The price of success, the cost of failure: Special Session on HIV/AIDS - Statistical Data Included

UN Chronicle, June-August, 2001

It is hard to believe it was only twenty years ago this June that the first clinical evidence for acquired immune deficiency syndrome (AIDS) was reported in the medical press. In the two intervening decades, more than 56 million men, women and children-a number nearly equal to the population of France or the United Kingdom-were infected with human immunodeficiency virus (HIV); some 22 million--about twice the, population of Mali or Zimbabwe--died of AIDS-related illnesses; and of those, 4.3 million--greater than the entire population of Uruguay or New Zealand--were children.

At the time, it shook our understanding of how to combat the disease. In 1981, it seemed medicine had few Limits and that the individual cases reported were more a medical mystery than the beginnings of a rampaging disease that would claim so many millions of lives. If it were not so frightening, it would seem almost quaint. How did we forget that deadly diseases could crop up at any moment, and that without targetted medicines, which could neutralize their complex methods of attack, we could face an incredibly quick-spreading epidemic-one that, before we could stop it, would turn into a worldwide pandemic?

Now, only a dogged, determined "battle plan"--in the words of United Nations General Assembly President Harri Holkeri-could hope to stop and reverse the spread of HIV/AIDS. In order to come up with such a global plan of action, the General Assembly in September 2000 decided to convene a special session.

The special session on HIV/AIDS opened in New York on 25 June 2001 and it was the first to be devoted to what, on the surface, appears to be a clear-cut health issue, which, however, proved to be anything but clear-cut. When the session ended on the evening of 27 June, Secretary-General Kofi Annan told the press that "some painful differences have been brought into the open. But that is the best place for them. Like AIDS itself, these differences need to be confronted head-on, not swept under the carpet."

The differences--and they were, significant--were met head-on. The extraordinary three-day meeting closed with every single Member State of the United Nations uniting behind an ambitious but vital Declaration of Commitment. More than a straightforward issue of health and medicine, the Declaration treats AIDS as a political, human rights and economic peril.

Heads of State and Government and representatives of all 189 UN Member States called for resources to be found for the battle plan. They committed themselves to reaching a target by 2005 of an overall annual expenditure on the HIV/AIDS epidemic of between $7 billion and $10 billion in low- and middle-income countries, as well as those experiencing or at risk of its rapid expansion. They also called for the implementation of measures to ensure that needed resources are made available, particularly from donor countries and from national budgets.

The Declaration also has Member States' undertaking to: confront the stigma, silence and denial; address gender-and age-based dimensions of the epidemic; and end discrimination and marginalization, putting human rights into the middle of the solution of a health epidemic.

In his closing remarks, Mr. Holkeri said that the concrete targets and follow-up mechanisms contained in the Declaration represented "the first global 'battle plan' against AIDS. It contains concrete targets for all of us to implement. It also contains mechanisms to follow-up: how those targets are to be reached. The beauty and significance of this Declaration of Commitment is in its pragmatic and straight-forward approach." It would serve as a tool for specific strategies to turn the tide of the epidemic. He also said that despite the overwhelming statistics and the real human suffering they represented, "there was hope". The international community must reach out to those who most needed that hope, or be held responsible for not acting when it had the chance.

The special session ended with a moment of silent prayer. Now, hard work lies ahead.

Waging War Against HIV/AIDS

Calling the Declaration of Commitment an "instrument for accountability", Dr. Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said it would form "a strong basis for future action". In the document, the General Assembly supported the establishment of a Global HIV/AIDS and Health Fund to finance an urgent and expanded response to the pandemic, based on an integrated approach to prevention, care, support and treatment. The Fund will also assist Governments in their efforts to combat HIV/AIDS, with priority to be given to the most affected countries.

Contributions to the Fund will be mobilized from public and private sources, with a special appeal to donor countries, foundations and the business community; including pharmaceutical companies, as well as from individuals. The Assembly also committed itself to launching by next year a worldwide fundraising campaign, conducted by UNAIDS and other partners, aimed at the public and private sector, to contribute to the Fund.