Sixty-second General Assembly GA/10723

Plenary

108^th Meeting (PM)

UNITED NATIONS MEMBER STATES URGED TO DRAMATICALLY SCALE UP EFFORTS TO ATTAIN

UNIVERSAL ACCESS TO HIV/AIDS PREVENTION, TREATMENT, SUPPORT BY 2010

At Conclusion of High-Level Review of Global Effort to Eliminate Scourge,

General Assembly President Highlights Gains, Presses Nations Not to Lose Momentum

As he closed the General Assembly’s high-level review of progress in the global fight against HIV/AIDS this afternoon, Srgjan Kerim, President of that body, urged Member States to continue to build on the success of improved treatment rates by dramatically scaling up efforts to reach universal access to HIV/AIDS prevention, treatment and support by 2010.

“We must not lose the momentum of the global response,” Mr. Kerim said in his concluding remarks to the meeting, stressing that “for every two people that begin HIV treatment, there are five new HIV/AIDS infections”.

The three-day review of the progress achieved in realizing the 2001 Declaration of Commitment on HIV/AIDS, as well as the 2006 Political Declaration, heard from more than 160 delegations in its plenary session and included five panel discussions that drew upon the experiences of a range of non-governmental organizations and specialized ministries of Member States.  (See Press Releases GA/10719 of 10 June and GA/10722 of 11 June for further information.)

During the session, speakers welcomed the figures in the Secretary-General’s report showing that, overall, antiretroviral coverage had risen by 42 per cent in 2007, reaching 3 million people in low- and middle-income countries, or approximately 30 per cent of those in need.

They pointed out, however, that huge challenges still remained to fill the gaps in coverage in both treatment and prevention, particularly in developing countries.  In 2007, according to the report, an estimated 2.5 million people were newly infected with HIV, and 2.1 million AIDS deaths had occurred.  Speakers also called for greater attention to the gender aspects of the disease, as women and girls now made up a majority of newly infected cases, over 60 per cent in sub-Saharan Africa.

In his remarks this afternoon, Mr. Kerim noted that delegations had stressed that the pandemic was a public health and development issue, and that an effective response for the long term must include the strengthening of public health systems.  That meant stemming the drain of trained health workers from developing countries to wealthier ones, hand in hand with strong national strategies to fight HIV/AIDS.

He noted that speakers had also emphasized that an effective response to the pandemic must have human rights and gender equality at its core, and must include all sectors and countries worldwide acting in a complementary and coherent manner.  Participants had also stressed that leadership and political accountability -- at both national and local levels -- were the most important part of the solution.

The speakers in today’s final plenary continued to describe the programmes that had been instituted in their countries to combat the disease and to assist those whose lives had been affected by it, as well as to outline their international cooperation, whether as donors or recipients of aid and technical assistance.

Towards improving the results of such international action, many discussed the effectiveness of United Nations efforts.  The representative of Mauritius said that reform of international institutions to enable them to deal with such large-scale challenges remained a priority.  With the HIV/AIDS picture in Africa undeniably gloomy and frightening for a continent still struggling to provide for the most pressing needs of its citizens, it was imperative that the international community take immediate actions to follow through on the pledges made since 2001.  Increased attention was needed to scale up integrated tuberculosis and HIV efforts, he said.

Ireland’s representative said that recent progress had shown that the United Nations “Delivering as One” reform strategy was beginning to yield results, but better coordination was still needed at the country level, among relevant United Nations agencies, the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria.  New resources must be aligned with other donor aid to improve aid effectiveness and promote local ownership, he said.

Also speaking this afternoon were the representatives of the Republic of Korea, Colombia, San Marino, Morocco, Albania, Belarus, Israel, Croatia, Turkmenistan, Saint Vincent and the Grenadines, India, Andorra, Tuvalu, Papua New Guinea, Italy, Cape Verde, Bolivia and Samoa.

Observers from the Holy See, International Federation of Red Cross and Red Crescent Societies, European Commission, International Organization for Migration, Inter-Parliamentary Union and the Sovereign Military Order of Malta also spoke.

The General Assembly will meet again at a time and date to be announced.

Background

The General Assembly met today to conclude its high-level meeting on a comprehensive review of the progress achieved in realizing the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS.

Statements

PARK IN-KOOK ( Republic of Korea) recalled that 33.2 million people were living with HIV worldwide, representing not just a public health problem, but a profound threat to human life.  It caused tremendous loss due to the social and economic burden it imposed, and hindered prospects for both poverty reduction and economic development.  There was a need to promote better coordination among Governments, civil society and international organizations.  Individuals should be educated on how best to avoid infection and access to voluntary testing and counselling should be stepped up.  Since half of those living with HIV were female and infection among youth was rising, there was an urgent need to focus on those groups.

He said his country had been contributing to the Global Fund to Fight AIDS, Tuberculosis and Malaria, announcing an additional pledge of $10 million over three years from 2007.  The Republic of Korea was also a member of the Executive Board of UNITAID, an international drug purchase facility that was established to secure sustainable supplies of affordable medication for people suffering from those diseases.  In addition, it had pledged $1.5 million to the United Nations Development Programme (UNDP) in its implementation of an AIDS response in the Republic of Congo and Nigeria.  Endeavouring to nurture an accurate and complete knowledge of facts relating to HIV, his Government was conducting mass media campaigns to address misperceptions about the disease and to eliminate discrimination.  Stigma and discrimination could impede efforts to mobilize active cooperation on AIDS prevention.

CLAUDIA BLUM (Colombia), aligning herself with the statements of the “Group of 77” developing countries and China, and the Rio Group, said her country was a low-prevalence country, although infection rates were rising among women.  Men having sex with men, female sex workers, youth, street people, prisoners and displaced persons were among the high-risk groups.  A new national response plan for 2008-2011 had recently been adopted, which provided for social protection, as well as evaluation and monitoring of AIDS programmes.  Approximately $100,000 had been devoted to those activities so far, with a large percentage going to prevention and treatment.  Mother-to-child transmission was another focus.

She said Colombia’s insurance system covered laboratory costs for people living with HIV.  Pregnant women with HIV also received special care through that insurance plan, which provided for the needs of their newborns, as well.  Colombia had succeeded in achieving 45 per cent coverage for people needing antiretroviral treatment, owing to the country’s health insurance scheme.  However, second- and third-line medication was not part of the scheme; she called on international support to help expand that coverage.

Safeguarding the dignity of HIV-positive individuals was another big focus in Colombia, as that fostered trust in public services and encouraged HIV-positive people to come out of hiding in order to seek the help they needed.  The rights-based approach being taken by her country went hand in hand with the provision of AIDS care, thus ensuring the inclusive nature of those services.  Since the poorest people were often at greatest risk, the country was also seeking to include AIDS strategies in its economic development strategies.  Civil society was a key actor in the success of those strategies.  However, technical and financial assistance in that area needed strengthening.

DANIELE BODINI ( San Marino) said his country was tackling its domestic HIV challenge through prevention and education strategies, which included specialized centres that educated women on sexually transmitted diseases and a national health plan that guaranteed free treatment and anonymity to all patients.  On the international level, the country worked with the United Nations Children’s Fund (UNICEF) on a project for mothers, children and young people in Gabon, as well as on youth organizations that aimed to promote awareness of HIV/AIDS in developing countries.

He was convinced that Member States, United Nations agencies, non-governmental organizations, educational institutions, media and the business sector must all work together to successfully fight the AIDS scourge.  His country was determined to share that responsibility with the international community.

HAMID CHABAR ( Morocco) reiterated his country’s commitment to combating the HIV/AIDS pandemic and expressed solidarity with attendees of the meeting who were living with the virus.  He stressed that only collective political will and international cooperation could overcome the pandemic, and time was running out for achieving the goal of universal access to prevention and care by 2010.  Only a boost in funding and combating sexism could make that goal plausible.

He said his country had an ambitious and realistic plan to reduce prevalence rates by increasing coverage to those most at risk.  The country’s leadership, officials and civil society were all working in the effort.  Thanks to the mobilization of all national and international partners, all AIDS patients had access to therapy.  He appealed for the further mobilization of resources to combat a scourge that was so destructive, particularly in Africa, where it should be fought through aid to development, as well as targeted assistance.

JOHN PAUL KAVANAGH ( Ireland) said that more than €100 million were spent annually on HIV and other “diseases of poverty” in his country, while a significant amount of its overseas aid went towards fighting poverty, disease and hunger.  The United Nations “Delivering as One” reform strategy was beginning to yield results, although better coordination was still needed at the country level among relevant United Nations agencies, the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria.  New resources must be aligned with other donor aid to improve effectiveness and promote local ownership.

He said prevention was at the core of Ireland’s HIV strategy, and “female-controlled HIV prevention commodities” were central to addressing women’s and young girls’ disproportionate vulnerability to the virus.  There was a direct link between the well-being of women and children and Ireland’s attention to the health of HIV-positive mothers.  For instance, the rate of mother-to-child transmission was less than 2 per cent, compared to 1 in 3 children who were born to an HIV-infected mother in sub-Saharan Africa.  The Fourth Global Partners Forum on Children affected by HIV and Aids, to be held in Ireland in October, was expected to bring together global leaders in an effort to focus attention on children’s needs.  Also concerned about the impact of current increases in global food prices for AIDS-affected communities, Ireland was committing itself to supporting HIV programmes that incorporated effective food and nutrition interventions.

SOMDUTH SOBORUN (Mauritius), subscribing to statements made on behalf of the Group of 77 developing countries and China, the African Group and the Southern African Development Community (SADC), said the HIV/AIDS picture in Africa was undeniably very gloomy and frightening for a continent that was still struggling to provide for the most pressing needs of its citizens and end poverty and hunger.  In order to overcome that humanitarian crisis, it was imperative that the international community take immediate actions to follow through on the pledges made since 2001.  In addition, increased attention was needed to scale up integrated tuberculosis and HIV efforts.

He said that, although the HIV prevalence rate in Mauritius was only around 1.8 per cent, his Government strongly believed it must be committed to the battle against the disease.  It had, therefore, increased allocations and was implementing a multisectoral plan for that purpose, and was funding non-governmental organizations to assist in the effort.  The fight against the pandemic was not easy to win, however, owing to the lack of financial resources and patent restrictions on drugs, among other obstacles.  It was crucial to obtain cheaper drugs and to invest heavily in key infrastructure in education and health.  International organizations should also be reformed to become more responsive to such global challenges.

ADRIAN NERITANI (Albania), aligning himself with the statement of the European Union, said his country was considered a low-prevalence country, but rapid economic and social growth had brought with it many problems associated with a free and open society.  In 2007 alone, there were 44 new HIV cases.  Albania faced the risk of a quick increase in HIV cases because of the growth of injecting drug users, coupled with low levels of knowledge on the issue and poor prevention and diagnosis capacity in its primary health-care system.  However, the Government was devoted to strengthening the partnership between the Health Ministry and non-governmental organizations, with the technical and financial support of agencies, such as the World Health Organization (WHO), the United Nations Population Fund (UNFPA) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

He said that a draft law on HIV/AIDS prevention and control was now in Parliament and was awaiting approval.  The main objectives of the national programme were maintaining the low prevalence of infection in the country, ensuring access to treatment and care and ensuring a close partnership between the public sector and civil society.  Greater attention was being placed on improved school curricula on HIV/AIDS education and increasing public awareness through media campaigns.  Fighting discrimination against HIV-positive persons was an important element in the overall fight against HIV/AIDS.

ANDREI METELITSA ( Belarus) said his country’s strategic plan included prevention, treatment monitoring and evaluation, and involved many sectors of society.  Fifty-two anonymous consultation centres had been funded by the Government and the Global Fund.  HIV patients had access to free medication and children were provided special allowances.  Information about the dangers of HIV/AIDS and treatment to prevent mother-to-child transmission were also priorities.  Through such measures, Belarus had achieved coverage for nearly 73 per cent of the population.  Cases of infection were still increasing, though slowly, so it was important to dramatically scale up the response to HIV/AIDS, not only through more treatment, but also through the creation of integrated systems and strategic plans, both nationally and internationally.

ILAN FLUSS ( Israel) said his country was fortunate to have a low rate of HIV/AIDS, thanks to broad-based efforts and programmes.  Since 1981, Israel had maintained a national HIV/AIDS register, and health education programmes had been developed for both the general population and at-risk groups.  Confidential HIV testing was available at all community clinics around the country, free of charge, and Israel was enacting landmark legislation authorizing children to request AIDS testing, without needing the consent of a parent or guardian.

Regarding the fight against AIDS elsewhere in the world, he noted the feminization of AIDS in sub-Saharan Africa and stressed the need for extra attention on the gender aspects of HIV/AIDS.  The vulnerability of children was also a focus.  In March and April, Israel had hosted an international workshop on the care and support of children affected by HIV/AIDS, in cooperation with UNICEF.  Israel’s Centre for International Cooperation was hosting professionals from Nigeria for a course on sexual health and AIDS prevention for adolescents.  That course complemented other “train the trainer” programmes recently held in Israel, in cooperation with Uganda, Kenya and UNAIDS in West Africa, which encouraged participants to return to their communities to implement educational programming.

He said partnership between Governments and civil society was crucial to implementing the Declaration of Commitment.  Israel’s outreach extended to neighbouring countries, as well as faraway countries like Swaziland, where an Israeli non-governmental organization was training Swazi doctors in HIV/AIDS prevention.  Since the challenge of HIV/AIDS could benefit from the best practices of others, Israel looked forward to nurturing partnerships between developed and developing countries, taking account of all stakeholders and sectors in the process.

NEVEN JURICA ( Croatia) agreed with previous speakers that more needed to be done at national and global levels, since the challenges posed by the epidemic remained as great as ever.  In 1990, Croatia had established a committee for the prevention of HIV/AIDS, leading to the adoption of a national programme to address its related challenges.  Among its objectives had been to implement blood and blood-product safety measures.  A reference testing and treatment centre had also been established, and was targeted at vulnerable groups.  A national insurance scheme made antiretroviral treatment available to all infected persons.

He said he was conscious of his country’s proximity to parts of Eastern Europe that were seeing the fastest growing HIV rates in the world.  Being a transit country with an economy heavily reliant on tourism, Croatia was especially vulnerable to the fast spread of HIV/AIDS within its borders.  For that reason, the Government was working to raise public awareness of the disease, while at the same time engaging civil society in a national response to the epidemic.

With regard to combating stigma associated with HIV/AIDS, he said education campaigns were targeting teachers, students and at-risk groups who played a major role in implementing Croatia’s HIV/AIDS policy.  Much was also invested in coordinating the activities of the Government and the non-governmental sector.  Meanwhile, projects financed by the Global Fund helped educate high school children regarding the risks of infection.  WHO’s Regional Office for Europe had helped the Adrija Stampar School of Public Health in Zagreb to become one of three “knowledge hubs” in the region.  The hub conducted HIV/AIDS surveillance for the region, where more than a third of HIV/AIDS sufferers were still thought to be unregistered.  The school had also successfully taught 450 participants from 52 countries about monitoring the epidemic.

AKSOLTAN T. ATAEVA ( Turkmenistan) said that in Central Asia the expansion of trade and economic integration had caused AIDS to spread more rapidly.  AIDS, which was linked to drug addiction and tuberculosis, was one of the most dangerous scourges known to mankind.  The problem was also compounded by hepatitis and other infections.  Without strong measures, the prevalence of HIV/AIDS could negatively affect her country’s economy.  The Government had adopted a comprehensive approach to AIDS treatment.  In 1991, legislators had adopted a law to promote prevention of HIV-related infections.  Another law had been adopted in 2001 on preventing diseases caused by HIV.  In 2005, Turkmenistan had launched a five-year national programme on HIV/AIDS.  It had also set up an interdepartmental coordinating committee, comprising more than 29 ministries and organizations, as well as a national plan for monitoring and assessing measures to counteract HIV/AIDS and a 2008-2010 financing plan.

Further, she said, the country’s health-care industry had mandated HIV screening for Turkmenistan’s population.  AIDS prevention services had been made a priority, and the national prevention programme regularly held educational events to teach people about new treatment methods.  The country’s laboratories were given the capacity to carry out serious research.  Turkmenistan had also set up AIDS prevention centres for women, which provided anonymous treatment and condoms.  With support from UNDP and UNFPA, Turkmenistan had opened a national youth prevention centre and organized AIDS prevention events on International AIDS Day.  Turkmenistan had a single national strategy to achieve the goal of providing universal access to prevention, treatment, care and support by 2010.  She called for greater support to concentrate the world’s efforts on expanding scientific research on HIV/AIDS. 

CAMILLO GONSALVES (Saint Vincent and the Grenadines) said that, while the title of the high-level meeting was couched in optimistic terms, asking Member States to take stock of “progress achieved” in the struggle against the AIDS pandemic since 2001 –- and individual States and the wider international community had indeed made progress –- data revealed clearly the tremendous challenges that remained, with preventable and treatable new infections causing deaths in every corner of the globe.

For instance, he said, his country had a very low HIV prevalence rate –- just 0.4 per cent in the general population –- and its National Strategic Plan, which included a Care and Treatment Programme and a Mother-to-Child Advancement Programme, had increased the speed and effectiveness of the Government’s response to HIV-related trends.  Further, antiretroviral treatment, which had only become widely available in 2003, now reached some 86 per cent of patients.

At the same time, however, Saint Vincent and the Grenadines was among the countries worldwide experiencing an increase in the feminization of the pandemic, and while overall numbers remained low, it was clear that the virus was spreading faster than ever, he said.  Survival rates among those infected with the virus were unacceptably low, which, frankly, might account for his country’s overall low prevalence rate.

Noting that the Caribbean region had the second highest HIV prevalence rate in the world, he said that the region’s laudable success in addressing the “heart rending” cases of HIV/AIDS among mothers and children, begged the question as to why local governments had fallen short when it came to treating other arguably less sympathetic segments of society.  “We must be careful not to allow our deeply held moral convictions or entrenched social norms to dissuade us from wholeheartedly and non-judgementally confronting HIV/AIDS wherever it occurs,” he said, stressing that the war against the virus might reach a point of diminishing returns if the battlefield was not expanded to places where general health care and education were the weakest. Winning the war against AIDS required massively scaled up funding for health care, education and treatment, he declared.

NIRUPAM SEN ( India) said the National AIDS Control Programme in India was committed to ensuring universal access to HIV/AIDS prevention.  Seventy-five per cent of the programme’s budget was allocated for preventive services, particularly among high-risk groups such as commercial sex workers, injecting drug users, truckers and migrant workers.  Voluntary blood collections had increased and the capacity of blood banks to screen out infected blood was continuously being strengthened.  Treating sexually transmitted infections was given high priority and a target of treating 10 million cases had been set.  The country’s data collection capacity had also increased manifold, which was essential for the country’s large size and diversity.  Counselling and testing services, which had started in a few centres in 2000, were now provided in almost 5,000 facilities.  Annual testing had risen more than six-fold in the past two years to 7 million people.  An additional 3 million pregnant women were tested under the prevention of mother-to-child transmission programme.

He added that a comprehensive communication strategy on HIV/AIDS addressed stigma and discrimination, with particular attention on youth and women, often the worst sufferers.  A Government policy document on gender equality and a draft law on AIDS were being finalized, which would, among other things, address stigma and discrimination.  To ensure that no Indian died of AIDS due to lack of treatment, 140,000 citizens were receiving antiretroviral therapy and treatment for opportunistic infections.  Blood monitoring services to determine when HIV-positive people might require treatment were also free.  The Government had actively involved civil society in the war on HIV/AIDS.  He expressed concern over the fact that, globally, only 30 per cent of those who needed antiretrovirals were receiving treatment.  Indian generic antiretrovirals were a hundred times cheaper and more suited to the developing world’s special needs.

CARLES FONT-ROSSELL ( Andorra) noted that HIV/AIDS knew no borders, affecting everyone, regardless of age, sex, social class, culture or country of origin.  The world must stay vigilant against the disease, especially in sub-Saharan Africa, where the largest number of people was affected.  The situation must be remedied by concentrating international financial aid to that region.

As for Andorra itself, he said the national strategy was focused on spreading information on prevention among teens and young adults.  The Ministry of Health, Social Welfare and Family had elaborated a prevention programme for youth, with the objective of promoting good habits, cultivating a sense of responsibility among young people and combating prejudice caused by misinformation.  To reach a wide range of adolescents, the Government had decided to work with groups of youth trainers, in sport and recreation centres, parents’ associations and school centres.

Apart from its traditional contributions to UNAIDS fund and programmes, Andorra had financed four projects in sub-Saharan Africa, he noted.  His Government also attached great importance to the project put in place in Cameroon, together with UNICEF, aimed at providing psychological and social support to AIDS orphans and other vulnerable children.  He urged the international community to continue fighting endlessly against what he called “one of the main causes of death on the planet”.

AFELEE F. PITA ( Tuvalu) said that, despite his countries remoteness and size, it had not been spared the effects of HIV/AIDS.  Tuvalu had diagnosed its first case of HIV/AIDS in 1995, and since then, 10 other cases had been confirmed.  Since the population was only 100,000, that translated into one of the highest per capita prevalence rates in the Pacific region.  In response, Tuvalu’s Health Ministry had partnered with non-governmental organizations to form the National AIDS Committee, through which Government departments and community groups could work together to halt the spread of the disease.  The Committee had had some success, and the Government had adopted a comprehensive strategy through 2012.

He said that, even with those efforts, the Government still had some concerns, including inadequate diagnostics and monitoring of patients on antiretroviral medications.  Also, the ability to test for the virus was not readily available in Tuvalu, so requests for tests were being sent for processing elsewhere in the region, with an average turnaround time of two to four weeks.  “This remains a great challenge if we are to offer people living with HIV in our country with [full] treatment,” he said.  Among other challenges was ensuring predictable and timely financial support for national HIV programmes.  His Government was committed to setting aside resources annually to support its relevant programmes, but additional and ongoing assistance was needed from the Global Fund, as well as the United Nations and other donors, whose efforts had been instrumental in supporting national priorities, such as HIV management, treatment care and support, blood safety and diagnostics.

ROBERT AISI (Papua New Guinea) said his had been the fourth country in the Asia-Pacific region to declare a general HIV epidemic after the HIV prevalence rate among prenatal women had surpassed 1 per cent in 2002.  At the end of 2006, a total of 18,484 people were confirmed to be infected with HIV, due largely to unprotected heterosexual intercourse.  The prevalence rate had been projected at 1.61 per cent in December 2007.  In 1997, the National AIDS Council had been set up to coordinate a national response.  The Government had launched the 2006-2010 National Strategic Plan on HIV/AIDS.  Twenty provincial AIDS committees had been established in 2000 and, in 2003, Parliament had passed the HIV/AIDS Management and Prevention Act, which addressed human rights principles on stigma and discrimination, confidentiality, testing and criminalization of intentional transmission of HIV.  In 2004, the Government had incorporated the Millennium Development Goals into its Medium-Term Development Strategy, stressing HIV/AIDS as a development issue and not only a public health issue.  The Government had also made addressing HIV/AIDS a priority expenditure area in the next five years, and had set up a parliamentary committee on HIV/AIDS.

He said that Papua New Guinea had applied the “Three Ones” principle of the UNAIDS.  For the multisectoral response to be feasible, sector-based coordination mechanisms had been created.  The draft national prevention strategy dealt with high-risk settings, behaviour modification activities for youth, marginalized populations and high-risk groups, such as sex workers and men who had sex with men.  The draft prevention strategy also addressed family and sexual violence and women’s empowerment.  The Government had honoured its commitment to combat HIV/AIDS by increasing funding from 7 million Guinean kina in 2006 to 18 million Guinean kina in 2007.  Also, a programme to prevent mother-to-child transmission had been launched in 7 of the country’s 20 provinces. 

ALDO MANTOVANI ( Italy), aligning himself with the statement of the European Union, said the HIV/AIDS epidemic had begun in his country in 1982, with the rate of infection and death peaking in 1995.  Italy’s national programme included measures for prevention, treatment and support, as well as research into developing vaccines.  One vaccine was already being tested in Italy and South Africa.  At the international level, Italy had been among the founders of the Global Fund and had contributed €790 million to date.  Italy had always included representatives of civil society in its delegation to the Fund’s Board.

Turning to sub-Saharan Africa, he said that Italy had launched a joint initiative to fight HIV/AIDS in that region, to which it had contributed €12 million between 2002 and 2008.  It had also established a parallel initiative to monitor AIDS-related tuberculosis, with the goal of maximizing the use of Global Fund resources to improve the performance of local health-care personnel and to help build a functioning partnership at the country level. At the same time, Italy had entered into bilateral agreements with several countries in the region to help them implement their national programmes to monitor AIDS and tuberculosis.

He said that, when Italy held the presidency of the Group of Eight industrialized countries (G-8) next year, it would make the fight against epidemics one of its central themes.  It was open to new ideas on how to tackle the issue, particularly the situation of women within the context of HIV/AIDS.  In addition, the food crisis, rise in oil prices and climate change were causing significant repercussions for the fight against HIV/AIDS and the effectiveness of antiretroviral therapy.  The world must work towards a solution to those problems.

ANTONIO PEDRO MONTEIRO LIMA ( Cape Verde) said the struggle to combat HIV/AIDS in Africa was long and painful.  It was important to be positive and retain hope.  Since independence, Cape Verde had made development a top Government priority.  Since the first case of AIDS had been diagnosed, Cape Verde had organized to confront the epidemic.  The first survey of HIV had showed a 0.46 per cent prevalence rate.  Thanks to financial support from France, Brazil, the European Union, the World Bank, the United Nations and the Clinton Foundation, Cape Verde had been able to keep the prevalence rate under 1 per cent.  In 2004, it had introduced antiretroviral therapies.  It had also set up a unique coordinating authority, chaired by the Prime Minister, in line with the “Three Ones” principle, to address the HIV/AIDS epidemic.  Thanks to $9 million in 2002 from the World Bank, Cape Verde’s cross-cutting national response had reached “cruising speed” in 2004.

He said that Cape Verde now belonged to the list of African countries that had best carried out the struggle against AIDS.  It was providing antiretroviral therapy to more than 100,000 sufferers.  The increased number of epidemiological studies and social surveys, involving the public sector, academia and civil society, had made it possible to understand the epidemic.  Decentralized care was also a great asset.  Work must continue to consolidate that progress.  Citizens had been given greater ownership in terms of prevention, treatment, care and support.  The Government was striving to identify funding sources to fight the scourge and was working to form partnerships based on specific proposals.  The country’s economic and social needs must be taken into account when it came to accessing global funds.  Cape Verde had made judicious use of funds already provided.  Without them and additional funds, however, his country could have serious regressions in controlling the disease.  He stressed the importance of showing the world that it was possible for Africa to combat the epidemic.

HUGO SILES ALVARADO ( Bolivia) said his country had responded to the epidemic in fits and starts, resulting in lost opportunities for establishing an orderly process of epidemiological study of the disease.  In the past two years, the Ministry of Health and Sports, responsible for the national AIDS programme, had launched a brand new programme based on four pillars: strengthening management of HIV/AIDS; promoting healthy lifestyles; emphasizing traditional medicine and family health; and “social mobilization”.  As a result of the new programme, the country had improved clinical techniques in diagnosis, therapy and service provision in general.

He said a prevention and protection act, promulgated last year, had helped define the rights of vulnerable groups of various sexual orientations, helping them to become less marginalized with regard to access to care.  The country was now working to eliminate entry restrictions for HIV-positive people.

The Bolivian Government had embarked on a system to better manage funding earmarked for HIV/AIDS, making sure to establish harmony with contributions from international donors, he said.  An orderly system of funding helped guarantee the supply of medication, psychosocial support and other health “inputs”.  However, available funds in Bolivia were sill insufficient to roll back the epidemic any time soon.  The country also needed the more active participation of key actors in civil society to help educate the population with regard to HIV/AIDS, and to help improve the living conditions of HIV/AIDS sufferers.  Bolivia also faced the challenge of delivering care and education to its large indigenous population.

ALI’IOAIGA FETURI ELISAIA ( Samoa) said the gap between commitments and results in terms of universal access by 2010 were at best uneven, and at worst unmet.  Clearly, but sadly, the diplomatic rhetoric had not been matched by actual commitments on the ground.  The staggering and sobering statistics underscored the enormity of the challenges in combating HIV/AIDS and treating and caring for the 34 million infected people.  More frightening still was the fact that most people living with HIV remained unaware that they were infected.  With all that in mind, he stressed that achieving universal access to care, treatment and prevention by the target date required strong leadership and political support.

Still, he said, universal access in itself would provide no real comfort to HIV-positive persons, unless it ensured access to and the affordability of the drugs required for treatment.  Along with the overriding objective of ensuring accessibility to treatment at reasonable prices, it was also critical to provide prevention education, strengthen health systems, scale up resources and research, and promote a culture of tolerance and understanding about HIV and the people living with it.  “To postpone action another day is immoral and not an option […] we owe it to the millions of blameless victims worldwide who are too sick and helpless to advocate for their rights -- yes their rights -- that we act decisively now and with passion,” he declared.

Archbishop CELESTINO MIGLIORE, Permanent Observer of the Holy See, said it had provided about $500,000 for the purchase of antiretroviral medicine, through its Good Samaritan Foundation.  The Bishop’s Conferences had helped establish more than 100 centres offering treatment, care and support to AIDS patients in India, and would open another 45 in the most isolated areas.  The Bishop’s Conference in the United States, through its Catholic Relief Services, had supported approximately 250 projects in the poorest countries, at a cost of more than $120 million.

He said that 4 million people had been reached through the assistance of 10,000 workers and volunteers worldwide.  That number included people requiring nutritional care and support, as well as those needing antiretroviral treatment.  One third of that assistance had been provided free of charge.  The Holy See and its various institutions were also supporting greater access to affordable, reliable and life-saving HIV testing, antiretroviral treatment and mother-to-child preventative drugs and diagnostic technologies.  That support was being provided in the context of encouraging greater compassion and solidarity for all members of society.

SHIMELIS ADUGNA, Vice-President, International Federation of Red Cross and Red Crescent Societies (IFRC), said IFRC had been specifically mentioned in the Assembly’s 2001 Declaration of Commitment, and that acknowledgement had spurred the joint Federation to take additional steps to increase the reach and effectiveness of the contributions of its volunteers.  Those efforts had included, among others, advocacy directed at donors to appreciate the cost effectiveness of investing in recruitment, training and proper support of volunteers, and working with Government partners to ensure that an enabling volunteer environment maximized their national-level contributions.

He said that IFRC, among its other initiatives, was collaborating with WHO to produce eight training modules for both its volunteers and the outreach workers employed by health ministries in various aspects of prevention, treatment and care.  Those modules had already been successfully adopted in several countries.  The Federation was concerned about actions and initiatives that undercut the positive momentum towards fulfilling the Declaration of Commitment, including moves to criminalize transmission of HIV.

Experience had shown that such energy should be devoted instead to reviewing legislation that fed stigma and social exclusion, including travel and employment restrictions on people living with HIV, he said.  Overall, mobilizing the power of humanity was at the heart of Federation’s response to HIV, and all the State and National Societies had pledged to work together in that spirit to take direct action at the community and family levels.  Among other things, the IFRC Global Alliance on HIV aimed to double programming in targeted communities and reach at least 137 million people by 2010.

FERNANDO M. VALENZUELA, Permanent Observer of the European Commission, said sustainable and robust country-led responses to HIV/AIDS were key to future success in fighting the epidemic.  Such responses required long-term political leadership, continued investments and the greater involvement of people living with HIV and affected communities.  Recent progress in fighting AIDS was closely related to the steep increase in financing.  However, the gap between available resources and actual needs increased annually.  The European Union had already provided 60 per cent of global development aid and was strongly committed to providing more.  It was also committed to reaching the goal of providing 0.7 per cent of gross domestic product for official development assistance by 2015, with an interim collective European Union target of 0.56 per cent by 2010.  At least half of that increase would be allocated for Africa, the region most affected by HIV/AIDS.

He said the European Union was also committed to providing better aid, in accordance with the Paris Declaration.  It was moving from earmarked projected financing towards budget support and results orientation.  That change was critical to strengthening country ownership and providing fiscal space to strengthen social sectors and enabling countries to invest in recurrent costs, such as the salaries of health workers and teachers.  As called for in the 2006 Political Declaration on HIV/AIDS, the Commission and European Union members were introducing more predictable financing modalities, notably the “Millennium Development Goals Contract”.  The challenge was to ensure that partner countries had the political leadership, planning and management capacity, strong civil society involvement and accountability measures to make optimal use of those resources.  The European Union had provided 60 per cent of total contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, totalling €622 million, and had pledged another €300 million for 2008 to 2010.

LUCA DALL’OGLIO, Permanent Observer of the International Organization for Migration, noted the increasing awareness of the link between migration and health, which, in turn, touched on issues ranging from security, social welfare, global access to care and treatment, human rights and sustainability of health services.  Open dialogue would contribute to improved health outcomes for migrants and host communities, especially to avoiding discrimination and promoting inclusiveness for mobile populations.

He said that, while a large majority of countries had a national AIDS plan, they lacked specific measures to address vulnerabilities inherent in the migration process.  For example, migrant workers, especially undocumented migrants, were often exposed to particular risks of contracting HIV.  To effectively address those risks, employers, workers and other groups working with migrant populations and people living with HIV must work jointly with each other and with Governments to developed targeted policies.

His organization was engaged with the UNAIDS task team on HIV-related travel restrictions to address that issue, and hoped to submit a report soon, he said.  The Global Forum on Migration and Development, to be hosted by the Philippines in October, was expected to focus attention on how migrants could best contribute to development in countries of origin, as well as in host countries.  It was important that HIV/AIDS issues were included in those deliberations.

JAMES JENNINGS, Executive Officer, Inter-Parliamentary Union, addressing the role of parliaments in the fight against HIV/AIDS, began by noting that the Secretary-General’s report had made no mention of parliaments or parliamentarians.  Nevertheless, the work carried out in parliaments was fundamental to any successful programme in the field of HIV/AIDS.  After all, every agreement forged at the intergovernmental level, sooner or later, ended up on the table of the legislator for debate, possible amendment and adoption.  So too would laws directed at breaking the barriers of prejudice and fear surrounding HIV/AIDS, as well as budgets devoted to each country’s HIV/AIDS programmes.

He said that a briefing organized by the Inter-Parliamentary Union before the high-level meeting began had gathered more than 100 parliamentarians, which was evidence of parliamentary interest in the cause.  After a session with senior representatives of UNAIDS and UNDP, the parliamentarians had discussed the question of HIV-related travel restrictions and the need for more enlightened legislation in that field.  They debated their role in the intergovernmental process and the need for more leadership by parliamentarians on how the epidemic was handled within parliaments.

Touching on the accessibility of treatment for persons living with HIV/AIDS, he said they had agreed on the need to reform national intellectual property laws, so as to ensure that those included the flexibilities already provided for under the Trade-Related Aspects of Intellectual Property Rights (TRIPs) agreement.  The parliamentarians called on developing countries to discourage their Governments from entering into bilateral trade agreements that included provisions with more extensive patent protection than what was required under the TRIPs.  They cautioned against the criminalization of HIV transmission, while resolving to strengthen laws to eliminate discrimination and travel restrictions for HIV-positive persons.

ROBERT SHAFER, Permanent Observer for the Sovereign Military Order of Malta, said that an intensified, much more urgent and comprehensive response was needed to reverse the global HIV/AIDS pandemic and avert millions of needless deaths.  The percentage of HIV-infected pregnant women receiving antiretroviral therapy to prevent mother-to-child transmission had increased from 14 per cent in 2005 to 34 per cent in 2007.  While that increase was encouraging, children still accounted for 1 in 6 new HIV infections.  His organization sought to end mother-to-child transmission by providing access to screening, prenatal therapies and medicine.  For those already suffering from HIV/AIDS, it had set up medical and palliative care programmes in Central and South America, Africa and Asia.  The HIV epidemic required a sustained, long-term response.  His organization aimed to administer humanitarian aid in a sustainable way, by helping to create sustainable structures, not just address acute crises as they occurred.  It worked in HIV prevention and treatment, as well as to strengthen health systems at large.

He said the HIV/AIDS response must be part of a comprehensive strategy that addressed basic health care needs.  By offering regular health care, many illnesses could be prevented.  The health care paradigm could shift from treating acute problems to prevention.  His organization was working towards that goal through the creation of health-care centres and the provision of vaccines.  Acute shortages of health-care professionals impeded that goal, he said, stressing the need to build the capacity of community-based groups to help members of vulnerable populations gain access to essential health and support services.  It was vital to increase training of community health-care workers.  He commended the Secretary-General for drawing attention to the joint problem of tuberculosis and HIV infection.  Those two epidemics must be addressed together.  His organization had been working for decades to fight the spread of tuberculosis, and would continue to expand its projects in that area.

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