Despite Remarkable Achievement in Tackling HIV/AIDS, Disease Remains ‘a Global Crisis, Causing a Death Every Minute’, Senior Official Tells General Assembly
Despite notable progress in HIV/AIDS prevention and treatment worldwide, speakers today warned the General Assembly that the epidemic remains a global concern requiring greater collaboration among Member States, particularly in reaching the most vulnerable countries and populations.
Csaba Kőrösi (Hungary), President of the General Assembly, introducing the report of Secretary-General António Guterres (document A/77/877), expressed his heartfelt condolences to all whose lives have been affected or upended by the AIDS epidemic. AIDS response is indissociable from the realization of the 17 Sustainable Development Goals, but “we are lagging behind”, he stated. However, there is reason for optimism, as a diagnosis that was once a death sentence has been transformed into a manageable chronic health condition, and over the last two decades, antiretroviral treatment and pre-exposure prophylaxis have decreased infections by 50 per cent and deaths by 70 per cent.
In some places, he noted, HIV treatment and educational material is readily and freely available but in others, it remains a serious taboo — due to persistent gender inequality, insufficient funding and fragile public health systems. He stressed that the international community failed to deliver in the early years after the outbreak because of preconceptions of how the virus spread. “For too many, AIDS is still a life-or-death issue. But it should not be,” he stressed, urging Member States and stakeholders to renew their political and financial commitments.
Guy Ryder, Under-Secretary-General for Policy, noted that almost 29 million people across the world are receiving life-saving treatment, the global roll-out of HIV treatment averted an estimated 16.5 million AIDS-related deaths between 2001 and 2020, and in 2021, the estimated 1.5 million new HIV infections were almost one third fewer than in 2010. “This is a remarkable achievement in just 10 years,” he said — “yet AIDS continues to be a global crisis, causing a death every minute”. Ending AIDS as a public health threat is integrally linked to broader efforts on poverty, hunger and access to health care — but adverse global economic conditions have led Governments to change their financing priorities. “We can end AIDS, if we are bold,” he said.
In the ensuing debate, delegations pushed for greater cooperation in confronting the ongoing crisis, spotlighting its persistence in Africa, despite advances in areas including the percentage of people treated and knowledge of one’s HIV status.
The representative of Somalia, speaking for the African Group, said the bloc is pleased by the decline in AIDS-related deaths and new HIV infections, while spotlighting the expansion of tuberculosis and HIV services’ integration. Expressing disappointment that AIDS remains the fourth leading cause of death in Africa, he pointed out that other regions have also experienced an increase in annual HIV infections. He appealed for concrete interventions to increase HIV prevention, diagnostics and treatment, noting that the 95-95-95 targets should be achieved. Highlighting that gains against HIV have stalled due to faltering political will and failure to confront inequalities, he reaffirmed the right of people living with HIV to be free from stigma and discrimination.
South Africa’s delegate noted progress there, with more than 5.7 million people currently on treatment and, as of March 2023, 94.2 per cent of people know their HIV status. Among those in treatment, 92 per cent were virologically suppressed. Since 2021, compared with 2010, new infections in the country have declined by 51 per cent, one of the steepest declines in HIV incidence in the Eastern and Southern African region. However, he expressed despair that the COVID-19 pandemic has reversed progress towards ending AIDS as a public health threat by 2030 — target 3.3 of the Sustainable Development Goals.
The representative of Kenya said HIV/AIDS remains a leading cause of morbidity and mortality in her country. The rate of infections among young people between the ages of 15 and 24 years old remains a concern and threatens young people’s potential as drivers of economic growth. In 2020, youth accounted for 35 per cent of new infections. Young women and girls are disproportionately affected by HIV/AIDS, and it is crucial to prioritize their specific needs, as those aged 15–24 are twice as likely to be living with HIV as men in that age bracket.
The representative of Barbados, speaking for the Caribbean Community (CARICOM), said its member States are using a comprehensive approach to realize an AIDS-free Caribbean — and according to the latest statistics, 77 per cent of people living with HIV in the region are aware of their status and 81 per cent of those diagnosed with HIV are in treatment. The bloc celebrates that, in the Caribbean, death due to AIDS decreased by 37 per cent and new HIV infections have been reduced by 29 per cent since 2010. However, he regretted there has been no progress in developing a new HIV vaccine.
Sounding a note of alarm, Canada’s delegate stressed that people in the most vulnerable situations continue to be left behind, especially adolescent girls and young women, as well as the 60 per cent of children aged 5 to 14 who are HIV-positive and not taking life-saving antiretrovirals. Today, the world is home to the largest generation of young people ever: 1.8 billion people are under the age of 25, representing 16 per cent of the world’s population, but 27 per cent of new HIV infections. She urged every Member State to make brave political decisions that prioritize the lives of the most vulnerable.
Other delegates reminded the Assembly of the deleterious effect of unilateral coercive measures in fighting the epidemic. The representative of Cuba noted that in 2015, his was the first country to eliminate transmission of HIV and syphilis from mother to child. However, it has struggled due to the criminal economic and trade blockade imposed by the United States for over six decades. He stressed that between August 2021 and February 2022, the blockade caused losses of $386.5 million, and it was estimated that Cuba’s gross domestic product (GDP) could have grown by 4.5 per cent had the blockade not existed.
Similarly, Iran’s delegate stressed that unilateral coercive measures imposed on his country continue to hamper its efforts to enhance health systems and HIV/AIDS responses. Such “internationally wrongful acts” impede access to medicine, medical equipment, vaccines, treatment and pharmaceutical products and hinder international cooperation on health. “These illegal measures must be terminated,” he stressed. The representative of Nicaragua stressed that ending HIV/AIDS by 2030 requires the end of such measures imposed on more than a third of the world’s population, which prevent access to essential means for countries to continue advancing the rights of their people, especially the most vulnerable.
In other business, following the debate, the Assembly adopted, without a vote, the resolution titled “International Day of the Arabian Leopard” (document A/77/L.71). By its terms, the organ decided to proclaim 10 February the International Day of the Arabian Leopard and invited all Member States, the United Nations system, international and regional organizations, civil society, non-governmental organizations and other relevant stakeholders to observe that International Day as appropriate.
The Assembly also invited all relevant stakeholders to give due consideration to enhancing international and regional cooperation in support of efforts to conserve the Arabian leopard, given its vitality to the ecosystem of the Arabian Peninsula. The United Nations Environment Programme (UNEP) in particular is invited to facilitate the International Day’s observance.
The General Assembly will next meet on Wednesday, 14 June, at 10 a.m. to address the promotion of a culture of peace.
Declaration of Commitment on HIV/AIDS
CSABA KŐRÖSI (Hungary), President of the General Assembly, introduced the report of Secretary-General António Guterres (document A/77/877), expressing his heartfelt condolences to all whose lives have been affected or upended by the AIDS epidemic and who have lost their loved ones to the disease. AIDS response is indissociable from the realization of the 17 Sustainable Development Goals, as pandemic prevention, preparedness and response — whether in addressing AIDS, or COVID-19 — is a cornerstone of the 2030 Agenda for Sustainable Development, but “we are lagging behind”, he stated. However, there is reason for optimism, as a diagnosis that was once a death sentence has, through both science and solidarity, been transformed into a manageable chronic health condition, and due to antiretroviral treatment and the use of pre-exposure prophylaxis, the last two decades have seen infections decrease by 50 per cent and deaths decline by 70 per cent.
In some places, he noted, HIV treatment and educational material is readily and freely available but in others, it is difficult to acquire and remains a serious taboo. This is due to familiar culprits: faltering political will, persistent gender inequality, insufficient funding, fragile public health systems and the failure to redress inequalities. The AIDS epidemic is a public health crisis, but the breadth of the epidemic has long roots in homophobia, transphobia and discrimination. He stressed that the international community failed to deliver in the early years after the outbreak because of preconceptions of how the virus spread. At that time, AIDS was still “the disease that is hard to talk about”. As understanding of the disease shifted, so did the response, he noted, embracing universality, equity and inclusiveness — principles crucial to pandemic preparedness and response.
He cited concrete measures to better respond to HIV/AIDS: addressing the gaps in HIV prevention, testing and treatment services; ensuring adequate and equitable funding; implementing evidence-based programmes; and using the synergies between AIDS response, broader health goals and the whole 2030 Agenda. “For too many, AIDS is still a life-or-death issue. But it should not be,” he stressed, urging Member States and stakeholders to renew their political and financial commitments to ending the pandemic, with the Sustainable Development Goals Summit in September offering the best opportunity to make ambitious pledges.
GUY RYDER, Under-Secretary-General for Policy, said the report shows some great strides in the global AIDS response. Almost 29 million people across the world are receiving life-saving treatment, the global roll-out of HIV treatment averted an estimated 16.5 million AIDS-related deaths between 2001 and 2020, and in 2021, the estimated 1.5 million new HIV infections were almost one third fewer than in 2010. “This is a remarkable achievement in just 10 years,” he said, adding the victories show the power of strong political commitment, global solidarity, evidence-driven strategies and mutually supportive partnerships between affected communities and public authorities. “Yet we mustn’t take our foot off the pedal. AIDS continues to be a global crisis, causing a death every minute.”
As the international community approaches midway towards the endpoint of the Sustainable Development Goals (SDGs), global and local inequalities are blocking progress. Ending AIDS as a public health threat is integrally linked to broader efforts on poverty, hunger, governance and access to health care for all. These have all been badly affected by multiple crises, including climate change and the COVID-19 pandemic. Ending AIDS is also linked to progress on human rights and social inclusion, from gender equality to tackling discrimination and stigma.
Yet adverse global economic conditions have led Governments to change their financing priorities, with some reducing funding for programmes and services that help end AIDS. “Reversing this shortfall is critical,” he said, adding that this will help meet the targets set out in the 2021 Political Declaration on HIV and AIDS and is essential to supporting broader health system functions, including pandemic preparedness and response. Investments are needed in new medicines and technologies that help lower the cost of vital products. “We can end AIDS, if we are bold,” he said, advocating for programmes based on solid evidence, driven by data, and law and policies that protect the human rights of all. There will be three major meetings dedicated to health during the Assembly’s high-level week in the fall of 2023: on tuberculosis, pandemic preparedness and universal health coverage. All three meetings will draw on the lessons learned from the response to AIDS. He said one of the biggest lessons of all is that political will — supported by the needed resources — has the greatest power to deliver on health and development. “Our progress on AIDS is a blueprint for progress on all the SDGs,” he added.
Statements
ABUKAR DAHIR OSMAN (Somalia), speaking for the African Group, said the bloc is pleased by the decline in AIDS-related deaths and new HIV infections, while spotlighting the expansion of the tuberculosis and HIV-services’ integration. Expressing disappointment that AIDS remains the fourth leading cause of death in Africa, he pointed out that other regions have also experienced an increase in annual HIV infections. To this end, he appealed for concrete interventions to increase HIV prevention, diagnostics and treatment, noting that 95-95-95 targets should be achieved. In 2021, 6 million people were unaware of their HIV infection and therefore were not receiving treatment, he said, calling for upgrading national health testing at the local level. Highlighting that gains against HIV have stalled due to faltering political will and failure to confront inequalities, including HIV-related health-care needs of people in prisons, he reaffirmed the right of people living with HIV to be free from stigma and discrimination. To this end, international support should aim at strengthening national systems across the board and implementing evidence-based and data-driven programmes at the national level. Expressing concern over a low-coverage of pre-exposure prophylaxis, human papillomavirus vaccination, cervical cancer screening and treatment in low-income countries — mostly in Africa – he appealed for more research and innovation for HIV vaccines and a medicine cure.
SILVIO GONZATO, representative of the European Union, in its capacity as observer, noted the first case of AIDS was diagnosed over 40 years ago, and it has been more than 20 years since the ground-breaking special session of the General Assembly on HIV/AIDS and the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Important progress has been made, but the pandemic has reversed hard-won gains against HIV. In 2022, he noted, the European Union pledged €715 million to the Global Fund for the period of 2023-2025, and together with its member States, as Team Europe, the total amount is more than €4.3 billion. The Union is committed to mobilizing the private sector to support and align with the 2030 Agenda, and its Global Gateway initiative focuses notably on prioritizing the security of pharmaceutical supply chains and the development of local manufacturing, with over €300 billion in investments being mobilized to help support health investments. Applauding the Joint United Nations Programme on HIV/AIDS (UNAIDS) for its leadership role in sexual and reproductive health and gender equality, he called for greater ambition in living up to the commitments of the Political Declaration. While decades of experience and evidence show that intersecting inequalities are preventing progress towards ending AIDS, he noted that with new diagnostics, prevention tools and treatment, the international community can achieve the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.
FRANÇOIS JACKMAN (Barbados), speaking on behalf of the Caribbean Community (CARICOM), said its member States are doing their part to end the AIDS epidemic by 2030. These Governments are using a comprehensive approach to realize an AIDS-free Caribbean and ensure persons living with, at risk of, and affected by HIV/AIDS, are empowered to practise safe and healthy lifestyles. CARICOM underscores that accessible, equitable and high-quality laboratory and community-based testing services are central to its HIV response. According to the latest statistics, 77 per cent of people living with HIV in the Caribbean are aware of their status and 81 per cent of the people diagnosed with HIV are on treatment. And 80 per cent of the people in the Caribbean on antiretroviral therapy are virally suppressed. The bloc celebrates that, in the Caribbean, death due to AIDS decreased by 37 per cent and new HIV infections have been reduced by 29 per cent since 2010. He underscored the importance of science, technology and innovation in advancing the national AIDS responses and the need for technology transfer in order to scale up capacity-building, as well as research and development, in developing countries. “Without a commitment to global accessibility, availability and affordability of medicines for all, we will be limited in our ability to prevent, diagnose and treat HIV infections and its co-infections and co-morbidities,” he added, regretting there has been no progress in developing a new HIV vaccine.
DINESH SETIA (India) said that his country’s unique HIV prevention model is centred around the concept of social contracting, through which the Targeted Interventions Programme is implemented with civil society’s support. Moreover, India’s national AIDS Control Programme has been revised, revived and revamped to focus on hard-to-reach and at-risk populations, he reported, adding that viral load testing facilities have been scaled up, and HIV counselling, testing and screening have been ramped up to eliminate the mother-to-child transmission of the infection. The country is also providing free antiretroviral treatment to 1.4 million people, including drugs to HIV-infected persons in Africa. In line with the Government’s motto “Together, for everyone’s growth, with everyone’s trust”, the national AIDS Control programme has signed memorandums of understanding with the public and private sector. “India aspires to scale up HIV care to reach 100 per cent of people living with this dreaded disease,” he observed, adding that the Government has set up care centres to provide stigma-free and quality care through an integrated approach.
NEVILLE GETZE (Namibia) cited significant progress, as the roll-out of HIV treatment globally averted an estimated 16.5 million AIDS-related deaths between 2001 and 2020, and the latest data from UNAIDS show that new HIV infections and AIDS-related deaths have continued to decrease. However, inequitable access to life-saving treatment, including vaccines, continues to linger and has been exacerbated as an unfortunate legacy of the pandemic — further compounded by ongoing conflicts across the world — while domestic funding for the HIV response in low- and middle-income countries has fallen for two consecutive years. He noted ongoing discussions in New York and in Geneva on the pandemic accord, the amendments to the International Health Regulations and the political declarations to be adopted at the upcoming high-level meetings of the General Assembly on Tuberculosis, Universal Health Coverage and Pandemic Prevention, Preparedness and Response — a critical step in ensuring greater equity in the global response to public health emergencies. While the collective means, innovation and partnerships exist to prepare for pandemic risks and global health emergencies, including HIV and AIDS, he stressed, “it is our responsibility to effectively put these efforts into motion”.
NOAH OEHRI (Liechtenstein), noting that 85 per cent of people living with HIV globally know their serostatus — of which 88 per cent are accessing antiretroviral therapy — said that that 92 per cent of the latter have suppressed viral loads. He spotlighted the decline in new infections in sub-Saharan Africa – the region with the highest HIV burden — while reporting the infections’ increase in Eastern Europe and Central Asia. Underscoring the importance of removing societal barriers to services, including discriminatory laws targeting lesbian, gay, bisexual, transgender, queer, questioning and intersex (LGBTQI) people, he emphasized that the HIV/AIDS response should also include the epidemic’s impact on women and adolescent girls. Further, he pointed out that pre-exposure prophylaxis constitutes a prevention tool that can reduce infections among at-risk populations, calling for expanding its use and availability beyond high-income settings. Since 2007, Liechtenstein has made regular financial contributions to UNAIDS, he observed, adding: “by investing in prevention, we have the best chance to eradicate HIV/AIDS once and for all”.
NJAMBI KINYUNGU (Kenya), aligning herself with the African Group, said HIV/AIDS remains a leading cause of morbidity and mortality in her country and the Government has adopted a people-centred, data-driven and multisectoral approach to the HIV/AIDS epidemic. It has implemented the second phase of the Kenya AIDS Strategic Framework to provide strategic directions to accelerated progress towards a Kenya free of HIV infections, stigma and AIDS-related deaths. Great focus has also been placed on HIV education and awareness as important components of HIV prevention. The rate of infections among young people between the ages of 15 and 24 years old remains a concern and threatens young people’s potential as key drivers of economic growth. In 2020, youth accounted for 35 per cent of new infections. Young women and girls are disproportionately affected by HIV/AIDS, and it is crucial to prioritize their specific needs in the response to the epidemic. In Kenya, young women aged 15–24 are twice as likely to be living with HIV as men in the same age bracket. “It is paramount that we prioritize the socioeconomic empowerment of individuals and communities affected by HIV and AIDS,” she said.
PATRICIA SOARES LEITE (Brazil) voiced concern that despite the remarkable progress, overall figures are not declining fast enough to reach global goals and targets. She endorsed recommendations for strengthened collective actions with a focus on equitable and affordable access to medicines and other health technologies; engagement with the community; sustainable financing; and international cooperation. Brazil has consistently progressed in the prevention and care with its Unified Health System, which guarantees universal and free access to treatment and diagnosis, with more than 700,000 people being assisted with free antiretroviral drugs. Noting that upper-middle-income countries such as Brazil are often not eligible for price reductions, and for affordable new products, she called for equitable and affordable access to medicines and other health technologies, so that all developing countries can provide innovative and effective diagnostics, prevention and treatment to their populations and reach everyone, everywhere. Any discrimination against people living with HIV and AIDS is a crime in her country, with a federal law guaranteeing the confidentiality about the condition in schools and workplaces. She recalled that Brazil has donated medicines and tests to several countries in Latin America and the Caribbean and is a founding member of the Global Council on Inequality, AIDS and Pandemics.
YAHYA AREF (Iran) said that his country has made significant progress in promoting the health and well-being of people at risk of or living with HIV, as well as in eliminating the disease transmission from mother to child and reducing AIDS transmission among drug users. However, unilateral coercive measures imposed on his country continue to hamper its efforts to enhance health systems and HIV/AIDS responses. Such “internationally wrongful acts” impede access to medicine, medical equipment, vaccines, medical commodities, treatment and pharmaceutical products and hinder international cooperation in the area of health. “These illegal measures must be terminated,” he stressed, adding that States must refrain from promulgating and applying such unlawful measures. He further reaffirmed the sovereign right of States in adopting and implementing policies and programmes related to health in accordance with domestic laws, national and development priorities, as well as religious, ethical, cultural and social specificities of their people.
JAIME HERMIDA CASTILLO (Nicaragua) noted his Government’s State policy provides quality comprehensive and universal care through free treatment and complementary examinations. National institutions prioritize the implementation of action policies aimed at groups of young people and adolescents to reduce infection rates and promote responsible sexual health. He noted that in 2006, Nicaragua had seven care clinics, but in May 2023, there are now 117, distributed throughout the country with multidisciplinary teams, doctors and nurses guaranteeing access to comprehensive, dignified and free medical care for approximately 6,800 people receiving antiretroviral treatment and an estimated 9,000 people with HIV. The Government has further developed a new strategy, “Living with HIV”, promoting fundamental values. To end HIV/AIDS by 2030, he stressed the urgency of ending the illegal unilateral coercive measures imposed on more than a third of the world’s population, which prevent access to essential means for countries to continue advancing the rights of their people, especially the most vulnerable.
XOLISA MFUNDISO MABHONGO (South Africa), aligning himself with the African Group, said his country has made notable progress with respect to its HIV prevention and treatment programme, with more than 5.7 million people currently on treatment. The latest data, as of March 2023, shows that 94.2 per cent of South Africans know their HIV status, and 75 per cent of people diagnosed were on treatment, which translates to a 71 per cent antiretroviral therapy coverage. Among those on treatment, 92 per cent were virologically suppressed. Since 2021, compared with 2010, new infections in the country have declined by 51 per cent, one of the steepest declines in HIV incidence in the Eastern and Southern African region. He expressed despair that the pandemic has reversed progress towards the Global Goal target of ending AIDS as a public health threat by 2030. The pandemic led to the worst economic downturn, which severely constrained public health budgets as resources were diverted to combating the virus. “That should be a wake-up call to develop a strong binding mechanism for pandemic prevention, preparedness and response, while also ensuring universal health coverage with the aim of addressing inequalities and fostering international cooperation and solidarity in addressing issues of global concern,” he said.
TITHIARUN MAO (Cambodia) said that his country’s national AIDS authority has been advocating for engaging community members, key populations and local and community-based organizations in HIV/AIDS response. Although the pandemic has hindered the Cambodia’s response to HIV/AIDS and other epidemics, the country has made progress to pre-pandemic baselines. Committed to a multisectoral response to AIDS, including its decentralization to subnational levels to ensure ownership of provinces, districts and communes, the Government has also increased fiscal space and social protection to reduce stigma and discrimination for adolescents, women and girls. “Eliminating stigma and discrimination in all aspects of society will substantially reduce the vulnerability of people living with HIV,” he observed, urging the international community to allocate more resources to fill HIV/AIDS financial gaps, including in technology transfer and improving access to medicine in developing countries. He also called for scaling up capacity-building, research, development and local pharmaceutical products.
SAMUEL ISA CHALA(Ethiopia), associating himself with the African Group, noted that an estimated 60.5 million AIDS-related deaths were averted in the past two decades, while almost 120 million HIV infections have been averted since 1990 through the increased use of condoms. Citing progress in sub-Saharan Africa, with the steepest reduction of new infections since 2010, he recalled that Ethiopia’s HIV prevalence decreased from 3.3 per cent in 2000 to 0.9 per cent in 2017. However, those gains are challenged among young people, which is concerning given over 30 million Ethiopians are under the age of 25. He noted that Ethiopia was one of 25 countries selected for the Global HIV Prevention Coalition, but challenges persist, including a lack of skill and quality of prevention programmes, as well as structural barriers. He called on the international community to scale up HIV prevention responses and resource mobilization and build partnerships among key stakeholders to enhance current momentum.
PORNRAWE POENATEETAI (Thailand) said that HIV-related services must be integrated into the universal health coverage system, while noting that her country is looking to include self-testing kits in its universal health coverage. Expressing support for community-led responses, she spotlighted the importance of population-led efforts, supported by the Government, in addressing HIV-related stigma and discrimination that is often felt in traditional health facilities. In this context, Thailand has rolled out a national community health worker certification on HIV/AIDS care, including a training to overcome stigma and promote understanding of “U=U” [undetectable equals untransmissible]. Recognizing the potential of leveraging digital technology to address discrimination, Thailand has developed an online crisis response system “Hello, POKPONG” for filing complaints on rights violations related to HIV/AIDS, including tests for employment. “As the world is now moving on from the response to the recovery phase of COVID-19, we need the same political will and sense of urgency to end AIDS,” she stressed.
TANYA HINTON (Canada) noted people in the most vulnerable situations continue to be left behind, especially adolescent girls and young women, as well as the 60 per cent of children aged 5 to 14 who are HIV-positive and not taking life-saving antiretrovirals. Today, the world is home to the largest generation of young people ever: 1.8 billion people are under the age of 25, representing 16 per cent of the world’s population, but 27 per cent of new HIV infections. She further noted that globally, AIDS-related illnesses remain the leading cause of death among women of reproductive age, with millions of young women continuing to contract HIV due to stigma and lack of resources. She noted that 90 per cent of the 1.8 billion young people in the world live in developing countries, where they often make up a large proportion of the population — for example, the median age in Niger and Uganda is 15 years old, demonstrating the need for youth-centred and integrated programming. According to United Nations Educational, Scientific and Cultural Organization (UNESCO) data, 85 per cent of 155 reporting countries have policies or laws about the provision of comprehensive sexuality education in schools — and yet, survey data from sub-Saharan Africa (2015–2020) show that only 38 per cent of youth (15–24 years) had comprehensive knowledge about HIV. She urged every Member State to make brave political decisions that prioritize the lives of the most vulnerable when designing local, national and international health interventions.
YURI ARIEL GALA LÓPEZ (Cuba) stressed that the clear impact of the pandemic should not translate into neglecting efforts to target HIV/AIDS. His Government has designed a public health approach focused on primary care and key populations, making progress in eliminating discriminatory stigma, gender stereotypes and sexist behaviour patterns and protecting sexual diversity. In 2015, Cuba was the first country to eliminate transmission of HIV and syphilis from mother to child as verified by the World Health Organization (WHO). He noted deaths due to AIDS are decreasing, with high levels of coverage for treatment and efforts to increase therapeutic levels to reach the 1990 goal. However, he emphasized that Cuba has had to overcome its status as a small island developing State, as well as the criminal economic and trade blockade imposed by the United States for over six decades. He stressed that between August 2021 and February 2022, the blockade caused losses of $386.5 million, and it was estimated that Cuba’s gross domestic product (GDP) could have grown by 4.5 per cent had the blockade not existed. Those measures further hamper UNAIDS efforts, and a real solution to HIV/AIDS will depend on international community solidarity and multilateralism.
KARA EYRICH (United States) said the report confirms that persistent inequities threaten progress for children, young women and girls and other at-risk populations, such as LGBTQI+ persons, people who use drugs and sex workers. Too many countries still have fragile and insufficiently resourced public health systems, making it difficult to offer services beyond HIV/AIDS treatments and undercutting the capacity to respond to emerging threats. Her delegation remains committed to ending the HIV epidemic at home and around the world. It rededicates itself to fighting the discrimination that frequently keeps people with HIV from obtaining needed services and living full lives. The international community cannot and must not lose sight of the very serious work still required to end the global HIV health epidemic by 2030. She noted that the United States President’s Emergency Plan for AIDS Relief (PEPFAR) is a partnership within the United States and with global partners, including UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Partnerships have brought considerable progress to ending the HIV/AIDS epidemic, yet the global response needs adequate resources to succeed in its mandate.
MARY RENWICK ANDERSON (United Kingdom), noting that her country remains a dedicated supporter of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Unitaid and UNAIDS in HIV response, said that its pledge of £1 billion to the Global Fund will help to save over 1 million lives in the next three years; provide antiretroviral therapy for 1.8 million people; and support HIV prevention programmes for 3 million members of key populations. Turning to the Secretary-General’s report, she drew attention to the recommendation addressing the importance of social, structural and systemic factors driving HIV-related inequalities. “If we are to truly end the AIDS epidemic, we have to tackle the inequalities that underpin it,” she stressed, calling for supporting rights-based models of key populations and LGBTQI people. Increasing barriers to HIV services through stigma, discrimination and criminalization discourage people from seeking vital health services for fear of attack or punishment, she observed, adding that this puts HIV response in jeopardy for all communities.
SYLVIA PAOLA MENDOZA ELGUEA (Mexico) called on the international community to ensure that it has learned from the fight against other pandemics, as well as from the coordination of objectives centred on people and communities. It is clear that care must consider social determinants, such as the stigma of discrimination and barriers to access to health, prioritizing those who are being left behind. Information must be promoted that measures health outcomes and takes into account different characteristics or conditions of people, optimizing strategies at the local, district, state and national levels. In the fight against HIV and tuberculosis, efforts cannot be suspended due to disasters caused by human beings, natural risks or other health emergencies. This must include supply chains that avoid shortages, as well as the protection, training and optimization of health workers. She emphasized that her country works in collaboration with the United Nations Population Fund (UNFPA) and carries out mobile sexual and reproductive health projects for people in transit along the migration routes of the Mexico-Guatemala border.
DMITRY S. ARISTOV (Russian Federation) said that HIV/AIDS incidence in his country is dropping, while prevention and treatment measures are helping to extend life expectancy of those infected with HIV. Moreover, the Russian Federation has one of the highest HIV testing coverages, which enables the illness to be identified in the early stages. Despite the country’s medical successes, it faces attempts to misrepresent its HIV statistics, he noted, reporting UNAIDS “alleged data” included the Russian Federation among the world’s highest countries in terms of HIV spread. Such reporting is “not accurate” he stressed, adding that it is yet “another propaganda and provocation” against his country. The Russian Federation has its own programme to combat HIV and finances it independently from the federal budget, unlike many countries, which — as a rule — use grants provided by international organizations. Turning to the Secretariat’s report, he pointed out that instead of internationally agreed approaches, it continues to impose comprehensive sexuality education. This poses a risk to the preservation of public health, protection of children and families, and combating narcotics use, he observed.
CHRISTIAN SCHLAEPFER (Switzerland) said the progress achieved towards ending AIDS as a public health threat by 2030 is not universal. The inequities that fuel the HIV/AIDS pandemic, particularly those affecting women, especially adolescent girls and young women in high-burden regions, and the stigma, discrimination and violence associated with HIV, are deeply concerning. “These shortcomings are a stark reminder of the significant barriers that still need to be overcome,” he said. Switzerland calls for an urgent collective response that includes a focus on prevention and evidence-based policies. This encompasses prevention measures with comprehensive sexual education, promoting the use of protection and providing harm reduction services to drug users. Promoting human rights and health equality is also important, and there is an urgent need to eliminate all forms of discrimination against people living with HIV/AIDS and protect their rights. A multilateral and multisectoral approach is necessary to enhance global cooperation and partnerships.
XU DAIZHU (China) cited an array of domestic approaches to HIV/AIDS, including accessibility of testing and follow-up treatment, nucleic acid testing and prevention of mother-to-child transmission and treatment assistance. Noting significant progress worldwide in the global AIDS response, she recalled the number of HIV infections keeps declining, with the number of new cases in 2021 being the lowest since 1980. However, the epidemic still represents a significant scientific, social, economic and political impact, requiring greater efforts from the international community. China is focusing on improving its national HIV response strategy and the protection and treatment of affected people and supports the United Nations system, particularly UNAIDS and WHO, in strengthening and promoting international community cooperation and sharing technologies and experience towards ending the global epidemic.
MICHAEL M. ESPIRITU, Sovereign Order of Malta, noting that HIV remains a global pandemic, cited Sollicitudo Rei Socialis by Pope John Paul II: “We must face squarely the reality of innumerable multitude of people — children, adults and the elderly, in other words, real and unique human persons, who are suffering under the intolerable burden of poverty.” The Order of Malta is committed to supporting the poorest and the most marginalized, he said, reporting that it has continued to combat the HIV pandemic globally through treatment, prevention and education programmes. In South Africa, the Order’s Cure Centre provides free testing and antiviral drugs for HIV-infected people, while also running a home in Mandeni for children made orphans by the spread of HIV/AIDS. In Kenya, the work of the Order’s relief agency since 2001 has focused effort on tuberculosis and HIV/AIDS diagnosis, prevention and treatment among the people living in Nairobi’s slums and various tribal groups. In Mexico City, the Order continues to run HIV transmission prevention programmes, while also managing courses for mothers and fathers; providing psychosocial counselling; and offering food supplements and hygiene kits for mothers and children.
ERICK NIDAL THOMAS, International Federation of Red Cross and Red Crescent Societies, said the global community must fully commit to achieving universal health coverage. The core concepts of this coverage — universality, non-discrimination, quality, access and protection from financial hardships — are key to unlocking access to HIV services. “…we must end inequalities to end AIDS”, he said. Every individual, regardless of their background or circumstances, must have access to HIV prevention and treatment. The programmes to support people living with or affected by HIV, including in humanitarian and fragile situations, need to target the needs of the most vulnerable — including migrants, refugees and crisis-affected populations. People living with HIV should be at the centre of the HIV/AIDS response and local organizations can best identify and respond to their communities’ specific challenges and opportunities to reach people in the last mile. There must be a commitment to driving innovation in HIV prevention, treatment and care, backed by sustainable investment, including in the current health political declarations.
MITCHELL FIFIELD (Australia), emphasizing that there is still more to be done, pointed out that there were 6 million people living with HIV in the Asia and Pacific region, with infection rates rising for the first time in a decade. Spotlighting his Government’s global and domestic efforts to reduce transmission, deliver effective treatment and minimize impacts, he underlined that supporting human rights, involving key populations and addressing both stigma and discrimination have been key elements of its response. He then voiced his concern that it has become more difficult to reach consensus on the issues of sexual and reproductive health and rights, as well as on ending stigma and discrimination. “We have the tools to address this epidemic and we know what works: partnerships between Governments, affected communities, researchers and clinicians, together with evidence-based programmes targeting key populations,” he said, urging all to galvanize efforts.
Sustainable Development
ABDULAZIZ M. ALWASIL (Saudi Arabia) — introducing the draft resolution titled “International Day of the Arabian Leopard” (document A/77/L.71) also on behalf of Bahrain, Jordan, Oman, Qatar, Kuwait, United Arab Emirates, Morocco and Yemen — said that the Arabian leopard represents beauty, serenity, physical strength, courage and freedom and has occupied a special status in the region for thousands of years. His Government has paid considerable attention to their protection and conservation by seeking to rescue them from extinction and secure their place in the wild. The proclamation of 10 February as an International Day would focus on the threats facing Arabian leopards so that the international community will rehabilitate ecosystems, spread awareness on conversation and increase both knowledge and long-term rescue plans, he stressed.
Ms. MENDOZA ELGUEA (Mexico) — speaking in explanation of vote before the vote on behalf of her country, as well as Argentina, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Panama, Paraguay and Peru — underlined the importance of regional cooperation to prevent and reverse the loss of species and their habitats. In that regard, she spotlighted an example from her region and called for increased actions and commitments at the international level to address the decline of biodiversity worldwide.
The Assembly then adopted “L.71” without a vote.
By its terms, the organ decided to proclaim 10 February the International Day of the Arabian Leopard and invited all Member States, the United Nations system, international and regional organizations, civil society, non-governmental organizations and other relevant stakeholders to observe that International Day as appropriate.
The Assembly also invited all relevant stakeholders to give due consideration to enhancing international and regional cooperation in support of efforts to conserve the Arabian leopard, given its vitality to the ecosystem of the Arabian Peninsula. The United Nations Environment Programme (UNEP) in particular is invited to facilitate the International Day’s observance.