General Assembly Session 60 meeting 87

The President

I would like to welcome participants to this afternoon's meeting.

Because we have quite a large number of speakers this afternoon, I would like to appeal to all speakers please to adhere to the three-minute rule, if possible, as well as to ensure that they do not read at running speed. We are in a race, but not running a race. We must capture what everyone is saying.

I now give the floor to Mr. Mohammad Nasir Khan, Minister of Health of Pakistan.

Mr. Khan (Pakistan)

I am pleased to be present at this gathering at which we are reviewing the progress made on the Declaration of Commitment on HIV/AIDS, adopted in 2001.

I would also like to express my deepest condolences in connection with the untimely and tragic death of Dr. J.W. Lee, Director-General of the World Health Organization (WHO), whose relentless efforts in the fight against HIV/AIDS have been and will remain an inspiration to all of us.

Undoubtedly, HIV/AIDS has emerged as the single most formidable challenge to the public health sector, to human rights and to development in the new millennium. Despite the significant increase in global commitments to control the HIV/AIDS pandemic in recent years, the virus continues to spread with alarming speed. Since the signing of the Declaration, more than 20 million people worldwide people have become infected with HIV, including 3 million infants who contracted HIV during gestation or as a result of breastfeeding.

Since HIV/AIDS infection cuts across all socio-economic groups, its transmission follows paths created by economic, social, political and gender inequalities, which include, but are not limited to, poor access to diagnosis and treatment of sexually transmitted infections, living away from one's family and indulging in high-risk behaviours. Poverty and HIV/AIDS is a lethal combination.

Despite its relatively low prevalence rate in Pakistan, HIV/AIDS is a growing concern for my country, where, according to recent estimates, there are approximately 70,000 people living with HIV/AIDS. Since the Declaration of 2001, Pakistan has made considerable progress towards fulfilling its commitments. We are among those countries that are closely observing and implementing the agreed protocols and guidelines. This is a great window of opportunity for Pakistan to implement its strong programme in that respect.

Pakistan recognizes the importance of a comprehensive policy framework that seeks to protect and promote all human rights, recognize the epidemic's gender dimensions, contribute to the eradication of stigma and discrimination, and promote the active engagement and involvement of people living with HIV/AIDS in society, especially young people and adolescents.

We need to formulate effective policies to control this epidemic. There is an urgent need to expand the scope of services in the area of HIV/AIDS prevention and care. Within this framework, the role of intergovernmental agencies and inter-donor cooperation -- that is, United Nations agencies and all donors -- is vital, and leadership becomes critical to generating support for HIV/AIDS prevention and care programmes. Above all, it must be recognized that the challenge of HIV can be met more effectively only if it is considered an integral component of overall human development plans, policies and programmes.

One of the crucial factors in that regard is access to antiretroviral drugs. They are needed now. Children in Africa, Latin America and all over the world need the drugs right now; hence it is imperative to make them available at an affordable cost. We understand that for the pharmaceutical industry, profits are important. But human lives are even more important. Similarly, the issue of patent rights, among others, should not be an impediment to the provision of these drugs. Generic drugs are indeed a life-or-death issue for the millions of people who are infected.

The only way to eradicate HIV/AIDS is to develop a vaccine against it, hence research is critical. We must all cooperate in that respect. Many African and Latin American countries have the necessary research capacity. It is important that the world work together to find a cure for this deadly disease.

We still have a long way to go to realize our dream of halting the spread of HIV/AIDS and reverse the tide by 2015. Realization of this dream will require strong political commitment as well as national and global leadership, the allocation of additional funds for research and development, the active engagement of civil society, culturally sensitive and appropriate interventions, and, above all, universal access to antiretroviral therapy.

We in Pakistan have made a tremendous political commitment in this area, led by the President and the Prime Minister. In fact, the first Asia-Pacific Women, Girls and HIV/AIDS Best Practices Conference was held in Pakistan. Ms. Nafis Sadiq participated, and the Prime Minister opened the conference.

Above all, nothing can be achieved without peace. It is important that we bring some sanity to this insane world of ours. We must stop the killing of human beings all over the world, the killing of women, children, babies and infants, the killing of defenceless, unarmed civilians. We must stop the destruction of the streams and the flowers and the trees.

Let us give hope to the millions of people affected. The Assembly should provide hope to each and every HIV/AIDS victim and ensure that the international community is united in responding to this global challenge. We must work to bring smiles to humanity and not inflict pain or cause tears to be shed.

We are one race, the human race. We have to live together. We have to help each other. We have to accommodate and tolerate each other. Nothing is politically right which is morally wrong. It is time that we have the courage to do the things that are morally right, and I know that this House, the United Nations, has the courage, the will and the determination to do just that for humanity. Let us all heal the world and fight HIV/AIDS together. Let us adopt the draft resolution.

The President

I now give the floor to Mr. Radoslav Gaydarski, Minister for Health of Bulgaria.

Mr. Gaydarski (Bulgaria)

I have the honour to address the General Assembly on behalf of the Government of the Republic of Bulgaria and to express our hope that, through our joint efforts at the national, regional and international levels, mankind will put a stop to the AIDS epidemic.

The Government of Bulgaria has proven that there is strong political will and an effective national response to AIDS, as well as a real commitment to meet international goals. The Government would like to underscore that additional efforts and further emphasis are needed.

First, we call for political will and governmental leadership in all countries. We encourage Governments to strengthen primary prevention measures and to raise awareness of AIDS. We call for an increase in national financial resources to respond to AIDS at the central and local levels, as well as for access to financial resources on the part of the civil sector. We ask international donors to continue to support the response to the problem of AIDS. We call upon Governments to acknowledge that the civil sector is an essential partner in prevention programmes, and to provide access for society's most vulnerable groups. We support a rapid expansion of HIV-prevention services and provision of services to the most vulnerable groups.

On behalf of the Government of Bulgaria, I would like to stress that we should work together now in an effective manner so that the world can be a better place to live in tomorrow because of the absence of AIDS.

The President

I give the floor to Her Excellency Ms. Triophodie Nkurunziza, Minister of the Presidency in Charge of AIDS of Burundi.

Ms. Nkurunziza (Burundi)

On behalf of the President of the Republic of Burundi, Mr. Pierre Nkurunziza, and on behalf of my entire delegation, I would like to extend my congratulations and thanks to the Secretary-General and to the General Assembly for having convened this meeting, pursuant to resolution 60/224 of 23 December 2005.

This meeting is being held at a time when Burundi is in the process of completing its 2002-2006 action plan. The implementation of our plan has been in keeping with the provisions of the Declaration of Commitment on HIV/AIDS, which was signed in 2001.

The organization and coordination of the fight against AIDS in Burundi is based on our awareness that AIDS is a national problem; indeed, the prevalence rate was 6 per cent in 2002. That has led the Government to establish the National Council to Combat AIDS, whose composition is multisectoral, with decentralized structures at all levels. The Council is led by the President of the Republic himself. That approach has enabled us to involve all State institutions, which makes it possible for all authorities to be engaged in the fight against AIDS. The "three ones" principle -- one unique plan for the country, one coordination system and one national follow-up monitoring plan -- has been welcomed by those institutions.

I am pleased to inform the Assembly that, in the current phase of implementing the plan, significant progress has been made in three areas: prevention, caring for persons infected with or affected by HIV/AIDS and strengthening caregiver capacities. Thus, we are striving to reduce high-risk sexual behaviours and to provide information and education to targeted groups. We are attempting to prevent HIV among young people through a vast network of Stop AIDS clubs and youth centres. Major efforts have been undertaken to reduce the risk of blood-to-blood HIV transmission. The number of sites for prenatal screening and monitoring of mother-to-child HIV/AIDS transmission has risen from 1 in 2002 to 11 in 2005.

Burundi has adopted a bolder policy regarding free access to care, prevention and treatment for people living with HIV, which has increased the number of people living with HIV who receive antiretroviral treatment from 600 at the end of 2002 to 6,700 in May 2006. That has been possible because of the support of partners such as the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria. I take this opportunity to thank them on behalf of all those whom they have helped in Burundi, who have found life and hope. Likewise, orphans and other vulnerable children are being identified and supported, including through efforts aimed at family placement, schooling, access to care and support for host families. Because of AIDS and the war, orphans make up 10.8 per cent of Burundi's population. In order to combat stigmatization, we adopted a law in September 2005 that provides protection for people living with HIV.

In conclusion, despite the immensity of the task, Burundi is firmly resolved to reverse the trend of the scourge of AIDS. The progress made over the past five years is a good reason to believe in a better future. Certain of the support of the United Nations, our partners and others who will be joining us, we look to the future with confidence.

The President

I now give the floor to Mr. Yuriy Polyachenko, Minister of Health of Ukraine.

Mr. Polyachenko (Ukraine)

I have the honour to read out the text of a message from President Victor Yushchenko of the Ukraine to the Participants at the High-level Meeting.

"The 2001 special session of the General Assembly, held at the initiative of the Ukraine and other States, became a turning point in the international community's fight against HIV/AIDS. Based on the global plan of action contained in the Declaration of Commitment adopted during the special session, special programmes for prevention and the treatment, care and support of affected people were developed and are being implemented by the Ukraine. The national coordination council for the prevention of the spread of HIV/AIDS, which brought together leading institutions in that area, aims to promote the all-Ukrainian comprehensive campaign to fight AIDS.

"Due to the actions taken, the Ukraine has managed to make substantial progress, in particular in providing access to antiretroviral therapy. Our country greatly appreciates the active cooperation with, and assistance from, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Bank and other agencies of the United Nations system, in particular the Joint United Nations Programme on HIV/AIDS, the World Health Organization and the United Nations Children's Fund. However, despite all the measures taken, the epidemiological situation in the Ukraine is still of a great concern. Regrettably, the rate of the spread of HIV/AIDS in the Ukraine remains among the highest in Eastern Europe. The upward trend in HIV infections continues.

"I would like to take this opportunity to reiterate once again Ukraine's commitment to the implementation of the United Nations Declaration of Commitment on AIDS. We are determined to act decisively to halt the spread of the epidemic. We look forward to continued productive cooperation towards that end, both with the donor community -- first of all with the World Bank and the Global Fund -- and with the entities of the United Nations system."

My delegation would like to associate itself with the statement made by the representative of Austria on behalf of the European Union.

It is our hope that the draft political declaration to be adopted today will add new and powerful impetus to the further consolidation of international efforts aimed at reversing the epidemic. We should be fully aware of our common responsibility to future generations.

The President

I now give the floor to Her Excellency Ms. Ulla Schmidt, Minister of Health of the Federal Republic of Germany.

Ms. Schmidt (Germany)

At the outset, let me point out that Germany fully aligns itself with the statement made by the representative of Austria on behalf of the European Union.

The German Government expresses heartfelt thanks to the Secretary-General for his initiative to fight together against HIV/AIDS and for his compassionate leadership in coordinating the forces of the world community and in developing those capacities further. In the global fight against AIDS, we need the knowledge, experience and commitment of people from various origins, professions and cultures in order to succeed.

I sincerely hope that this High-level Meeting will send the message that respect for human rights plays a pivotal role in the prevention and treatment of HIV/AIDS. I am appalled that, after a 25-year struggle against AIDS, stigmatization and discrimination are still obstructing people's access to prevention, treatment and care in many areas of the world. It must become a matter of course that no one -- including drug users, men who have sex with men, and female sex workers -- is ostracized. It is in our own interest to stand up for the protection and support of human rights. That is the only basis on which our AIDS policies will have sustainable success.

It must also become a matter of course that we no longer close our eyes to sexual violence against women or to the suppression or exploitation of women or the violation of their fundamental human rights. The greater vulnerability of women and girls must be addressed through improved opportunities for education, the strengthening of their social and economic status and ensuring functioning health services. Germany supports some 50 partner countries in their efforts to combat HIV/AIDS, in part through comprehensive programmes to overcome existing deficits within their health care systems, and we will continue to do so.

I welcome the fact that in today's draft declaration, we once again declare our support for prevention. The prevention of new infections should remain a mainstay of combating the pandemic for the long term. The German Government supports consistent implementation of the "three ones" principle, more effective coordination of national and international activities in the fight against HIV/AIDS and their integration into national health policies.

Today we know that the rapid establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria was a resounding success. Germany has contributed to the Fund and will continue to do so.

The world looks to us for leadership. We need to act with determination so that, in all countries, a new generation can grow up healthy. In order to ensure that, it is essential to use clear language in education and to overcome social and cultural obstacles. That is not easy, but we know it works. The best means in that regard is effective cooperation among Governments, non-governmental organizations and civil society, including vulnerable groups. I am deeply convinced that young people will manage their sexuality with a strong awareness of their personal responsibility if they are been given factual and comprehensive information.

The President

I now give the floor to Ms. Pilar Mazzetti, Minister for Health of Peru.

Ms. Mazzetti (Peru)

Allow me, first of all, to say that Peru associates itself with the statement made by the representative of Guyana on behalf of the Rio Group.

We would like to thank the Secretary-General for the documents he has presented to us, which have served as the basis for the various deliberations we have held during this Meeting.

In Peru, a country of 27 million inhabitants in which the epidemic is still not widespread, we have based the fight against HIV/AIDS on a rights-based approach and placed it in the context of the fight against poverty. Access to antiretroviral treatment is part of the right to health in general and to sexual and reproductive health in particular. We have also included a gender perspective in our efforts, emphasizing the empowerment of women and vulnerable groups.

Since 2001, Peru has built a social and financial infrastructure to combat HIV/AIDS, in preparation for providing access to treatment. The social infrastructure serves as our national multisectoral coordinating focus for health, in which the health and other ministries are brought together with, in particular, civil society. Through that structure, we have been able to secure resources from the Global Fund, which have made it possible to buy medicines and to put together a national strategy to combat HIV/AIDS. We have begun to provide treatment to 4,452 people to date, in a decentralized manner. Beginning in September, that treatment will at last be covered fully by the Peruvian Government, thereby consolidating our financial infrastructure. We have presented the details of that effort to provide access, as well as the lessons we have learned, in an exhibition and in publications that we distributed at the various events held as part of this Meeting.

The process of acknowledging the role of civil society and working more closely with it has not been easy. However, we are continuing to build mutual trust. We believe that the participation of civil society will ensure the continuity of the progress made. Working together has been facilitated by the motivation provided by the efforts of the Global Fund and the support of many institutions, in particular the Joint United Nations Programme on HIV/AIDS, which has provided technical guidance and assisted us in our work, thereby enabling us to be more efficient.

We must now begin to address the outstanding items on the agenda, which have become clear as a result of our experience. We must strengthen prevention efforts among vulnerable populations, which are often not very visible. Included in that population are men who have sex with men, sex workers of both genders, transsexuals, transgender people and incarcerated persons. In particular, we must focus on indigenous women, children at risk and adolescents.

Because treatments are being scaled up rapidly, it is vital that we strengthen the health-care system and our workers' capacities. We would ask that, to that end, new financial and technical modes of assistance be sought. This could be an excellent opportunity for donors that may be interested in consolidating their support for Latin America. If such a strengthening does not take place, our region will become more vulnerable, and there will be a risk of the development of generalized epidemic.

We therefore deem it a priority for the international community to continue to mobilize resources, but at a higher level, in order to mount a comprehensive response to this challenge. Initiatives must be launched to declare the medicines, and their related components, used to treat the disease a humanitarian necessity at the global level.

Finally, my country will support the declaration to be adopted, despite the fact that we would have preferred a more explicit document that would have mobilized our countries, in particular developing countries, so as to face HIV/AIDS head-on, rather than merely expressing our concern.

The President

I now give the floor to His Excellency The Honourable Pehin Dato Paduka Haji Suyoi Bin Haji Osman, Minister of Health of Brunei Darussalam.

Mr. Osman (Brunei)

Brunei Darussalam very much welcomes the convening of this High-level Meeting. The past few days have already provided valuable insights with regard to evaluating progress and reassessing our efforts to combat the HIV/AIDS epidemic. Some important progress has been made since the special session on HIV/AIDS. The Declaration of Commitment on HIV/AIDS (resolution S-26/2, annex), adopted in June 2001, was a demonstration of our strong resolve to combat the HIV/AIDS epidemic. And just last year, during the Millennium Summit review, our leaders committed to undertake further efforts to address the issue. However, as we can see from the Secretary-General's report, and as became clear during the interactive sessions held over the past few days, more needs to be done.

Prevention strategies have not been fully focused in our efforts to tackle the epidemic. That has resulted in an increase in infection rates, with over 4.9 million new infections in 2005 alone. Successful prevention, together with effective treatment, is the solution to the problem of HIV/AIDS. People's awareness of HIV, including knowledge of their own status, is a powerful driving force in changing behaviour. It can also indirectly reduce stigma, create more openness about HIV/AIDS and increase the willingness of people to come forward for testing and counselling.

We therefore strongly support the Secretary-General's call for a renewed emphasis on HIV prevention. Brunei Darussalam is also pleased to note that a plan was launched in January 2004 to expand collaboration between national programmes on tuberculosis and on HIV/AIDS to curb the growing epidemic of tuberculosis and HIV co-infection. Tuberculosis and HIV/AIDS together present a massive challenge. Collaboration on tuberculosis and HIV can deliver effective, comprehensive care and prevention at the community level and can help us to reach the "3 by 5" target. However, we all need to act.

It was heartrending to hear about the real-life experiences of persons living with HIV/AIDS, who recounted the physical, emotional and social traumas that they have experienced, as well as the ups and downs and the fight, the triumph and the success in the struggle against HIV/AIDS. We are confident that the opportunity provided for civil society hearings brought a lot of issues to the fore that need to be addressed and from which we can learn.

Despite all of the commitments that the international community had made, inequalities in financial distribution and in access to prevention, care, support and treatment persist globally, especially for the majority of people with HIV/AIDS, who live in developing countries. Most are deprived of not only antiretroviral therapy, but also simple medications to treat opportunistic infections and to alleviate pain. Thus, the next step is to translate the political and financial will and commitments into meaningful and effective action.

Prevention, care, treatment and support can and must be made available to all who need them. That will be so only if all countries, regions and organizations give their full support to the Declaration of Commitment on HIV/AIDS. Obstacles to the success of those programmes must be removed and barriers torn down in order for us to move forward and achieve our targets.

As the saying goes, prevention is better than cure. However, in our efforts to fight the epidemic effectively, prevention, treatment, care and support programmes must go hand in hand and must be implemented together. The pivotal role played by regional and international cooperation, which has led to the achievements made thus far, needs to be further enhanced. We must share lessons learned and experiences gone through so that we can enrich one anothers' efforts.

The President

I give the floor to His Excellency The Honourable Nimal Siripala de Silva, Minister of Health Care and Nutrition of Sri Lanka.

Mr. Siripala de Silva (Sri Lanka)

I feel extremely pleased and privileged to be in this forum and to bring warm and friendly greetings from His Excellency Mahinda Rajapaksa, the President of Sri Lanka, and the people of Sri Lanka.

HIV certainly is becoming a kind of weapon of mass destruction -- a dreadful phenomenon that destroys human beings as surely as the wars waged on the face of the earth. It is an invisible enemy of humankind that respects no borders and devastates the economies of some countries more terribly than famines or natural disasters.

We know that the marvels of medicine have been able to overcome many diseases. Often, dedicated health personnel alone have been able to bring about remarkable successes. But we now know that in order to overcome HIV, a pure biomedical model alone will not be sufficient or even relevant. I believe that even imparting knowledge through awareness programmes alone would not bring about such a change. We need to take a wider, holistic approach that eliminates stigma and introduces sustainable behavioural change. For that purpose, we need to take coordinated multisectoral action to supplement efforts in the biomedical field. This calls for high-level political leadership, and I have no doubt that the United Nations has organized this high-level consultation with that objective in mind.

Sri Lanka has a literate population, and our societies have been blessed to have their historical Buddhist and Hindu religious traditions and culture, strengthened, more recently, by the influence of Islamic and Christian values. That foundation of a good education and traditional values, as well as the ethos of our people, have helped enormously in preventing the rapid spread of HIV in Sri Lanka.

Although Sri Lanka records a very low prevalence of HIV, a climate and an environment conducive to its rapid spread already exist in the country. Indeed, 1.5 million of its people work overseas; marriages are taking place at a later age; there is continuing stigma and discrimination; social and cultural values are eroding within certain sections, accelerated by globalization; and there is a lack of sufficient awareness about safe sex. Those factors can easily tip the balance.

I am pleased to state that Sri Lanka, having taken to heart the lessons learned from the experiences of other regions, has been able to provide political leadership at the highest level to confront HIV. Successive Governments and leaders have shown their unwavering commitment by going public and speaking about HIV. The newly elected President, Mr. Mahinda Rajapaksa, has given the highest priority to this undertaking. We have a vibrant programme for increasing awareness among the political leadership at all levels, covering 85 per cent of the central, provincial and local government political leadership. In addition, we have mobilized civil society fully in those efforts. Currently, more than 45 non-governmental organizations are working actively with the National AIDS Control Programme.

Sri Lanka has always considered free health care as an investment and therefore has extended antiretrovirals free of charge to all persons in need of them. I must thank the World Bank, the United Nations Population Fund (UNFPA), the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), as well as other multilateral and bilateral organizations, for their generous technical and financial support.

Taking the Sri Lankan experience into account, let me emphasize that HIV programmes should target mainly women and adolescents, and that the whole gamut of prevention and treatment activities should be an integral part of a wider reproductive health programme.

As a tangible expression of its commitment, Sri Lanka, despite being a country with a low prevalence of HIV and no related public health burden as of yet, will host the eighth International Congress on AIDS in Asia and the Pacific (ICAAP) in August 2007. The theme of this significant event, "Waves of change -- Waves of hope", is, we believe, very apt. I extend a sincere invitation to each and every one of you to attend that Congress next year.

The President

I give the floor to His Excellency The Honourable John Rahael, Minister of Health of Trinidad and Tobago.

Mr. Rahael (Trinidad and Tobago)

Trinidad and Tobago is a small Caribbean country of 1.3 million people. As a matter of fact, Trinidad and Tobago is the smallest country to have qualified to play football in the World Cup in Germany next week -- and our first match, Mr. President, is against Sweden. We may be small in size, but we are big in passion.

In Trinidad and Tobago, the first case of HIV was detected in 1983. Today, there are 15,000 persons living with HIV in our twin-island republic. Across much of the Caribbean region, the first two decades of the epidemic were marked by increasing mortality and morbidity due to AIDS. But in 2002, the Government of Trinidad and Tobago began providing free antiretroviral treatment for those in need.

In 2004 we launched the National AIDS Coordinating Committee, located within the Office of the Prime Minister, to manage our five-year HIV/AIDS strategic plan. It is truly a multisectoral body, with strong representation from civil society, persons living with HIV, youth groups, faith-based organizations, development organizations, the private sector and key Government ministries.

I am pleased to report some of our country's successes in the area of strategic and comprehensive interventions. AIDS mortality is down by 60 per cent, the incidence of AIDS cases is down by 48 per cent and the incidence of HIV is down by 16 per cent from peak levels.

The factors that have helped us to make that encouraging progress include increased commitment to the response at all levels of society, including at the very highest levels of Government; the mobilization of financial, technical and human resources; strong public-private partnerships and capacity-building with non-governmental organizations; and improved facilitation and coordination across all sectors. My Government bas recognized that a sustained and comprehensive response to HIV is critical if we are to realize our bright prospects for economic and social development.

In the face of the special challenges impacting small countries like ours, Trinidad and Tobago is committed to stronger efforts to combat stigma and discrimination against those infected with HIV and those vulnerable to the epidemic, through legislative and social reform. We are also committed to further expanding access to treatment in all districts in the country, to providing the requisite attention to improving the sexual and reproductive health of young women -- and all citizens -- and to ensuring the meaningful participation of persons living with HIV in the response.

We in Trinidad and Tobago have always been proud of our musical, artistic and cultural diversity. We are now harnessing our cultural strengths and employing our national icons to fight stigma and discrimination and to achieve positive behaviour change. However, we are humbled by the long road ahead of us and must scale up our efforts to match an epidemic that is still very much a clear and present danger.

The Government of Trinidad and Tobago is fully committed to reversing the spread of HIV. The Assembly can be assured that Trinidad and Tobago will do its part to fulfil the Declaration of Commitment and to achieve all of the Millennium Development Goals.

The President

The President of the General Assembly is supposed to be 100 per cent neutral and impartial, but I will be facing great difficulties when Sweden and Trinidad and Tobago meet in the World Cup. We can only hope for a draw.

I will now give the floor to His Excellency Mr. Ponmek Daraloy, Minister of Public Health of the Lao People's Democratic Republic.

Mr. Daraloy (Laos)

It is for us, the delegation of the Lao People's Democratic Republic, a great honour and a great pleasure to have the opportunity of participating today in this special session of the United Nations to follow up, review and evaluate the implementation of the decision of the twenty-sixth special session of the United Nations in 2001, in particular the implementation of the Declaration of Commitment on HIV/AIDS. I should like most sincerely to thank Secretary-General Kofi Annan for having convened this highly important session.

Five years after the 2001 special session, we can say that if urgent and resolute action is not taken at the national, regional and global levels to enhance and strengthen our respective responses in the area of the prevention and treatment of HIV/AIDS and support for people living with HIV/AIDS, we cannot hope to achieve either the objectives of the Declaration of Commitment set for 2010 or the sixth Millennium Development Goal.

This special session is a valuable opportunity to relaunch and energize the global response to HIV/AIDS. It is in that context that the Lao People's Democratic Republic has been able to benefit from the decisive and continuous support of Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization (WHO) and other United Nations agencies in its effort to address the issue of HIV/AIDS, so as to achieve in the near future the objective of universal access.

The Government of the Lao People's Democratic Republic remains totally and fully committed to facing the global scourge of AIDS and to continue its efforts to ensure universal access to prevention and treatment by all Laotians who may need it. Laos, it is true, remains a country with a low HIV prevalence, with an overall total of 1,827 HIV-positive individuals as of the end of 2005. Among the 1,069 overall cases of AIDS, 637 persons have already died and 350 are under antiretroviral treatment.

Many factors make our country particularly vulnerable to HIV and AIDS; these relate to its geographical location and to the increased migration to and from the country along the major land transit routes, both those that now exist and those that are to be constructed. They relate also to lifestyle changes among some populations at risk, including young people. Potentially, Laos could experience a serious and dangerous HIV/AIDS epidemic.

Mr. Daraloy (Laos)

With the support of the Joint United Nations Programme on HIV/AIDS, the World Health Organization and other key stakeholders, the Lao People's Democratic Republic has developed a new national HIV/AIDS strategy and action plan for 2006 to 2010, with the aim of ensuring universal access to prevention, care and support for all in need, as far as possible. HIV and AIDS are included as a priority in the sixth national socio-economic development plan, and the Lao People's Democratic Republic is actively engaged in the Association of South-East Asian Nations (ASEAN) Task Force on AIDS.

The emphasis in our national HIV/AIDS strategy and action plan is on the promotion of safer sexual behaviour, especially among the most vulnerable groups. Key strategies are the integration of sexually transmitted infection and HIV prevention services into reproductive health programmes, addressing the vulnerability of women, young people and children, the provision of services such as voluntary counselling and testing, and the prevention of mother-to-child transmission. Goals include adequate, accessible, affordable and acceptable supplies of essential HIV/AIDS and sexual and reproductive health-related commodities, comprehensive condom programmes, diagnosis of sexually transmitted infections and the provision of drugs.

Last month, a second antiretroviral therapy treatment site was opened in Laos, in the capital, Vientiane, and others will follow. We are confident that, with the continued support of external development partners and the United Nations system, our goal of treating 100 per cent of adults and children in need will be reached by 2010.

Coming back to the Secretary-General's message on urgency, we do indeed need renewed and substantial efforts at the global, regional and country levels. We are happy that the Lao People's Democratic Republic is still a low-prevalence country; we think that our efforts to date have been at least partially responsible for this low prevalence. Much has been achieved during the past five years, but a great deal has still to be done. A country like the Lao People's Democratic Republic will need an increased long-term commitment from external development partners to support its response financially and to strengthen its capacity to implement its programmes. In that respect, the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the much-needed complementary role of United Nations system are highly appreciated.

We will also continue to work with all of our partners in the greater Mekong subregion and in ASEAN to halt the spread of the epidemic. We know that we have a long way to go. But, with reenergized assistance and cooperation from the United Nations system and the international community, we are determined to do our utmost to reach global and national targets by 2010. In that conviction, we wish this meeting every success.

The President

I give the floor to His Excellency Mr. Maksim Cikuli, Minister for Health of Albania.

Mr. Cikuli (Albania)

As the representative of a low-prevalence country and region for HIV/AIDS, I must stress that we must act now. We should not delay intervention until the epidemic becomes visible to everybody, but should implement comprehensive prevention and treatment programmes right now while prevalence are rates are still low. Albania's first case was detected in 1993, and HIV/AIDS figures have doubled since 2000. Implementation of immediate interventions such as the nationwide screening of every blood unit to be used for transfusion has prevented the spread of the epidemic in a country that had high rates of endemic hepatitis B in the early 1990s.

We are facing a different situation today. We are still in the early stages, with the epidemic remaining concentrated in just a few specific groups. It is also important to understand that the spread of the epidemic is linked to certain illegal activities. To curb the epidemic, we must support proven public health interventions that address those illegal activities. HIV/AIDS prevention programmes are an essential part of the fight.

We have access to new and significant resources in our fight against HIV/AIDS, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the United States Government initiative and many other initiatives. However, we need to ensure that prevention, care, treatment and research approaches are mutually complementary. We must recognize that our status as a low-prevalence country provides us with a rare opportunity to show the world that the epidemic can be stopped if all known prevention methods are applied and if available resources are used wisely and in accordance with well defined priorities. We also must recognize that prevention can work if we develop targeted approaches to address HIV/AIDS in specific populations, understand the factors causing those groups' vulnerability to infection, and work to protect and promote their health and human rights in an effective manner. Prevention programmes must be adapted to the real-life settings in which they are carried out. We must also stress Government responsibility and involve the most vulnerable groups in the development of such programmes.

We must eliminate obstacles to the use of sexual and reproductive health services for prevention. Only a well-formulated multisectoral approach that emphasizes the importance of fully respecting sexual and reproductive rights in the context of HIV prevention will enable us to win the fight against HIV/AIDS.

Furthermore, we must recognize that instead of prosecuting injecting drug users, we must provide them with services and programs that address their addiction and reduce harm, such as making safe injections available and implementing substitution therapy and rehabilitation programmes. Statistics show that, in Albania, policies and laws which respect the health and human rights of drug users and which set up harm reduction programmes at the community level are indispensable to stop the epidemic.

The provision of full access to treatment for all people living with HIV/AIDS in Albania and a commitment to enacting and enforcing laws which ensure full empowerment of people affected by the disease with a view to eradicating all forms of AIDS-related stigma and discrimination show the Albanian Government's dedication to the prevention of HIV/AIDS in the country.

Low-prevalence countries should act while the epidemic is at their door and should consider the fight against HIV/AIDS to be an integral aspect of the moral imperative to ensure prosperity and security in our region. As political leaders, we must be courageous enough to take risks to improve the public's health.

We fully align ourselves with the statement delivered on behalf of the European Union.

The President

I appeal to all present in this Conference Room to keep talking to a minimum so that we can hear all the statements and show our appreciation for what delegations are contributing to this very useful debate.

I now give the floor to His Excellency Mr. Jean-Louis Robinson, Minister of Health and Family Planning of Madagascar.

Mr. Robinson (Madagascar)

My delegation associates itself with the statement made by His Excellency Mr. Denis Sassou Nguesso, President of the Republic of the Congo, on behalf of the African Union. Nonetheless, Madagascar wishes to take this opportunity to share with the international community its thinking and its experience in the fight against HIV/AIDS. I shall discuss action we have taken at all levels of society with a view to attaining the goals set out in the 2001 Declaration of Commitment on HIV/AIDS (resolution S-26/2, annex).

In Madagascar, the fight against AIDS involves the very highest levels of our leadership, in the person of His Excellency Mr. Marc Ravalomanana, President of the Republic. With a view to stemming the spread of the epidemic, we have developed a national strategic plan to coordinate and strengthen prevention activities. The plan provides for the creation of a climate conducive to a multisectoral approach, particularly with respect to improving access to information and to the primary means of prevention; ensuring quality of services; putting in place a follow-up and evaluation system; and the development of international cooperation in the fight against AIDS. To that end, we are carrying out a massive campaign to raise awareness and ensure responsibility-sharing among all sectors of the population. The President of the Republic and his wife officially launched the screening campaign by setting a good example.

We are determined to continue to improve information activities; the challenge now is to guide the population towards responsible behaviour. The media have contributed to that end. We sponsor sociocultural events as a springboard for communicating strong messages. We organize advocacy sessions with local and national elected officials. We have mobile video units for areas that are difficult to reach, and we have distributed thousands of crank-operated radios and organized listening groups. Moreover, screening and treatment services and services to prevent mother-to-child transmission are gradually being provided throughout the country.

The campaign is beginning to bear fruit: more than 85 per cent of our people have general information about HIV/AIDS and are aware of essentially how it is transmitted and of how it can be prevented. But, despite those results, my country has decided to continue its focused efforts: vigilance must be the order of the day. In fact, results on numbers 10 to 14 of the national core indicators defined by the Joint United Nations Programme on HIV/AIDS (UNAIDS) show the gap between the goals and the results. We are aware of the real threat posed by the epidemic, and we must act now. To be effective, prevention must be based on the promotion and protection of and respect for individual rights, including equality between the sexes. It must be based on actions that have proven to be effective, and it must be exhaustive in its scope.

The HIV/AIDS pandemic has spared no country its devastating economic, social and cultural effects. The level of our participation at this meeting reflects our genuine determination to find common approaches to eradicating this scourge, or at least reversing the trend. Prevention is indispensable, but at the same time those infected must know that they have access to free antiretroviral treatment. We lay stress on improving reproductive health services and the prevention of mother-to-child transmission: prevention and care for HIV-positive mothers and children form part of a care continuum.

Inequality in the fight against AIDS is an injustice which further widens the gap between the most vulnerable sectors and those who possess the necessary resources. We bear witness to the scale of the scourge and the speed of its spread, when we see the daily tragedy of HIV/AIDS victims, especially in poor countries. This sad reality demands that we display renewed solidarity through strengthened international cooperation.

The best way to fight HIV/AIDS is to increase the financial resources, which must be commensurate with the pandemic. That is not a choice: it is a necessity. We require financial resources to meet our obligation to improve the general health care infrastructure, to continue and intensify our prevention programmes, to guarantee better access to treatment and to speed up the development process.

We are convinced that we must not lose the opportunity provided by this event. We call upon all public and private actors, civil society and the leaders of bilateral and multilateral bodies to make every effort to strengthen our fight against this global scourge. We solemnly appeal to the conscience of the citizens of the international community: they should actively support the Global Fund to Fight AIDS, Tuberculosis and Malaria. We are firmly convinced that the technical and financial partners who have stood by us in this fight so far remain prepared to support us so that, together, we can win the battle against HIV/AIDS.

The President

I now give the floor to His Excellency Mr. Eyitayo Lambo, Minister of Health of Nigeria.

Mr. Lambo (Nigeria)

The Nigerian delegation extends its appreciation and thanks to you, Mr. President, for convening this High-level Plenary Meeting, on the item entitled "Follow-up to the outcome of the twenty-sixth special session: implementation of the Declaration of Commitment on HIV/AIDS" (resolution S-26/2, annex). Nigeria fully aligns itself with the statement delivered this morning by His Excellency the President of the Republic of the Congo, in his capacity as Chairman of the African Union.

President Olusegun Obasanjo personally leads the national campaign against the pandemic and continues to play a pivotal role at the continental level. He recently hosted in Abuja a Special Summit of the African Union on HIV/AIDS, Tuberculosis and Malaria, where our heads of State or Government adopted an African Common Position in which they reaffirmed their commitments to previous declarations, decisions and resolutions and pledged to take immediate action to ensure universal access to HIV/AIDS, tuberculosis and malaria services by 2010. Nigeria strongly stands by that African Common Position.

The Federal Government has continued to undertake a massive nationwide advocacy and public enlightenment campaign involving major stakeholders, which has led to a change in the sexual behaviour patterns of men and youths. There is now greater demand for and use of condoms and, more significantly, our men are increasingly reducing the number of their sex partners. These developments have led to a significant reduction in the number of people afflicted with the disease: from 5.8 per cent in 2001 to 4.4 per cent in 2005, which is a decrease of about 25 per cent.

In the spirit of the "three ones", the Federal Government established the National Action Committee on AIDS to coordinate at the national level the fight against the disease. Nigeria was the first country to adopt the global task team recommendations with respect to alignment and harmonization of programmes and resources. A national strategic framework and a national monitoring and evaluation framework were developed to provide the umbrella instrument for the response to the pandemic. The Government promotes a multisectoral response system to HIV/AIDS which incorporates a wide range of stakeholders, including state and local governments, networks of people living with HIV/AIDS, civil society groups and faith-based organizations.

Since 2003, there has been a significant increase in Government funding for HIV/AIDS. To ensure availability of resources, the Government has allocated to HIV/AIDS 5 per cent of the proceeds from the debt relief extended to Nigeria by the Paris Club, out of the 25 per cent provided by the Government for all the health-related Millennium Development Goals.

Nigeria has far exceeded the modest target of treatment for 10,000 adults which it set for itself following the 2001 special session. Over 70,000 adults and 1,500 children have now been placed on free antiretroviral therapy, with a plan to scale up treatment to cover 250,000 people by the end of this year. HIV-positive pregnant woman are also provided free ante-natal care and delivery services.

In spite of the many successes that have been recorded globally in the fight against the pandemic since 2001, there remain substantial obstacles which we must overcome. The lack of human and institutional capacity is the single biggest obstacle to an effective response to AIDS in many developing countries, particularly in the most heavily affected countries.

We must collectively and resolutely respond to the many challenges posed by HIV/AIDS in a comprehensive manner, including through the development of new partnerships and the strengthening of national health systems. In the area of prevention and care, the international community must continue to devote sums for research and development of medicines, vaccines and microbicides that would lead to the eventual elimination the epidemic. HIV/AIDS is a disease of our time and Nigeria is convinced that it is not beyond the capacity of our generation to find a cure for it.

Nigeria is concerned that external funding is becoming increasingly unpredictable and unsustainable. We therefore call on the international community, particularly the donor community, to strengthen its partnership with Africa by providing continuous, predictable support to the Global Fund to Fight AIDS, Tuberculosis and Malaria and by increasing technical and financial assistance to African countries within the framework of the recommendations of the global task team and other multilateral and bilateral mechanisms.

Finally, we call on our development partners to work with African countries, the African Union Commission and regional economic communities to ensure long-term and predictable financing and provide financial and technical support for our efforts in a coordinated, efficient and country-led manner.

The President

I now give the floor to His Excellency The Honourable Leti Pelesala, Minister of Home Affairs of Tuvalu.

Mr. Pelesala (Tuvalu)

It is indeed a great privilege for me to represent the head of Government of Tuvalu to deliver this statement at this very important High-level Meeting. I associate myself with the statement to be delivered later by the chairman of the delegation of Papua New Guinea on behalf of the Pacific Islands Forum.

Although it is an isolated independent nation that is small in terms of population and resources, Tuvalu too has been affected by the unfortunate migration of this global epidemic -- HIV/AIDS -- at a proportion that puts the country high on the list of infection per capita, and at a rate that is alarming in terms of the continued existence of our population. My presence here despite our limited resources reflects the seriousness with which Tuvalu views the need for real action against HIV/AIDS and our hope that the global community will deliver. The epidemic is particularly serious to us because of our high population mobility due to the search for overseas employment and training opportunities.

Tuvalu appreciates the assistance it has received under the Global Fund to Fight AIDS, Tuberculosis and Malaria; much has been achieved through this support. However, it must be emphasized that accessing these funds is a problem for small island developing States such as Tuvalu; HIV/AIDS programmes still need more assistance to ensure their success. Moreover, resolution 59/311, on the Mauritius Strategy for the Further Implementation of the Programme of Action for the Sustainable Development of Small Island Developing States, needs to be properly recognized and integrated into global efforts against HIV/AIDS. The Strategy clearly identified this particular epidemic as an area of critical concern also to the sustainable development and survival of small island developing States. A special Global Fund window for small island developing States such as Tuvalu would be useful. There is also a role for regional bodies, such as those in the Pacific, to play in facilitating access to the Global Fund.

Tuvalu continues to stand in strong solidarity with other regions of the world most affected by this epidemic and in need of urgent help. The global response to HIV/AIDS must accelerate the provision of financial and technical support to Governments and civil society.

I am happy to report that Tuvalu has made progress in its HIV/AIDS programmes since the first high-level meeting on HIV/AIDS. The Government, in partnership with non-governmental organizations and civil society, has formulated a national sustainable development strategy -- Te Kakeega II 2006-2015 -- setting HIV/AIDS as a high strategic priority. We need help for its full implementation.

While we are indeed grateful for the assistance and support we have received from donor countries, we appeal to global official development assistance partnerships focusing on least developed countries and other vulnerable regions to honour their commitments and meet them in full. This is crucial to the achievement of our national goals as required under the Millennium Development Goals.

To conclude, we believe that the global response to and fight against HIV/AIDS is to be waged not only with money but, most important, with political will and moral values throughout the entire spectrum of civil society. It is not a fight between Governments and organizations on the one hand and a faceless enemy on the other. It is a battle between civil society and itself, where the battle lines are drawn in the mind and the heart of society.

We offer these thoughts in the belief that no amount of funding can resolve this particular epidemic. The solution lies with us all: individuals in our various communities.

The President

I now give the floor to His Excellency Mr. Gundalai Lamjav, Minister of Health of Mongolia.

Mr. Lamjav (Mongolia)

As of today, Mongolia is considered a low-prevalence country with, only 21 known cases of HIV/AIDS. We have launched a massive media campaign to make people aware of the increasing threat of HIV/AIDS. Our main tool is radio and television broadcasting. Nowadays, in the era of globalization and rapid information technology development, people do not spend much time in reading brochures and printouts. Therefore, I want to emphasize to all decision-makers that they should focus on radio and television broadcasts. I urge them to involve their stars and celebrities in short radio and television spots.

This month we will organize a national seminar that will focus on how to achieve the "three ones" principle in the fight against HIV/AIDS. With the support of our national and international partners, my Government is committed to implementing a national Healthy Mongolian Population programme, which emphasizes the prevention of sexually transmitted infections and HIV/AIDS, first aid and, especially, the improvement of primary health care in Mongolia. Later this year, Mongolia will be hosting its first international conference on HIV/AIDS among-low prevalence countries.

The Government's main task is to make Mongolia a country free from HIV/AIDS. To achieve that goal, we need further support and the close cooperation of international organizations and donor countries.

On behalf of the Mongolian Government, I want to express our appreciation to His Excellency Mr. Kofi Annan for organizing this very important forum and for inviting all of us. Also on behalf of the Mongolian people, I want to thank the United Nations Population Fund, the World Health Organization, the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNICEF and the United Nations Resident Coordinator in Mongolia for their valuable contribution to the health of the Mongolian people.

I wish all participants success in their fight against the pandemic.

The President

I now give the floor to His Excellency Mr. David Parirenyatwa, Minister of Health and Child Welfare of Zimbabwe.

Mr. Parirenyatwa (Zimbabwe)

Zimbabwe feels honoured to address this very important gathering as we review progress in the fight against HIV and AIDS since 2001. We welcome this meeting very much indeed. So much has been said in the media about Zimbabwe, most of it negative, and I would like at this meeting to say what is happening in Zimbabwe in terms of HIV and AIDS. I am proud to say that the Government of Zimbabwe was the first one -- and is the only one -- to have a national AIDS levy: the National AIDS Trust Fund. This is a tax on income; all our workers are taxed at 3 per cent. It goes into a national coffer called the National AIDS Trust Fund. This has worked very well for us, because we have not had many resources or much support from elsewhere. The funds are used from the national level right down to the district level.

Zimbabwe has fully embraced the "three ones"; within Zimbabwe we have all agreed, together with the United Nations system, our non-governmental organizations (NGOs) and civil society, that we should honour that initiative and allow the Government to lead in implementing it. The national coordinating body for the "three ones" initiative is the National AIDS Council. The Council is now in the process of formulating and finalizing a monitoring and evaluation mechanism, which we believe will also complete the "three ones" requirements.

We in Zimbabwe are completely convinced of the importance of the fight against HIV and AIDS. We will provide statistics showing that in Zimbabwe this has been a most active fight. In 2000, the prevalence rate in Zimbabwe was as high as 31 per cent. By 2003 it had come down to 24.6 per cent. Now, as I speak, it is 20.1 per cent. While I accept that that figure is still extremely high, I am pleased that there has been a steady decline in prevalence between the ages of 15 and 49. We attribute this in particular to behavioural change among our people; that is manifested in the fact that the number of sexually transmitted infections has dropped. We have also found that the age of sexual debut has risen within Zimbabwe. Another particular reason for this is that we have a very strong team, which includes the Zimbabwe National Network of People Living with AIDS, an organization representing people living with AIDS; faith-based organizations; traditional leaders; the business community; civil society; and NGOs.

In Zimbabwe, we have united among ourselves and said, "Let us fight HIV/AIDS together". That has given us a real way forward. We believe in this action of prevention. Our first fight, our first principle, is prevention. The second is prevention. And the third is prevention.

We look at prevention in terms of prevention of mother-to-child transmission. We also enhance and strengthen voluntary counselling and testing. In Zimbabwe, since 1985, all transfused blood is screened for HIV and other transmissible diseases. HIV/AIDS education is part of school curricula in Zimbabwe from grade 4 to grade 9. We are now in the process of trying to make that syllabus an examinable subject for those age groups.

We are pleased that, in the context of prevention, we have also formulated a strong national plan of action for orphans and vulnerable children. Many of our partners have provided support for this action, particularly UNICEF, and we are very pleased that that has been the case as we fight HIV/AIDS.

The challenge has been the issue of affordable drugs and medicines. In Zimbabwe, we have a local company that manufactures first-line antiretroviral drugs. This company is doing well. To date, we have put 31,000 people on antiretroviral drugs, in both the public and private sectors. Nevertheless, these 31,000 people represent only 10 per cent of the people that should receive such therapy. The challenge therefore is still great, but we will support the domestic company that is making antiretroviral drugs. We call upon our partners to support us in that particular regard.

Let me mention the particular circumstances that arose when Zimbabwe embarked upon a very long overdue but justified land reform programme. While we were pursuing this programme, we immediately faced a great deal of protest, and many countries reduced their support to our health sector. I am glad that, now, five years down the road, some of our partners are coming back, in particular, Canada and the Swedish International Development Cooperation Agency; and we have always had the support of the United Kingdom Department for International Development, the European Union and, of course, the United Nations system.

We are pleased that this High-level Meeting of the General Assembly is occurring at this particular time. Zimbabwe looks forward to an appropriate, strong political declaration from this Meeting as it will provide us with strengthened impetus to act.

The President

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