collectively," a speaker said. "I hope we are not just listening to each other, but also hearing each other in promoting success in fighting this epidemic." In that connection, several speakers agreed that improved accountability mechanisms were crucial to sustain and measure progress towards universal access. Among other measures, standardized target setting, expenditure tracking and public reporting on the efforts in the implementation of agreed goals were mentioned.

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