Sixty-seventh General Assembly

Plenary

84^th Meeting (PM)

General Assembly Meeting Welcomes Secretary-General’s

 

Recommendations for Meeting Targets on HIV/AIDS

 

Appointment of United Nations Conference on Trade and Development Head Confirmed

The General Assembly today welcomed the Secretary-General’s report on expediting United Nations efforts to bring the global AIDS epidemic fully under control, deciding to include that question as an item on the agenda of its sixty-eighth session.

He said that action on a draft decision titled “Implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS” would be taken at a later date.

Among his recommendations, Secretary-General Ban Ki-moon called for immediate implementation of specific steps to close the AIDS resource gap and allocate resources more strategically, while eliminating inequities in access to HIV-related services and integrating health and social protection services.

Addressing the meeting, he said the review was taking place almost halfway to the 2015 target date set by the Political Declaration, which established a new framework of shared responsibility and global solidarity.  Since 2011, the world had moved closer to its goal of no new HIV infections, no discrimination and no AIDS-related deaths, he said.  In more than 56 States, the pandemic had been stabilized and new infection rates reversed.  Globally, new HIV infections had declined by one fifth since 2001.  Treatment now reached more than half of all those needing it in low- and middle-income countries.  “We have made important progress to turn the tide on the HIV epidemic,” he declared.  “We are paving the way to achieve an AIDS-free generation.”

But more funding was vital, particularly for cash-strapped programmes to help key populations, including sex workers, men who had sex with men and drug users,to fully realize the global targets, he said.  Antiretroviral therapy must be expanded as a “human rights imperative and a public health necessity”.  The cost of treatment, which had fallen dramatically, must be lowered further.

Women and girls were still at unacceptably high risk for HIV, with a young women infected every minute, he continued.  Less than one third of children living with HIV received the treatment they needed.  Moreover, people living with the disease still faced widespread stigma, discrimination, gender-based violence and punitive laws.  “We all have to step up with courage and integrity to protect vulnerable members of our human family,” he said, calling on the approximately 45 countries and territories that continued to deny entry, stay and residence to people living with HIV to repeal such discriminatory laws.

Echoing that concern, Acting General Assembly President Rodney Charles (Trinidad and Tobago) stressed the importance of fulfilling the commitment to universal access to HIV prevention, treatment, care and support by making sure no one was criminalized, excluded or left behind.  He encouraged Member States to use today’s meeting as a “bridge” to the high-level September meeting on the Millennium Development Goals.  “By leveraging the AIDS response as an engine to advance progress towards achieving the other Millennium Development Goals and broader social and economic development, we can maximize the impact of the scarce resources and promote sustainable development for the post-2015 era.”

Discussing the state of the global epidemic and the Secretary-General’s related report, delegates welcomed the steady decline in new infections, notably in low- and middle-income countries, as well as the commitment of those nations to invest increased human and financial capital in combating the scourge.

Djibouti’s representative, speaking on behalf of the African Group, said the 2012 African Union road map on shared responsibility and global solidarity for AIDS, malaria and tuberculosis laid out a response plan to improve health governance, diversify financing and speed up access to affordable, high-quality medicines.

Similarly, Mozambique’s representative, speaking on behalf of the Southern African Development Community (SADC), said that, as one of the regions hardest hit by the pandemic, Southern Africa had scaled up its response as a regional priority, distributing condoms, conducting HIV testing and counselling, and enacting programmes to prevent mother-to-child transmission.

India’s representative joined the chorus of speakers calling for low-cost affordable treatment, noting that the high cost of antiretroviral drugs was a major obstacle to an AIDS-free world.  The Indian pharmaceutical industry had been plugging that critical gap by producing high-quality, affordable drugs for use domestically and in other developing nations, he said, adding that there were not enough second-generation antiretroviral drugs, especially since only 4 per cent of people receiving treatment had access to them.

Australia’s representative expressed disappointed that many programmes for key high-risk populations remained largely underfunded domestically.  Australia’s own “harm reduction” programmes for injecting drug users had yielded benefits; for every dollar invested in them between 2000 and 2009, an estimated four were returned in health-care cost savings and 32,000 infections were averted.  “We must all heed the call for a more strategic investment approach for the HIV response,” he said, calling for an end to ineffective programming and inefficient governance architecture.

At the outset of the meeting, the Assembly decided to appoint Larbi Djacta ( Algeria) to the International Civil Service Commission (ICSC), replacing Fatih Bouayad-Agha ( Algeria), who died recently.  Mr. Djacta’s term is effective immediately and runs through 31 December 2016.

The Assembly also decided to confirm the appointment of Mukhisa Kituyi (Kenya) as Secretary-General of the United Nations Conference on Trade and Development (UNCTAD) for a four-year term, from 1 September 2013 to 31 August 2017.

Also speaking today were representatives of Haiti (on behalf of the Caribbean Community), Russian Federation, Botswana, Ukraine, Zimbabwe, Armenia, Norway, Canada, Kenya, Bahamas, Japan, Sweden, France, Côte d’Ivoire, Thailand and the European Union delegation.

The Assembly will reconvene at 10 a.m. on Tuesday, 11 June, to conclude its debate on implementation of the Declaration of Commitment and the Political Declaration on HIV/AIDS

Background

Meeting this afternoon to consider the implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS, the General Assembly had before it a report of the Secretary-General titled “Accelerating the AIDS response:  achieving the targets of the 2011 Political Declaration” (document A/67/822).

Statements

Statements delivered on behalf of the following delegations could not be reflected owing to a lack of audio and interpretation at the Meetings Coverage Section’s work space:  Haiti (on behalf of the Caribbean Community), El Salvador, Russian Federation, Ukraine, Armenia, Canada, Japan, Sweden, France and Côte d’Ivoire.

ROBLE OLHAYE ( Djibouti), speaking on behalf of the African Group, said the continent’s commitment to addressing HIV/AIDS remained unwavering.  As a reflection of that commitment, Africa continued to put in place initiatives aimed at accelerating progress in response efforts.  They included the African Union road map on shared responsibility and global solidarity for AIDS, malaria and tuberculosis, adopted by Heads of State and Government in 2012.  It laid out a response plan to improve health governance, diversify financing and speed up access to affordable, high-quality medicines.  The recent African Union Summit had launched the first thematic accountability report on the “African Union-G8 partnership:  Delivering results towards ending AIDS, Tuberculosis and Malaria in Africa”.  It aimed to motivate greater leadership, particularly around issues of access to medicines, sustainable financing, human rights and gender equality.

The rate of new infections had declined or stabilized in many countries, and AIDS-related deaths had fallen by one third in sub-Saharan Africa as treatment coverage improved, he said.  Coverage in preventing mother-to-child transmission across the continent had increased from 15 per cent in 2005 to 54 per cent in 2009, and numerous behavioural indicators, including an increasing age at “sexual debut”, a decline in the number of sexual partners and greater use of condoms, were reporting favourable trends.  Still, there was a serious shortfall in resources, he said, adding that stigma and discrimination persisted.  Additionally, with access to treatment coverage in the sub-Sahara region at 56 per cent, the African Group urged developed countries to support the strengthening of health systems in the developing world, while reaffirming its determination to work towards an AIDS-free generation.

ANTÓNIO GUMENDE (Mozambique), speaking on behalf of the Southern African Development Community (SADC), said that, as one of the regions hardest hit by the pandemic, SADC had scaled up its AIDS response as a regional priority.  SADC members had adopted, among other things, the Protocol on Health, the Maseru Declaration on the Fight against HIV/AIDS and the SADC HIV/AIDS Strategic Framework, in addition to regional and national documents.  In line with the SADC Strategic Framework, the region continued to implement condom promotion and distribution, behaviour-change communication, HIV testing and counselling, safe medical circumcision, the mainstreaming of HIV/AIDS across all sectors and treatment to prevent mother-to-child transmission.  It had also implemented the Southern Africa Regional Programme on Access to Medicines and Diagnostics, aimed at promoting a more efficient, competitive market for essential medicines by supporting SADC pharmaceutical programmes and building the region’s capacity for pharmaceutical policy reform.  An HIV/AIDS unit had been set up within the SADC secretariat, he added.

SADC members had witnessed the positive impact of targeted investment in human and financial resources in support of those infected and affected by the pandemic, he said.  Recognizing the importance of strong partnerships with various development and financing institutions, as well as technical support to achieve universal access to HIV/AIDS prevention, treatment, care and support, SADC members had launched an initiative with global partners in March for accelerated action on tuberculosis and HIV until 2015.  Despite progress, however, the pandemic’s severe impact and the related tuberculosis epidemic threatened to reverse the hard-won development gains made in the SADC region over the past few years.  SADC members still needed urgent attention to HIV/AIDS prevention and social mobilization; improved care, counselling, testing, treatment and support; accelerated development and mitigation of the impact of HIV/AIDS; more resource mobilization; and stronger institutional, monitoring and evaluation mechanisms.

CHARLES THEMBANI NTWAAGAE (Botswana), associating himself with the African Group, said he was encouraged by progress in scaling up access to treatment, the decline in new infections, the increase in HIV testing and the regular use of condoms.  On the basis of those and other achievements, the vision of zero new infections, zero discrimination and zero AIDS-related deaths was achievable.  However, the world should not be lulled into complacency by those “seemingly impressive results”, he cautioned, emphasizing the continuing need for concerted international efforts to thwart the epidemic.  For example, there must be a redoubling of efforts to address barriers that undermined effective responses, such as those relating to law and policy, access to services, and the elimination of stigma and discrimination.  Committed and visionary leadership was also needed, as was predictable and sustainable funding, he said, underlining the need to ensure that HIV and AIDS remained a priority on the post-2015 agenda.

CHITSAKA CHIPAZIWA (Zimbabwe), associating himself with the African Group and SADC, said the impact of HIV/AIDS on health-care delivery in his country had been severe, reversing impressive gains in human and social development.  Increased infant mortality and reduced life expectancy showed the extent of that setback.  The health-delivery system’s capacity to cope was severely undermined by limited resources and competing priorities, while “brain drain” further aggravated the already dire situation.  However, the overall progress made since the adoption of the Political Declaration on HIV/AIDS showed that, with a more decisive escalation in financing, it might be possible to achieve near-zero new infections and 100 per cent antiretroviral therapy coverage for those already infected.  As for Zimbabwe’s progress in fighting the spread of HIV/AIDS, especially in a time of severe economic hardship, he said domestic resources had been mobilized through an AIDS levy, enabling the country to finance 31 per cent of its antiretroviral drug programme.  It hoped to allocate 15 per cent of the national budget to health by 2015, he said, underscoring the importance of assistance received from the Global Fund “over these difficult years”.

GARY QUINLAN ( Australia) said an estimated 850 people would be newly infected with HIV during the course of today’s meeting and more than 580 already sick people would die.  Key populations such as sex workers, injecting drug users and men who had sex with men were still disproportionately affected by the pandemic, and the barriers to treatment and service for them must be removed.  He congratulated low- and middle-income countries that had in the past year strengthened their commitment and leadership by increasing domestic resources for the HIV response, and encouraged others to follow suit.  However, he said he was disappointed that many programmes for key populations at higher risk remained largely underfunded domestically.

At-risk populations were at the centre of Australia’s own efforts, which included harm reduction and minimization programmes for injecting drug users, he continued.  For every dollar invested in such programmes between 2000 and 2009, an estimated four dollars were returned in health-care cost savings, and 32,000 infections were averted.  “We must all heed the call for a more strategic investment approach for the HIV response,” he stressed.  “We must work smarter and stop investing in ineffective programming and inefficient governance architecture.”  In July 2014, he said, Australia would host the twentieth International AIDS Conference in Melbourne, which would showcase examples of strategic investments that were producing real results for at-risk populations.

TINE MØRCH SMITH (Norway) said there was “no room for complacency” in respect of HIV/AIDS.  The epidemic was far from over and continued to grow in several countries, especially where it was driven mainly by drug use.  HIV-related work was entering a new phase in which there was a greater need to treat the epidemic as both an infectious and a chronic disease, she said.  With the generation of children who had lived with HIV all their lives now becoming adolescents, they needed sexual and reproductive health services so they could make smart choices regarding their own sexuality and fertility.  Young women especially needed access to family planning and other reproductive health services.  Norway still faced growing challenges relating to the growing incidence of HIV among men who had sex with men and to caring for immigrants living with HIV, she said.  Because of the associated stigma, the Government was focusing on issues relating to exposure, transmission as well as improving the penal code, through a national law commission and cooperation with UNAIDS.  Highlighting the active role played by people at high risk, as well as those living with HIV, she said it had led to substantive changes in the pricing of medicine, but there was still a need for greater participation, regardless of whether “they have made lifestyle choices that are not generally accepted”, or even legal in some countries.

ASOKE KUMAR MUKERJI ( India) said the adult HIV-infection rate in his country was close to 0.3 per cent, but in absolute terms the HIV-positive population totalled some 3 million.  The main aim of the national programme to combat HIV/AIDS was to halt and reverse the epidemic’s spread by 2015.  It involved scaled up efforts to target interventions at high-risk groups, strategizing on comprehensive information, education and communication packages for specific segments, and scaling up service delivery.  Since HIV/AIDS affected socioeconomic development, the aim was to fully mainstream prevention, care and treatment into all national schemes.  The Government had involved the corporate sector, non-governmental organizations and other stakeholders to that end, he said.

Access to low-cost affordable treatment was vital, he said, describing the high cost of antiretroviral drugs as a major obstacle.  The Indian pharmaceutical industry had been plugging that critical gap by producing high-quality, affordable drugs for use domestically and in other developing countries, he said, adding that the availability of second-generation antiretroviral drugs would not have a meaningful impact if low-cost generic products were not available on the market.  Only 4 per cent of people receiving treatment had access to second-generation medicines.  At present, India was meeting approximately 80 per cent of global antiretroviral drug demand, and was committed to using all flexibilities under the Trade-Related Aspects of Intellectual Property Rights (TRIPs) to ensure the availability of affordable, quality medicines for all people living with HIV.

KOKI MULI GRIGNON ( Kenya) said that over the past decade her own and other sub-Saharan African countries had shown that the epidemic could be contained through aggressive multisectoral community-level approaches driven by senior political leadership.  Kenya’s HIV prevalence rate had dropped to 6.3 per cent from more than 13 per cent in the 1990s thanks to such programmes in priority sectors, backed by effective legislative, policy and institutional frameworks.  The Government would continue to promote aggressive awareness campaigns and the expansion of voluntary counselling and testing, she said.  Despite the gains, however, HIV/AIDS remained a leading cause of death due to inadequate, unpredictable funding to sustain progress and bolster interventions.  To address that challenge, the National AIDS Control Council had devised a local funding mechanism modelled on public-private partnerships.

With an estimated 13,000 newly infected children in 2011, Kenya had also launched a national campaign in November 2012 to stop new infections among children by 2015, she continued.  It mobilized citizens, especially women of reproductive age, to access HIV prevention services, and provided preventive services for HIV-positive pregnant mothers.  Emphasizing that less expensive antiretroviral drugs were critical to universal access to prevention, treatment, care and support by 2015, she said one way to address that was to strengthen the capacity of low- and middle-income countries to develop and manufacture essential drugs.  In that regard, she welcomed the Global Fund’s declaration of support for locally produced essential medicines, adding that she looked forward to its supporting implementation of the Pharmaceutical Manufacturing Plan for Africa.

EUGENE GLENWOOD NEWRY (Bahamas), associating himself with CARICOM, said the region had seen the sharpest decline in new infections, with his own and a few sister countries witnessing a drop of more than 50 per cent.  That was due, in the Bahamas, to a prevention message targeting youth.  Prenatal antiretroviral therapy had resulted in the near-elimination of mother-to-child transmission, there had been no perinatal transmissions in 2010 and only two in 2011, both from mothers who had not followed prenatal antiretroviral treatment.  In 2011, 60 per cent of those in need had had access to the free treatment services offered by the Government, closing the gap further and decreasing the AIDS mortality rate.  However, tuberculosis remained a challenge among the HIV-positive population.  In addition, the ongoing financial resource challenges of low- and middle-income countries adversely affected their response.  Persistent and significant declines in international development assistance and unfair restrictions on access to

financial assistance, combined with the need for CARICOM Governments to divert limited resources to other pressing health challenges, were threatening the region’s socioeconomic development, he said.

NORACHIT SINHASENI (Thailand) said that, in pursuit of zero new infections and zero discrimination, his country had implemented a rights-based and gender-sensitive approach.  It was also experimenting with innovative pilot financing models, such as a “country prevention fund” to scale up its response.  It was unacceptable that some 7 million people lacked access to life-saving treatment, and even more appalling that access was lowest among children.  The Trade-Related Aspects of Intellectual Property Rights flexibilities were critical, as was preserving the availability of generic alternatives and increasing the capacity of low- and middle-income countries to manufacture essential medicines.  Thailand understood that in order to achieve the “3 zeroes”, it must enhance cooperation beyond its borders, he said.  With contributions from the Global Fund it had been able to provide prevention, treatment and care for migrant workers.  In November, it would host the Eleventh International Congress on AIDS in Asia and the Pacific.

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For information media • not an official record