Sixty-fifth General Assembly

High-Level Meeting on HIV/AIDS

Panel Discussion (AM)

Nobel Laureate Leads Strong Calls for Integrating Global Response into Broader

 

Health Agendas, as Panel Discusses Taking AIDS Out of Isolation

 

Former President: ‘Militants for Health’ Could Help Save 1 Million Lives by 2015

Francoise Barré-Sinoussi, 2008 Nobel Laureate in Medicine for helping to discover the human immunodeficiency virus (HIV), led strong calls at the United Nations today for integrating the global response to AIDS into broader health agendas, and for taking advantage of every opportunity to reach those living with HIV or at risk of infection whenever and wherever they interacted with local health-care delivery systems.

Ms. Barré-Sinoussi’s address was one of the highlights of the final panel discussion held in connection with the General Assembly’s high-level review of the 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration, which opened at Headquarters on Wednesday and wraps up later today.  The Panel’s focus — taking AIDS out of isolation and leveraging the response for broader health and development — set the stage for a lively debate that illustrated the impact of health outcomes on a range of issues, including social justice, women’s empowerment, tolerance and human rights.

Moderated by Laurie Garrett, Head of the Global Health Programme at the Council on Foreign Relations, the Panel was chaired by Gervais Rufyikiri, Second Vice-President of Burundi, and featured, alongside Ms. Barré-Sinoussi, Jorge Sampaio, Special Envoy of the Secretary-General to Stop Tuberculosis; Aditi Sharma of the International Treatment Preparedness Coalition; and Ragnhild Mathisen, Deputy Minister for Health and Care Services in Norway’s Ministry of Health.

“This needs to be done now,” Ms. Barré-Sinoussi said, drawing on nearly 40 years of experience as a virologist at the renowned Pasteur Institute, where her work and that of researchers from around the world formed the basis for unprecedented successes in HIV/AIDS-related treatment and care.  Yet, with those successes, HIV was becoming a chronic condition, and many people living with the virus still lacked access to treatment.  It was imperative, she emphasized, to build upon proven treatment models to optimize overall clinical health-care systems and efficiently extend the reach of services to tackle other illnesses such as tuberculosis and malaria.

Treatment of HIV/AIDS had itself contributed to the attainment of key Millennium Development Goals, including in the area of maternal and child health, she continued, cautioning, however, that further progress could stall behind discrimination against people living with the disease and the communities most affected by it.  Educating populations was therefore critical, as was empowering them with information about the disease and their rights and treatment options.  That was especially necessary for women and girls.  “It’s a responsibility for all of us, at all levels,” she stressed, calling on politicians, activists and international organizations to step up their efforts to put the lessons learned over the past 30 years at the service of those who needed the most help.

She went on to urge biologists and researchers to do better in communicating the impact of HIV/AIDS research on other health issues.  Indeed, over the years, antiretroviral drugs originally devoted to controlling the AIDS-causing virus had become critical in treating hepatitis B, and were showing “promising results” for treating hepatitis C.  Further, research on tuberculosis had improved because of the high number of co-infections with HIV, she said.  Many new tools and “very fancy” technologies used to treat HIV were now also helping in other health fields.  Still, as work towards finding a cure continued, and the collateral benefits that such research would certainly have became clear, “we all have to somehow become activists”, she said.

In a rousing address that echoed the call for activism, Mr. Sampaio, a former President of Portugal, said it was deeply troubling that stakeholders were still being forced to negotiate tuberculosis care into AIDS strategies and outcomes, especially when that disease was the major killer of people with HIV.  “How can we accept that a curable disease is killing people who have managed to live on antiretroviral medication?” he asked.  It was absolutely unacceptable that “every single minute three people living with HIV have their lives snatched away by tuberculosis, ‘a curable disease’”.  Between now and 2015, perhaps a million lives could be spared if the international community integrated and coordinated health services for HIV/AIDS, tuberculosis and malaria.

Such integration was particularly vital when there was an obvious scarcity of funds and health-care workers, he continued.  Screening for the disease must be carried out simultaneously, and health issues must be included in broader discussions about development.  “I ask you to try and become militants for health,” he said, urging the participants to return to their home countries with strong messages for political leaders about strengthening national health-care systems for the benefit of all.

“The answer is simple: just treat the people,” said Ms. Sharma, stressing that treatment must be at the core of efforts to integrate the response to HIV into broader health-care schemes.  Universal access to HIV treatment was a fundamental right and a public health goal, she said.  “Integrate, but not just for the sake of it, but to save lives,” she added, pointing out that in South-East Asia, research had shown that programmes geared towards HIV were beneficial when used to treat other diseases.  Sadly, research had also revealed higher numbers of deaths among HIV-positive people — especially women living with the virus — who were forced, out of fear, lack of information or lack of money, to shift between three or four different specialized health centres for treatment.

Ms. Sharma was among those who said that the speeches in the General Assembly Hall, as well as the substance of the outcome document to be adopted today, were out of touch with “both science and reality”.  Indeed, even as the national statements were delivered in the plenary, “we [have been] forced to listen to Governments that want to wish away the very people who most need treatment”, she said, citing sex workers, prisoners, men who have sex with men and migrants among those most blatantly ignored.

Such attitudes were most shocking because “it is so clear that the HIV strategies that are the most successful are the ones that are targeted at these groups from the very beginning”, she continued.  With that in mind, Ms. Sharma said the outcome document must go beyond naming just a few of those groups and express support for political action to protect and promote their rights, while ensuring universal access to treatment, prevention, support and care.

In his opening remarks, Mr. Rufyikiri said that while progress had been made in the fight against HIV/AIDS, the virus still took a serious toll on vulnerable populations, including the poor and those suffering from other diseases, such as tuberculosis.  “We must be able to reach out to all people living with HIV, adapt our responses, and integrate them into general health care,” he said.  In addition, he called for improved coordination among all health and development sectors to favour long-term responses, “much in the way we now manage hypertension and diabetes”.

He said that in many African countries, scaling up broader health-care programmes had led to the first large-scale HIV-response programmes.  Burundi’s own response had allowed the country to bolster its broader health system, leading to better research, application of new technologies and improved health-care centres.  “We must use an integrated approach that is based on people [and] following that approach, we will eliminate HIV/AIDS,” he said.  At the same time, it was clear that while Burundi and some other African countries had enjoyed success in changing HIV strategies, they were nevertheless hampered by a lack of resources that undercut their ability to attract and retain qualified medical professionals, afford the best medicines and tools, and rehabilitate outdated or inadequate medical centres.

Ms. Mathisen said donor countries certainly had a responsibility to work towards integrating not only health-care services, but to integrate health issues into the development agenda, especially in the run-up to 2015, the deadline year for realizing the Millennium Development Goals.  She also stressed that health-care systems must be strengthened, in order not only to treat diseases and provide prevention strategies, but also to teach people how to live with those diseases after they had been diagnosed.

Recounting her country’s experiences, she said the Government had spread responsibility for its HIV/AIDS strategy — “Acceptance and Coping” — among six different ministries.  She added that she was one of those who stressed that living with HIV was becoming a chronic condition and should now be treated as such.  Ms. Mathisen also called for a greater focus on the impact of HIV on people also coping with non-communicable diseases.

Among the audience members sharing their national experiences, a speaker from Senegal said his country’s Government had worked hard to usher in an era “from stigma towards integration”, with an emphasis on condom distribution and health programmes targeting sex workers and young people.  He also noted that the fight against HIV was a key element in the effort to improve global health.

Speakers from Mexico and Barbados urged a more focused political agenda that would strengthen not only national health systems, but also social systems with a view to improving responses to HIV/AIDS.  Specifically, the representative of Barbados said his country was grappling with the issue of attitudes in the realms of tolerance and behavioural change.

At the same time, he was among those who called for a broader examination of HIV/AIDS response systems that saw the disease as more than a health issue.  One way to do that would be to work more closely with civil society and the communities most impacted by the virus.  Many of the Government participants agreed that the components of a comprehensive health system would include strengthened leadership and management; a larger and better-trained workforce that would empower nurses and nurse practitioners, among others; improved research; and integrated health information systems.

Also participating in the discussion were representatives from South Africa, Russian Federation, Ukraine, Brazil, Thailand, Mozambique and India.

Representatives from the United Nations Office on Drugs and Crime, UNITAID and Médecins Sans Frontières also made interventions, as did other civil society stakeholders.

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For information media • not an official record