General Assembly Session 57 meeting 49

Mr. Redai (Ethiopia)

My delegation wishes to take this opportunity to express its profound appreciation to General Assembly President Kavan for the excellent manner in which he has been guiding our deliberations, and we are very confident that under his able stewardship the work of this session will reach a successful conclusion.

The Ethiopian delegation is very pleased to share with this body its observations on the report of the Secretary-General on progress towards implementation of the Declaration of Commitment on HIV/AIDS, an issue of crucial importance, not only to my country, but also to the world community at large.

We sincerely thank the Secretary-General for his comprehensive and informative report. We welcome the report, and we are in full agreement with many of his findings. In particular, we share the view that, while political commitment has contributed to a modest increase in resources, country-level activities remain limited for managing the epidemic. If HIV/AIDS-ravaged nations are to create a critical mass and mount a sustained effort to curb the disease, the need for capacity-building is more critical than ever. For this to happen, expertise has to be engaged, experience has to be shared and new and additional resources have to be mobilized.

We share the consensual view that the HIV/AIDS pandemic is not simply a health problem, but rather, a political, economic and social challenge. It is also a serious security threat. The epidemic is impacting individuals, families, nations and the world community at large.

My delegation wishes to seize this opportunity to express its appreciation to the crucial role that the Joint United Nations Programme on HIV/AIDS (UNAIDS) is playing in the fight against the HIV/AIDS pandemic. My delegation also commends the important contribution of the Global Fund to Fight Aids, Tuberculosis and Malaria and wishes to see cooperation, coordination and synergy between UNAIDS and the Global Fund, especially in the area of capacity-building.

AIDS continues to be the major preoccupation of countries in Africa south of the Sahara, including my country, Ethiopia. The pandemic is negatively impacting our population and economy and compromising development efforts. The gravity of the problem in the continent led to the 2001 Abuja Declaration on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases, whose implementation has been accorded maximum attention in subsequent African forums.

Ethiopia is the country with the third largest number of people living with HIV/AIDS. Currently, 1 in every 11 Ethiopians lives with the virus. Thousands of children are orphaned, and the number of elderly people left without providers is on the rise. This is a source of great concern in a country like mine, where there is no established welfare system.

On the economic front, HIV/AIDS is undermining the country's unceasing efforts to eradicate poverty and to ensure food security and access to basic social services, such as clean water, primary health care and education. The socio-economic impact of HIV/AIDS has not yet been assessed. The massive loss of our youth not only limits our socio-economic development, but will also eventually lead to a total rupture of the social fabric of society, unless the pandemic is curbed.

For us in Ethiopia, the issue of reversing the spread of HIV/AIDS is a question of survival. Ethiopia is fully aware that addressing the scourge expeditiously and aggressively is crucial; otherwise, the future cost of development will be extremely high. Certainly, a quick shift in priorities will be increasingly difficult, if not impossible, since resources are limited, health facilities are inadequate and the costs of raising public awareness, as well as education and treatment, are high.

My Government is taking concrete measures to combat this scourge. An HIV/AIDS policy has been adopted. A National HIV/AIDS Prevention and Control Council, chaired by the President of the country, has been set up, and the same idea has been followed in the various administrative structures. Furthermore, several ministries have formed and designated HIV/AIDS task forces and focal persons.

A five-year plan is being put in place. Numerous policy directives and guidelines to advise HIV/AIDS patients are being issued. Funds for the anti-HIV/AIDS campaign are being allocated. The media, religious institutions and non-governmental organizations (NGOs) are playing vital roles in raising public awareness about the epidemic, as well as in rendering counselling services to victims of the disease. Another area of focus in the fight against the epidemic is to encourage voluntary testing.

Despite these efforts, a lot remains to be done. Lack of capacity remains one of the major obstacles. In this respect, we would like to thank the United States Agency for International Development (USAID), the Government of Norway, the United Nations Children's Fund (UNICEF), the World Bank and others for the support they have rendered in building the capacity of the regional AIDS council secretariats and its implementing partners in HIV/AIDS prevention programmes for youth, as well as in mobilizing resources for the health sector.

However, this global crisis calls for further global involvement in the search for a solution. It cannot be tackled by nations individually. It is the considered view of my delegation that national HIV/AIDS control efforts must be complemented with meaningful support from the international community, international financial institutions, civil society, the business community and the private sector.

Before closing, my delegation wishes to draw the attention of the international community to the looming famine in our country, which is compounding the impact of the scourge. This is imperative, as income is too meagre for basic needs, let alone for access to antiretroviral medicine.

Therefore, while my delegation is appreciative of the immediate relief assistance to the drought victims, we are fully convinced that lasting solutions can be achieved only by tackling the root causes of poverty through the translation of international and national commitments from vision to action.

Mr. Dube (Botswana)

My delegation joins this debate with the hope that, in addition to reviewing progress that we have made so far, we will take time to reflect on the obstacles that we have encountered, then map out a new strategy for the implementation of the political commitment that we undertook in the Declaration of Commitment on HIV/AIDS.

Botswana welcomes the report of the Secretary General on progress in the implementation of the Declaration of Commitment on HIV/AIDS (A/57/227 and Corr.1). We would like to take this opportunity to commend the Secretary-General for his comprehensive and concise report.

While we may be pleased with reports of increased commitment and determination by world leaders to be at the forefront in the fight against this pandemic, we are the first to admit that a lot still needs to be done before we see a meaningful change in our collective efforts to control the disease. The Secretary-General has correctly observed in his report that this epidemic will not be halted without a substantial strengthening of the response by the international community.

In the Declaration of Commitment on HIV/AIDS, we undertook that by 2003, Member States would establish national targets to reduce by 25 per cent HIV prevalence among young men and women in the 15 to 24 age group in the most affected countries by the year 2005. As we approach the end of the first year since the special session, it is doubtful that those targets will be fully established and begin to be operational during 2003.

The statistics from the Joint United Nations Programme on HIV/AIDS (UNAIDS) make sombre reading as we review our targets. They indicate that only 20 per cent of the world's population that is already infected or at risk of infection have access to HIV/AIDS treatment. Those stark figures are a clear indication of the struggle ahead if the international community is to make a difference in the fight against HIV/AIDS.

Botswana remains one of the countries most affected by this disease. Current estimates indicate that 38 per cent of pregnant women, aged between 15 and 49 years, and 27 per cent of men and women in the same age group, are infected with the virus. Overall, we estimate that 330,000 people out of a population of 1.7 million live with HIV.

HIV/AIDS is the most serious challenge facing our country today. Indeed, it will become a threat to our very existence as a nation unless drastic action is taken immediately. We have decided as a country to accord the highest priority to a programme of education, prevention, care, support and treatment of people suffering from HIV/AIDS.

As a first step, Botswana has established a multisectoral National Aids Council (NAC), chaired by the President. Members of the NAC are drawn from all sectors of society: Members of Parliament, the public service, the private sector, non-governmental organizations, trade unions and religious organizations. Its mandate is to manage, coordinate and implement a national response to HIV/AIDS.

The NAC has already developed a national strategic framework that will guide the planning and implementation of programmes for HIV/AIDS prevention and treatment, care and support programmes and strategies designed to influence behaviour change at the national, district and community levels.

Botswana has now embarked on its third medium-term plan, which will focus on prevention, treatment and intervention programmes. The prevention strategy now under implementation covers the following areas.

The programme on the prevention of mother-to-child transmission came into effect in 1999. Today, Botswana provides full treatment to all pregnant mothers who have tested positive for HIV and who are willing to be treated. The uptake, unfortunately, has been rather slow, due largely to the stigma attached to people with HIV/AIDS. Official estimates, however, indicate that 40 per cent of babies born of HIV-positive mothers who were treated have been protected from HIV infection.

The Government has now embarked on an intensive education campaign to encourage partners and relatives of infected women to be more supportive of them. In this campaign, non-governmental organizations are also playing a very supportive role.

Condoms, including the female condom, are being provided free. A system of distribution has been set up, with support from the African Comprehensive HIV/AIDS Partnerships (ACHAP), through centres or dispensers in public areas such as shopping malls, in schools and in offices.

A youth education programme was recently launched in collaboration with the Ministry of Education. ACHAP is providing funds to procure computers, videos and other audio-visual materials, which will be distributed to schools. Programmes targeting youth will also be broadcast on national television. In that context, we are pleased to report that we have signed an agreement with Brazil for the provision of technical assistance in the dissemination of those youth programmes through radio and television.

Currently, the Total Community Mobilization programme has reached 900,000 people in towns and villages across the country. It is expected that within two years, every town and village will have its own community-based HIV/AIDS prevention programme.

Lastly, the prevention campaign is mounting a public education campaign through the media, billboards and drama. Those activities have become a very popular form of entertainment and learning, but with very serious content.

With regard to treatment, Botswana has now embarked on full antiretroviral therapy at public hospitals for all patients who opt for the treatment. The programme is relatively new and, in its first two years, has not yet reached the target population of 19,000. Four centres have now been set up, and they are currently treating more than 2,000 patients, including children. The success rate has been good thus far, with 80 per cent of those who are receiving therapy showing remarkable improvement. One hundred deaths have been recorded among those on full antiretroviral treatment.

The Government is running a successful community home-based care programme in close collaboration with certain non-governmental organizations. That programme is very effective, as it enables the sick -- who otherwise would have been crowded into hospitals -- to be cared for by their families at home.

As part of the national effort to determine the total number of people affected by the disease, Botswana has set up 14 voluntary testing centres around the country. They are being run and financed in collaboration with the Centers for Disease Control and Prevention of the United States. The results from the testing centres also help us determine the kind of treatment that should be recommended for each patient.

In collaboration with the Harvard AIDS Institute, Botswana has built a laboratory -- which we believe is the first of its kind in sub-Saharan Africa -- to develop a vaccine for the sub-type C virus, which is peculiar to our part of the world. Vaccine trials are due to commence later this year.

The HIV/AIDS pandemic has had a devastating impact on our children. For the first time in our history, Botswana must deal with a growing population of orphaned children and children of parents who are so weakened by the disease as to be unable to look after them. To meet those challenges, we have now set up an orphan care programme. A number of orphans are looked after by relatives. For those children, Government provides free food, clothing, medical treatment and education. A small number of orphanages are being operated by non-governmental organizations and by churches. The Government is now supporting them with subsidies to meet some of their operational costs, which are rising as more children are brought in. Plans are now in an advanced stage to build a Children's Centre of Excellence, which will treat all diseases affecting children, especially those associated with HIV/AIDS. The Centre is being set up in collaboration with the Baylor College of Medicine in the United States.

The task that we have set for ourselves is enormous and expensive. We have been fortunate to have established partnerships with other organizations and with pharmaceutical companies to help us tackle the pandemic. They include the Harvard AIDS Institute, the Bill & Melinda Gates Foundation, Pfizer, Merck, Bristol-Myers Squibb and, of course, ACHAP.

The magnitude of the effects of HIV/AIDS on the socio-economic development of Botswana has been devastating. The leadership and the people of Botswana, however, are determined to fight the pandemic using every means at their disposal. Our gratitude goes to the friendly Governments and donor-partners who have shared their resources and knowledge with Botswana.

In conclusion, I should like to reiterate the view already expressed by many speakers that the threat posed by HIV/AIDS to the lives of our people and to our socio-economic development -- especially in developing countries -- is real and will be costly. Let us therefore recommit ourselves to the objectives of the Declaration of Commitment of the special session if we are to secure the future of the generations to come.

Mr. Laurin (Canada)

Canada would like to thank Secretary-General Kofi Annan for his stalwart leadership in focusing world attention on the global HIV/AIDS crisis. We also congratulate Dr. Peter Piot and his team on the leadership that the Joint United Nations Programme on HIV/AIDS (UNAIDS) has demonstrated in coordinating the work of United Nations institutions and specialized agencies on HIV/AIDS and in supporting national commitments, both in the context of the Declaration of Commitment of the General Assembly special session and elsewhere.

The Secretary-General's comprehensive report on progress towards implementation of the Declaration of Commitment on HIV/AIDS (A/57/227 and Corr.1) does not make for easy reading. Like the historic special session during which we adopted the Declaration of Commitment, the report highlights the fact that, in only 20 years, the HIV/AIDS pandemic has caused untold suffering and death worldwide, destroying entire communities, undoing development gains and posing a serious threat to whole continents, as is currently the case in Africa. The situation is growing worse in a number of ways.

But the report also serves to remind the world that there is hope. As Dr. Piot told us during his presentation two weeks ago, we already know what works. This epidemic can be turned around, and the tools that we need in order to do so are outlined in the Declaration. As the Secretary-General's report makes clear, a comprehensive attack must entail many elements. It must include strategies to protect especially vulnerable groups. Canada's domestic efforts have focused on men who have sex with men, on injection-drug users, on sex workers and on prisoners, among other groups. A comprehensive approach also includes prevention, care, treatment and support as integral elements of the same continuum. We are pleased to see that the report recognizes that effective HIV/AIDS strategies must be committed to respect for human rights, particularly those of women, men and children with HIV/AIDS, of their families and of caregivers. As the process leading to and beyond the special session has demonstrated, and as we all agreed in the Declaration of Commitment, the challenge of defeating this epidemic cannot be met without the full engagement of a wide number of disciplines and sectors, including civil society, non-governmental organizations and the private sector. We must bring renewed vigour to the fight to build greater political commitment behind a comprehensive attack on a scourge that is destroying communities and destabilizing entire regions.

(Spoke in French)

Canada takes its commitment to following up on the special session seriously. Last June we sent to the United Nations our first annual report on the implementation of the Declaration of Commitment, which was developed in consultation with stakeholders in Government and civil society. We intend to submit a second annual report next year, using a similar inclusive process to develop it. Canada's international development assistance, provided through the programmes of the Canadian International Development Agency (CIDA), will continue to work toward the achievement of the Millennium Development Goals and to meeting the commitments spelled out in the Declaration of Commitment.

For its part, CIDA will continue to focus on four social development priorities, namely basic education, child protection, health and nutrition, as well as HIV/AIDS, while at the same time strengthening our investments in rural development, including agriculture, water and the environment.

Canada is increasing its efforts against HIV/AIDS and will continue to work with developing countries and countries in transition to meet the goals and commitments of the Declaration. We strongly support the formation of partnerships between Governments and civil society to improve prevention efforts to strengthen care, treatment and support, and to promote and protect the rights of those infected by HIV/AIDS. This includes more diligent efforts to reach those most vulnerable, including women, youth and children, injection drug users, prisoners, displaced persons and persons affected by conflict, men who have sexual relations with men, and commercial sex workers.

We understand that some delegations have asked for more information regarding particular strategies recommended by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in fighting HIV/AIDS among the most vulnerable groups. We encourage these delegations to engage with an open mind in dialogue with UNAIDS on the development and implementation of appropriate strategies to fight this epidemic. CIDA has committed to quadrupling its investment in the fight against HIV/AIDS, which will attain 80 million Canadian dollars by the year 2005. Canada also recently increased its annual funding to UNAIDS by 5 million Canadian dollars. As president of the G8 this year, Canada is pleased to have been able to focus the attention of this group on the issue of HIV/AIDS.

The G8 Africa Action Plan clearly identifies improving health and confronting HIV/AIDS as a key objective and includes specific commitments to tackle this challenge. The Global Fund to Fight AIDS, Tuberculosis and Malaria, first discussed at the Genoa G8 Summit and finalized shortly after the Kananaskis Summit, emerged as a result of the growing consensus among world leaders regarding the magnitude of the threats posed by this health epidemic in the developing world. Canada is pleased to have played a key role in the Fund's foundation and has pledged $100 million over four years to the Fund. Additionally, at the Kananaskis Summit, Canada committed 50 million Canadian dollars to crucial research towards the development of an HIV vaccine.

We look forward to the ongoing review of the implementation of the Declaration of Commitment in the fall of 2003. As the Declaration calls for an interactive discussion on the Secretary-General's report in 2003, a thorough review of further progress in implementation will be critical, especially since 2003 is the year when the first set of targets comes due and it will be the first year when the indicators developed by UNAIDS will be monitored. Canada looks forward to engaging in this discussion as part of the General Assembly session, with the appropriate involvement of civil society.

Much remains to be done in following up the special session on HIV/AIDS. The report has described once again the scope of the challenges we all face. We pledge our cooperation with all concerned in seeking to meet them.

Mr. Alabi (Nigeria)

My delegation would like to thank the Secretary-General for his useful report contained in document A/57/227, on agenda item 42, concerning "progress towards the implementation of the Declaration of Commitment on HIV/AIDS". We also wish to state that the adoption of the Declaration by the General Assembly in June 2001 is a confirmation of urgent global concern for the HIV/AIDS epidemic, whose prevalence rate and spread has become increasingly alarming. Wherever it exists, particularly in countries of sub-Saharan Africa, AIDS presents a huge and complex humanitarian crisis, with large-scale destabilizing effects on the economy, social cohesion, political stability and development.

My delegation wishes to observe that the HIV/AIDS scourge continues to defy all actions taken at both national and international levels to reverse its spread. Available statistical data by UNAIDS are quite staggering and dismal. For instance, they indicate that those currently living with the disease total 40 million, with a total of 3 million deaths in 2001, while the total number of children orphaned by AIDS and living at the end of the same year was put at 14 million. Similarly, the United Nations Development Programme (UNDP), in its 2001 Situation Assessment and Analysis, on Children's and Women's Rights in Nigeria, states that, as of 1999, 2.6 million Nigerians, aged 15 to 49, were infected. It further records that over the same period, the country had the fourth largest number of those infected in the developing world, after South Africa, India and Ethiopia. The epidemic is on the increase in Nigeria, though at a slower rate when compared to other countries in sub-Saharan Africa. Similarly, in the report of the Secretary-General, the point is made that the rates of infection among young people also continued to rise in Eastern Europe and Asia. Therefore, this confirms the Declaration's recognition of the epidemic as the single greatest threat to the well-being of future generations and would remain so unless countries give utmost priority attention to its implementation.

Permit me to state that Nigeria attaches great importance to the implementation of the Declaration. This is manifested in the measures put in place to accomplish time-bound targets on AIDS programmes in the country. Also, the Government, in order to achieve progress in efforts to combat the spread of the pandemic, established effective cooperation with friendly countries and the United Nations system, particularly UNAIDS, UNDP, the World Health Organization and the United Nations International Children's Fund, as well as with civil society, relevant non-governmental organizations and other stakeholders.

In recognition of its significant leadership role in the fight against HIV/AIDS, the Government has evolved coherent policies and initiatives to enhance efforts for the prevention of the spread of the disease, while at the same time averting new infections. The genuine commitment of the Government is demonstrated in the setting up of the National Action Committee on AIDS, headed by President Olusegun Obasanjo.

The Committee is charged with the responsibility of coordinating the national response and strategy of implementation of the Declaration. The Government has also put in place multisectoral strategies which include education and training of personnel, as well as the involvement of the media and communication experts in information dissemination in schools and workplaces. This approach has been quite useful in changing the attitude of denial of those who are afflicted and has helped to make successful the UNAIDS-led campaign against the stigmatization and discrimination often suffered by people living with HIV/AIDS.

Furthermore, since those afflicted fear exclusion or attack, the Government has formulated appropriate policies and legislation to eliminate discrimination and to protect the basic rights of the afflicted to education, health care and job opportunities at all levels in the country.

Based on Nigeria's understanding of the nature of the disease as an economic as well as a health problem, the Nigerian Government continues to intensify efforts towards its effective management and control. For example, the National AIDS/STD Control Programme of the Ministry of Health conducts surveys, does research and produces data which make it possible to obtain a fairly clear picture of the nature, scope and spread of the epidemic. Also, to demonstrate its strong resolve to implement the Declaration, the Government approved voluntary free AIDS tests and professional counselling for all concerned.

Similarly, the National Action Committee on AIDS continues to encourage the active involvement of local communities, non-governmental organizations and other stakeholders in the promotion of all anti-HIV/AIDS activities. The national association for people living with HIV/AIDS, through its active participation in conferences, seminars and workshops, continues to prove quite resourceful in the context of the overall national response to combat the continued spread of the disease. Indeed, it must be stated that Nigeria is committed to taking a holistic approach to tackling the pandemic, including the provision of antiretroviral drugs to all HIV/AIDS sufferers and the use of appropriate educational strategies to enhance knowledge about its nature and prevention.

Consequently, it is our strong belief that for anti-HIV/AIDS efforts to be successful, they must transcend the national boundaries of all Member States. They must also involve concerted action on the part of Governments, intergovernmental agencies, non-governmental organizations, civil society, the United Nations system and the entire international community. This will require aggressive political will in order to strengthen commitments and to forge the partnerships necessary to build capacity and to enhance effective interventions through comprehensive programmes for prevention, care and treatment worldwide, particularly in Asia and Africa, which are the worst hit by the epidemic.

My delegation is therefore of the view that, unless existing obstacles are overcome, efforts to combat the scourge of HIV/AIDS in developing countries will remain elusive. Already there are prevailing sociocultural and attitudinal problems to overcome in most of sub-Saharan Africa, where both orthodox and traditional medical practitioners engage in unsafe practices. Clinics, hospitals and laboratories use unsterilized instruments for skin piercing and bloodletting. Tattooing, incisions, the draining of wounds and genital mutilations are among the procedures that are carried out without regard for equipment sterilization or safety procedures.

In addition, the problem of denial by those living with the disease still persists. The situation is compounded by inadequate technical assistance and resources for the training of personnel and the care of children orphaned or made vulnerable by the epidemic.

It is most unfortunate that Africa is severely constrained by a dearth of resources in its efforts to intensify the fight against the scourge. Part of the reason is that the level of official development assistance to developing countries is not only abysmally low but also discriminatory. This situation creates doubt as to whether Africa would receive priority consideration in the allocation of the resources of the Global Fund to Fight AIDS, Tuberculosis and Malaria to strengthen preventive measures and to mount an aggressive response to stem the spread of the disease.

To make matters worse, many of the world's leading pharmaceutical companies are more concerned with the protection of intellectual property and patent rights, while Africans are threatened with decimation by the lethal nexus of HIV/AIDS and other opportunistic diseases. Added to this is the crippling debt burden, which continues to deprive African countries of the resources needed to ameliorate the plight of those living with the pandemic.

At this juncture, I would like to reiterate my country's persistent call for the forgiveness of the external debts of African countries, the servicing of which continues to consume the scarce financial resources required for the funding of the basic socio-economic development needs and the infrastructure of affected countries. Furthermore, in view of the apparent correlation between the extent of poverty and the spread of the HIV/AIDS epidemic in any given society, we cannot overemphasize the imperative of increased official development assistance and funding from the Global Fund, in support of the developing and least developed countries, in the procurement and the distribution of antiretroviral drugs to HIV/AIDS victims.

In conclusion, while Nigeria strongly believes in the United Nations as the only body that can provide meaningful global leadership in the fight against HIV/AIDS in a coordinated and coherent manner and without discrimination, it notes with regret that the impact of the comprehensive international effort to provide HIV/AIDS-centred assistance has hardly been felt in many parts of Africa. The slow and relative progress recorded so far in some African States can be traced largely to the personal and collective commitments of the continent's leaders. It is on this score that Nigeria appreciates the recommendation of the Secretary-General calling on the international community, especially the donor countries, significantly to increase their contributions to anti-HIV/AIDS efforts.

To this end, we consider it essential that a comprehensive review of the global assistance to and the strategy for Africa be carried out. Support should be given to genuine partnership that will coordinate existing efforts at the national and regional levels, with a view to complementing the laudable role of the United Nations system and other international approaches aimed at achieving the objectives of the Declaration of Commitment on HIV/AIDS in African countries. Nigeria welcomes meaningful cooperation with like-minded countries in this regard.

Mr. Belinga-Eboutou (Cameroon)

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