Sixty-third General Assembly

Plenary

90^th Meeting (AM)

Halting spread of hiv/aids will require far greater access to prevention services,

Treatment, care, support, say speakers as General Assembly concludes review

Postpones Action on Draft Decision on Issue;

Also Adopts Text Changing Peacebuilding Fund’s Terms of Reference

Halting and reversing the spread of HIV/AIDS by 2015 required far greater access to HIV prevention services and AIDS treatment, care and support than was currently available, General Assembly delegates stressed today, as they concluded their wide-ranging review of progress to date in fighting the pandemic.

Discussion throughout the two-day meeting, which heard a total of almost 50 Government and other representatives take the floor, centred on successes in, and obstacles to, implementing the 2001 Declaration of Commitment on HIV/AIDS and the follow-up Political Declaration of 2006.  Speakers today hailed from countries with varying degrees of HIV/AIDS prevalence, but urged a united front against a common threat.

Libya’s delegate stressed that the number of HIV-infected people was growing in poor African countries. The situation was compounded by the fallout from the current financial crisis and he called on donors to redouble their efforts to combat the disease.  Dealing with HIV/AIDS must move on parallel tracks, first concentrating on prevention efforts and then providing care for those infected.

Costa Rica’s delegate pointed out that countries that had registered positive results still needed access to international cooperation to make their achievements last.  The Global Fund to Fight AIDS, Tuberculosis and Malaria should pay more attention to the needs of middle-income countries.  Its criteria for resource allocation were based on indicators that showed an HIV prevalence of more than 1 per cent of the population in middle-income countries.  But, given the socio-epidemiological characteristics of HIV/AIDS, no country should be left out of an inclusive response.

The representative of Bosnia and Herzegovina said his country had low HIV/AIDS prevalence and, thus, was categorized a low-level epidemic country.  As such, it had an opportunity to monitor and establish control over such a lethal infection.  The Council of Ministers, in cooperation with the Joint United Nations Programme on HIV/AIDS (UNAIDS), had created a national advisory board to fight the disease.

Other speakers underscored that HIV/AIDS understood no borders, labels, cultures or religious traditions.  They noted that interventions must begin with alleviating stigma and discrimination.

Saint Lucia’s delegate reminded participants that the “sex worker” label often limited the ability to see someone as a whole person who, in most cases, had been trafficked, manipulated and sexually abused.  The current global response of legalizing sex work was inadequate and prioritized “safer sex” over the well-being of the person.  Policies that targeted demand for sex workers were a key starting point for addressing that problem.

A representative of the Inter-Parliamentary Union (IPU) said such action by a member of parliament could mean taking a courageous stand before an electorate that might have mixed views on ways to tackle HIV, or speaking out for groups that were disadvantaged as a result of prejudice, discrimination and ignorance.  She was concerned at the increasing tendency among legislatures to criminalize the transmission of HIV in certain circumstances.  Before rushing to legislate, careful consideration must be given to the possibility that some laws could stigmatize people living with HIV.

The Assembly deferred action on a resolution entitled “Implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS” (document A/63/L.73).

Statements in the AIDS debate were also made by Israel, Ukraine, Saint Kitts and Nevis, Nicaragua and Saudi Arabia, as well as the Observer for the International Organization for Migration (IOM).

Also today, the Assembly adopted a consensus resolution on the Peacebuilding Fund (document A/63/L.72), by which it noted the arrangements for the revision of the Fund’s terms of reference, as contained in the United Nations Secretary-General’s report (document A/63/818).  It urged all Member States to consider making voluntary contributions to the Fund.

Further, it requested the Secretary-General to submit an annual report on the Fund’s operations and activities and, further, to include in the annual report submitted to the sixty-sixth session, findings and recommendations from the next comprehensive independent evaluation.  Finally, it decided to include in the draft agenda of its sixty-fourth session an item entitled “Report of the Secretary-General on the Peacebuilding Fund”.

Introducing the resolution, India’s representative stressed that the Fund should be able to provide fast, short-term emergency funding to create “quick wins” in the early stage of peace consolidation.  Equally, it should provide catalytic funding to address the causes of conflict over the medium term.  The revised terms of reference would contribute towards that end.

Background

The General Assembly met this morning to resume its consideration of the implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS.

Statements

ILAN FLUSS (Israel) recalled the adoption of both the 2001 Declaration of Commitment and 2006 Political Declaration, since which incredible efforts had been expended to address the spread of HIV.  But, the goal to achieve universal access to treatment by next year was “beyond our reach”.  He found that alarming, especially since HIV/AIDS plagued five and a half million young people between the ages of 15 to 24 in 2007, nearly half of whom were girls living in sub-Saharan Africa.  Botswana was an exemplary model of how a national holistic approach derived from political recognition, will and decision to confront HIV/AIDS could deliver inspiring results.  The world must renew its commitments to halt the spread of HIV, and must direct its focus on women and girls in particular.

He stressed the importance of a comprehensive and holistic approach, saying it was important to provide preventive education for health professionals, teachers, community leaders and the youth ‑‑ an effort that Israel was fully committed to.  MASHAV, Israel’s international development agency, worked on training and capacity-building with partner countries, and had hosted participants from Cameroon, Nigeria, Côte d’Ivoire, Ethiopia and Kenya.  Topics included contraceptive use for adolescents, adolescent sexuality, interpersonal communication, gender stereotypes, sexual violence and abuse, and stigma and self-esteem.  Medical staff from Ethiopia benefited from MASHAV’s course on HIV Clinical Training on Antiretroviral Therapy, which addresses cultural, social, psychological and medical aspects of HIV with a focus on health professionals.

He said local, national and international partnerships were crucial, and partners could serve as a catalyst for positive achievements by sharing successful models and by communicating on prevention, training, capacity-building and direct care.  Israel was dedicated to partnering with other countries, especially in sub-Saharan Africa to mitigate and eventually eradicate HIV/AIDS.  It had a low rate of HIV/AIDS, with approximately 5,000 people living with HIV as of 2007.  That was due, in part, to cultural trends and broad-based efforts and programmes that included education, widespread and free testing and direct care.  Some services were community-based.  He said the international community must heed the Declaration of Commitment on HIV/AIDS that said “leadership involves personal commitment and concrete actions”.

YURIY A. SERGEYEV (Ukraine), aligning himself with the European Union Presidency, welcomed the Joint Inspection Unit report reviewing the United Nations’ progress in achieving Millennium Development Goal 6 (combating HIV/AIDS, malaria and other diseases), target 7.  The General Assembly’s twenty-sixth special session on HIV/AIDS and the high-level meeting to review progress in realizing the Declaration of Commitment on HIV/AIDS were important landmarks in achieving consensus on key HIV/AIDS goals.  Ukraine was among the countries that had initiated the historic special session and had since made significant strides in response to the epidemic.

He said Ukraine had made progress towards achieving universal access in preventing mother-to-child transmission of HIV and raising awareness of prevention measures, especially among children.  It also had taken steps to increase access to drug substitution therapy.  At the same time, Ukraine was well aware of the dangers of the disease and recognized the enormity of the tasks ahead.  The Government was deeply concerned by the rate at which the epidemic was spreading.  National authorities were working to translate international strategies into various national programmes, a task that required increased funding from the Government and consistent support from foreign partners.  “Victory in this fight can only be achieved through intensive work all over the world,” he said, urging more global support for the most affected countries and increased financing for research.  Policies and strategies to that end should include measures in the areas of prevention, universal access to treatment, care, support and affordable medicine.  Ukraine was eager to contribute to international cooperation in tackling the disease.

JAIRO HERNÁNDEZ (Costa Rica), aligning himself with the Rio Group, agreed that, one year from the deadline for reaching goals set in 2001 and 2006, there was much to be done.  The financial crisis had jeopardized achievements in many countries.  The link between underdevelopment and high HIV/AIDS incidence was a major obstacle in developing nations and he called for joint action to achieve universal access to prevention, treatment, care and support services.  Countries that had achieved positive indicators still needed access to international cooperation to make the achievements sustainable and the Global Fund to Fight AIDS, Tuberculosis and Malaria should pay further attention to the needs of middle-income countries.  Costa Rica had made important efforts in such areas as access to antiretroviral therapy, prevention of mother-to-child transmission and testing, but more had to be done to make those achievements sustainable.

The Global Fund’s criteria for resource allocation was based on indicators that revealed an HIV prevalence of more than 1 per cent of the total population in middle-income countries and of 5 per cent of vulnerable groups.  Given the socio-epidemiological characteristics of HIV/AIDS, no country should be left out of an inclusive response.  The imperative of protecting human rights was clear, not only in providing access to medical care, but in allowing for adequate levels of socio-economic development for those who lived with the virus.  A challenge lay in providing adequate protection for vulnerable persons like sex workers, drug users and men who have sex with men.  There were also worrying infection levels among adolescents and targeted prevention strategies were needed.  It was of the utmost importance that efforts to strengthen laws and social protection strategies ensure the welfare of those affected by HIV/AIDS.  Fighting the disease was a common task and collaboration among all sectors was essential in the pursuit of answers.

DELANO F. BART (Saint Kitts and Nevis) said his country was plagued with a high rate of HIV prevalence and the impact on various sectors of society was wide-ranging.  A responsible approach to the disease had resulted in a decline in the overall death rate, and greater access to antiretrovirals for people living with AIDS.  There was an increasing awareness of the need to reduce stigma and discrimination, and more professionals were being trained in AIDS-related fields.  But, despite his country’s best efforts, AIDS was still the leading cause of death among persons aged 15 to 44 years.  The rate of infection was increasing among women and men who had sex with men, and the Caribbean still had the second highest HIV prevalence rate in the world.

He noted that, since the high-level meeting on HIV/AIDS in 2008, the international community had been beset by a financial and economic crisis.  The United Nations had spent the last few months focused on addressing that crisis, as had the Bretton Woods institutions, international and regional organizations, and both powerful and developing States alike.  In the midst of that, it was important to maintain the same level of commitment expressed one year ago to combat AIDS.  At the 15 June meeting on advancing global health, convened by United Nations Secretary-General Ban Ki-moon, the Director-General of the World Health Organization (WHO) had suggested the same.  He commended the United Nations Secretary-General and the Director-General of WHO for the forum, and also commended the Joint United Nations Programme on HIV/AIDS (UNAIDS) for its leadership in the cause, especially in the movement towards universal access.

He said Saint Kitts and Nevis had called on Member States to renew their commitment to official development assistance (ODA), without which all progress ‑‑ on education, treating the sick, providing infrastructure to treat the sick, developing drugs and providing appropriate local legislation ‑‑ would be lost.  The number of people living with the illness had grown, which meant that additional resources would be needed to care for them.  In addition, Saint Kitts and Nevis endorsed the Department of Public Information’s role in creating public awareness.

IVAN BARBALIĆ (Bosnia and Herzegovina), aligning himself with the European Union, welcomed the significant progress achieved in combating AIDS, with the United Nations as a leading force and hub of joint action.  He congratulated all who had contributed to common efforts, saying that results would not be possible without cooperation between Governments and civil society.  Indeed, combating HIV/AIDS was among the highest priorities.  HIV infection was a threat to human security, making detection imperative.  Testing and antiretroviral treatment should be free and accessible to all.

Also, there was concern that the current financial and economic crises placed an additional burden on efforts to fight the disease, he said.  Bosnia and Herzegovina had a low HIV/AIDS prevalence, with the first AIDS case registered in 1986.  As it had been categorized as a low-level epidemic country, there was an opportunity to monitor and establish control over such a lethal infection.  The Council of Ministers, in cooperation with UNAIDS, had created a national advisory board to fight the disease.  The non-governmental sector had implemented awareness-raising campaigns and established cooperation with other international non-governmental organizations.  In that context, he attached the utmost importance to regional cooperation and noted that the third Balkan Regional Conference on HIV and AIDS was held in his country last year.  In closing, he said Bosnia and Herzegovina was fully committed to implementing the Declaration of Commitment on HIV/AIDS and the Political Declaration.

SARAH FLOOD-BEAUBRUN (Saint Lucia), noting that HIV/AIDS prevalence rates in the Caribbean were second only to those in sub-Saharan Africa, said her country’s epidemic was significant though not yet classified as “generalized”, as prevalence was not above 1 per cent.  However, any increase in poverty would increase social and economic vulnerabilities, and thus provide an environment for the epidemic to grow.  As such, her country’s very survival depended on winning that battle.  People in Saint Lucia took pride in their vibrant traditions, culture and practices and their primary concern was that the now concentrated epidemic would spread into the general population.

To prevent that crossover, Saint Lucia’s efforts had focused on encouraging delay in sexual debut, discouraging multiple concurrent sexual partnerships and promoting condom use, she said.  Through media and education programmes, the Government would continue to support the existing cultural value of committed relationships as an ideal, and work closely with both youth leaders and faith-based groups to prioritize delayed sexual debut.  Peer education would be a major vehicle for such prevention-focused messages.  As sex workers and men who have sex with men were at higher risk for HIV/AIDS, their acute needs had to be addressed in a “person-centred” approach.  The “sex worker” label often limited the ability to see someone as a whole person who, in most cases, had been trafficked, manipulated and sexually abused.  The current global response of legalizing sex work was inadequate and prioritized “safer sex” over the well-being of the person.  Policies that targeted demand for sex workers were a key starting point for addressing that problem.

As for men who have sex with men, interventions must begin with an alleviation of stigma and expansion of routine testing and counselling, she said.  The health benefits of committed relationships must be emphasized in the context of overall health.  She encouraged all States, especially those dealing with a concentrated epidemic, to join her country in confronting the social forces that tended towards poverty, malnutrition and susceptibility to chronic illness.  The person was at the centre of Saint Lucia’s response to HIV/AIDS.  Success could only come from solidarity among all actors in addressing people’s comprehensive needs.

JAIME HERMIDA (Nicaragua), aligning himself with the statement delivered by the Rio Group yesterday, said social injustice and poverty caused by the neo-liberal economic system had accelerated the spread of AIDS and other illnesses.  The fight against AIDS was, in turn, being exacerbated by the global economic and financial crisis, because States were being deprived of funds to support that cause.  For that reason, he called on developed countries to fulfil their commitment to provide official development assistance to developing nations, and to enable developing nations to implement national development plans that were free of conditionalities.  The close link between sustainable development and health and education had long been established; as such, there was a need for a multisectoral and multicultural approach to fighting AIDS that took on a human rights and gender perspective.

He said Nicaragua had developed a family-community health-care system, devoted to providing comprehensive care through the joint effort of community agents, health-care personnel and non-governmental organizations.  Through its health-care system, it was delivering antiretroviral treatment to the people that needed it, and was conducting activities to reduce the risk of infection for vulnerable groups.  Treatment was also being provided for sexually transmitted diseases more generally.  It was monitoring the spread of diseases, such as AIDS and tuberculosis through second-generation monitoring methodology, which had led to improvements in Nicaragua’s health indicators.  The governing body in charge of the national response was guided by a monitoring and evaluation plan that complied with the “Three Ones” programme on HIV/AIDS.

He said workshops were sometimes held in consultation with civil society and the private sector.  One of Nicaragua’s priorities was to seek strategic alliances with international corporations.  It was also trying to harmonize its actions with other nations, such as Brazil, Venezuela, Iran, Cuba and Mexico, and international agencies such as UNAIDS, United States Agency for International Development (USAID), United Nations Children’s Fund (UNICEF), United Nations Population Fund (UNFPA) and others.  There was a vast improvement is the diagnosis of AIDS in recent years ‑‑ where there was only one laboratory in 2003, there were 143 centres in 2008.  Those centres also provided counselling, comprehensive care, and guaranteed access to antiretrovirals for people living with HIV.

AHMED H.M. GEBREEL (Libya), aligning himself with the African Group, said interest in the AIDS pandemic must be translated into concrete action.  Despite progress in combating the disease, the number of HIV-infected people continued to grow, particularly in poor countries in Africa.  The disease’s spread in Africa was compounded by the present financial crisis.  As such, he called on donors to redouble their efforts to combat HIV/AIDS.  Dealing with the disease must move on parallel tracks, the first concentrating on prevention and the second providing the necessary care for those infected.

In addition, he said fear of the disease should not be directed at those infected by it.  They had rights and responsibilities and they must be educated about them.  They must understand how the disease was transmitted.  He urged caution not to mix non-discrimination measures with prevention measures.  Actions must take into account the cultural, social and religious factors of various societies to prevent the spread of HIV/AIDS.

OMAR ALI SALEH AL OYAIDI (Saudi Arabia) said his country had had a national programme to fight AIDS since 1986.  The medical laboratories were equipped to diagnose the virus and monitor its spread throughout the country.  Saudi Arabia was one of the financial supporters of the Global Fund to Fight AIDS, Tuberculosis and Malaria, increasing its contribution to $18 million in the 2008 to 2010 period.  It was currently focused on aiding low-income countries in their prevention efforts.

SAPANA PRADHAN MALLA, Inter-Parliamentary Union (IPU), said that one of the aims of parliamentarians was to push for more forthright parliamentary leadership in dealing with the AIDS epidemic.  That could mean taking a courageous stand before an electorate that might have mixed views on ways to tackle HIV, or speaking out for groups that were disadvantaged as a result of prejudice, discrimination and ignorance.  Indeed, the IPU was concerned at the increasing tendency among legislatures to criminalize the transmission of HIV in certain circumstances.  In the IPU, parliamentarians had made it clear that, before rushing to legislate, careful consideration must be given to the possibility that some laws could stigmatize people living with HIV.  There was also a need to remedy the shortcomings in legislators’ knowledge of issues connected to HIV and AIDS.  For example, in the context of universal access to antiretroviral therapy, parliamentarians needed to know and understand the problems connected with pricing, trade laws and distribution.  They needed to know why drugs did not reach people.  More information was needed on the multilateral property regime and its repercussions on access to medicines.

As part of its learning experience, she said the IPU had joined the National Assembly of South Africa to set up a regional training seminar for members of parliament on drug accessibility and affordability.  The question proved more intricate than the technicalities of World Trade Organization TRIPS (Trade-Related Aspects of Intellectual Property Rights) flexibilities, which were complex to being with.  Even when drugs were affordable, there were difficulties relating to storage and distribution.  Further down the line, there were complexities relating to compliance with prescription regimes and making sure that medicines were put to their proper use.  Another area where the IPU was taking action was on HIV-related travel restrictions, having adopted recommendations that would open the way to push for legislative reform and thus bring an end to discrimination.  HIV and AIDS was an eminently political question and, while welcoming the Secretary-General’s report, she could not understand why it made “no reference whatsoever” to the work done by parliaments.

ANKE STRAUSS, Liaison Officer, International Organization for Migration (IOM), said that, while progress had been made in several areas since the Declaration’s adoption, challenges remained, including in addressing the link between migration and derived health outcomes.  Migration itself did not equate to increased HIV risk; migration was complex and there were several types of mobile populations.  HIV prevention, care, treatment and support programmes must take into account the unique vulnerabilities of migrants.  Disparities between a migrant’s place of origin and destination often existed, particularly concerning health determinants, as did the circumstances that drove mobility, like poverty and violence.  Migrants often lacked access to HIV-related services, as they were often unaware of them.

She said more information was needed on HIV and population mobility.  Also, efforts to assist health systems to better capture data on the health of migrants and their use of services in a rights-based manner were urgently needed.  HIV and population mobility responses required multisectoral cooperation.  Within countries, that meant it was crucial to have open, multisectoral dialogue based on shared societal values, such as human rights, as well as sound public health principles.  Beyond national borders, it was equally important to ensure a multisectoral regional consultative process that brought together the migration, health and labour sectors.  Her organization looked forward to continued work with States, UNAIDS and other partners on issues related to HIV and migration.

Introduction of Draft Resolution

Resuming consideration of agenda item 101, the General Assembly had before it a draft resolution on the United Nations Peacebuilding Fund (document A/63/L.72).

Introducing that resolution, HARDEEP SINGH PURI ( India) said the text was the outcome of a process that began with discussions to identify Member States’ views on the Fund’s operation and relationship to the Peacebuilding Commission.  Those views were distilled into a non-paper that served as an input for the Secretary-General’s draft report on the Peacebuilding Fund.  The subsequent report became the point of departure for the draft resolution.  The purpose of the exercise was to ensure that revision of the terms of reference for the Fund would help improve its efficiency.

Indeed, the Fund should be able provide fast short-term emergency funding to create “quick wins” in the early stage of peace consolidation, he said.  Equally, it should be able to provide catalytic funding to address the causes of conflict over the medium term.  The revised terms of reference would contribute towards that end.  “The spirit of the revised terms of reference is as important as the text,” he said.  Revision was guided by two broad objectives:  enhancing the Fund’s capacity as a flexible, responsive resource for peacebuilding support, and maximizing the synergy between the Fund and the Commission through provisions for more transparency and consultation.

The Assembly then adopted by consensus resolution A/63/L.72 and concluded its consideration of that agenda item.

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