UN Secretary-General Calls on Governments to Take Up AIDS Challenge

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UNDER EMBARGO UNTIL 15.00GMT. New York, 20 February 2001

UN Secretary-General Calls on Governments to Take Up AIDS Challenge

Seeks Global Commitment to Reverse AIDS Spread

NEW YORK (20 February) – Declaring the HIV/AIDS epidemic " the most

formidable development challenge of our time " , United Nations

Secretary-General Kofi n, in a report released today, calls on

governments to secure a global commitment for intensified and

coordinated action.

The report has been issued in preparation for the General Assembly

Special Session on HIV/AIDS, which will take place in New York

from 25 to 27 June 2001. The first round of substantive

negotiations for the Special Session are set to take place

the week of 26 February, based on the report.

The report calls for intensified and broadened political and

financial commitments by nations in their response to the

AIDS crisis. Alarmed by the accelerating epidemic and its

global impact, the General Assembly decided in November 2000

to hold a Special Session on HIV/AIDS at the highest political

level. The Session follows calls for concrete action made

in the UN Millennium Declaration, adopted in September 2000

by world leaders at the Millennium Summit.

More specifically, the report calls on governments worldwide

to meet a set of seven critical challenges that will help

reverse the AIDS epidemic:

* effective leadership and coordination,

* alleviating the social and economic impact of the epidemic,

* reducing the vulnerability of particular social groups to HIV

infection,

* achieving agreed targets for the prevention of HIV infection,

* ensuring that care and support is available to people

infected and affected by HIV/AIDS,

* developing relevant and effective international commodities,

* mobilizing the necessary level of financial resources.

" Leadership is fundamental to an effective response, " said Mr n,

referring to one of the challenges highlighted in the report. " One of

the key issues facing the global community is developing and sustaining

such dedicated leadership, vital if the nature of the epidemic is to be

clearly understood throughout society and a national response mobilized. "

Another core challenge is to alleviate the epidemic's social and

economic impacts. In many countries, AIDS has significantly undermined key

sectors. Its negative impact is evident in economic development, education,

health and agriculture. In addition, conflict, war, economic uncertainty,

gender inequality and social exclusion have all made people more vulnerable

to HIV infection, according to the report.

The report also states that an expanded prevention effort is vital to

containing the spread of the epidemic and spending on prevention

helps avert the future cost and impact of infection. A particularly effective

intervention is the prevention of mother-to-child transmission. A

short course of antiretroviral treatment can cut the rate of transmission to

children by 20-50%.

As well as the need to strengthen health care systems, the

affordability of medicines for opportunistic infections and antiretroviral

therapy – one of the greatest barriers to improving access to care – must be

dealt with.

Some progress in reducing the price of medicines has resulted from the

dialogue between the UN system and several research and development

based pharmaceutical companies, initiated in May 2000, as well as through

the increasing availability of generic versions of antiretroviral drugs.

Despite these efforts, much more needs to be done if access to care

and treatment is not to remain out of reach for the majority of people

living with HIV and AIDS, according to the report.

The report says continuing inequalities in access to effective care

and treatment must be specifically addressed through all possible means,

including tiered pricing, competition between suppliers, regional

procurement, licensing agreements and the effective use of the health

safeguards in trade agreements.

In his report, the Secretary-General also calls for focussed

international research and development to produce microbicides and vaccines for

HIV/AIDS, and for greatly increased resources to meet the challenges of a

growing epidemic.

One of the goals of the Special Session will be to call for a

strengthening of financial commitments in the response to AIDS, which remains

vastly underfunded.

Lessons Learned

Despite the dramatic and ongoing spread of the epidemic, much has been

learned since it surfaced two decades ago and the potential to

reverse AIDS has never been higher.

" Collective experience with HIV/AIDS has evolved to the point where

it is now possible to state with confidence that it is technically,

politically and financially feasible to contain HIV/AIDS and dramatically reduce

its spread and impact, " Mr n said in his report.

By the end of 2000, 36.1 million men, women and children around the

world were living with HIV or AIDS and 21.8 million had died from the

disease. The same year saw an estimated 5.3 million new infections globally and

3 million deaths, the highest annual total of AIDS deaths ever.

However, an even greater epidemic can be prevented, according to the

report. Large-scale prevention programmes in virtually all settings have

clearly demonstrated that the spread of HIV can be reduced, especially among

young people and hard-to-reach populations.

The report also said that successful responses have their roots in

communities, that empowering young people and women is essential, and

that people living with HIV or AIDS are central to the response. An

approach based on human rights is fundamental: combating stigma is a human

rights imperative on its own, as well as of instrumental value in fighting

denial and shame, both of which are major obstacles in opening dialogue about

HIV/AIDS.

A Complex Mosaic

A key lesson learned from the epidemic is that it is complex and must

be tackled on several fronts – by dealing with its risks, the factors

that affect vulnerability to it, and the epidemic's impact.

" AIDS has become a major development crisis. It kills millions of

adults in their prime. It fractures and impoverishes families, weakens

workforces, turns millions of children into orphans, and threatens the social

and economic fabric of communities and the political stability of

nations, " said Mr n. It has become clear that single, isolated activities do

not yield sustained results, and that interventions to reduce HIV risk and

change behaviour are effective only when a range of government ministries and

partners in the social, economic and health fields are involved.

AIDS is now found everywhere in the world but has hit hardest in sub-

Saharan Africa. Africa is home to 70% of adults and 80% of children living

with HIV, and to three-quarters of the people worldwide who have died of AIDS

since the epidemic began. During 2000, an estimated 3.8 million people

became infected with HIV in sub-Saharan Africa, and 2.4 million people died.

AIDS is now the primary cause of death in Africa.

Asia has so far escaped the high infection rates registered in

Africa. Only three countries – Cambodia, Myanmar and Thailand – have prevalence

rates exceeding 1% among 15 to 49-year olds. But infections are rising. In

South and Southeast Asia during the past year, 780,000 adults, almost two-

thirds of them men, became infected. East Asia and the Pacific registered

130,000 new infections.

The countries of Eastern Europe and the former Soviet Union present

some of the most dramatic trends in the worldwide AIDS epidemic. Previously

characterized by very low prevalence rates, the region now faces an

extremely steep increase in the number of new infections, up from

420,000 at end-1999 to at least 700,000 a year later.

In Latin America, an estimated 150,000 adults and children became

infected during 2000, bringing the total number of infected to 1.4 million. The

Caribbean has the highest rate of HIV infection in the world after

sub-Saharan Africa and AIDS is already the single greatest cause of

death among young men and women in this region.

High-income countries witnessed a major decline in AIDS-related

deaths in the late 1990s because effective antiretroviral therapy is keeping

people alive longer. However, this good news is tempered by a stall in

prevention efforts and by new infections which show no sign of slowing. In 2000,

despite years of awareness about AIDS, 30,000 people in Western

Europe were infected and 45,000 in North America.

For more information, please contact Pensri Tasnavites, UNAIDS Media

Advisor, Bangkok, Tel. (+ 66 2) 257 0300, Fax. (+ 66 2) 257 0312, Anne

Winter, UNAIDS, New York, (+41 79) 213 4312, Dominique de Santis,

UNAIDS, Geneva, (+41 22) 791 4509), Shih, UNAIDS, New York, (+ 1 212)

584 5024 or Pragati Pascale, UN Department of Public Information, New

York (+1 212) 963 6870. You may also visit the UNAIDS Home Page on the

Internet for more information about the programme (http://www.unaids.org).