General Assembly Session 62 meeting 105

The Acting President

There are 107 names remaining on the list of speakers. In order to accommodate all the speakers for the high-level meeting, I would like to strongly appeal to speakers to limit their statements to five minutes.

I now give the floor to Her Excellency The Honourable Esther Byer-Suckoo, Minister of Family, Youth Affairs, Sports and the Environment of Barbados.

Ms. Byer-Suckoo (Barbados)

At the outset, Barbados wishes to align itself with the statements Caribbean Community and by Antigua and Barbuda on behalf of the Group of 77 and China.

There can be no doubt that for the past 25 years, HIV has emerged as one of the greatest threats to human security; it continues to dominate the global landscape, decimating human capital and weakening social structures.

In the Caribbean region, which has the second highest prevalence after sub-Saharan Africa, the impact of the disease has been no less devastating. AIDS is now among the leading causes of death in persons between the ages of 25 to 49.

We in Barbados have therefore had to double our prevention efforts, and I am pleased to report the tremendous success of our prevention of mother-to-child transmission programme: over the past three years, only one child has been born HIV-positive in Barbados.

Our responses at every level must reflect the dynamics of the disease and, therefore, must adapt to address the key issues encountered. Central to those issues is universal access to HIV prevention, care, treatment and support services by all in need, regardless of gender, immigrant status or sexual orientation. That is more than access to antiretroviral drugs, but includes access to highly trained professionals, suitable facilities, current information and funding. In addition, it calls for the elimination of all barriers to access.

In Barbados, standard mobilization efforts have primarily captured public and private sector partners. We have also learned that engaging civil society partners, including persons living with HIV, is neither easy nor straightforward, but it is crucial and effective. Our pledge is to achieve universal access, and that means that every partner in our national AIDS programme must cooperate and collaborate to attain that goal.

Last July, we convened a special consultation on universal access for our civil society partners. That saw a unique movement away from merely sharing ideas to orienting our partners on the nuances of universal access and clarifying any pressing concerns.

The assurance given by our non-governmental partners that they will play an integral role in our quest towards universal access must be supported by equally strong action on the part of the Government. Successive Governments in Barbados have shown their commitment to responding to the challenges that the HIV epidemic poses to the social and economic stability of our island.

Over the past two weeks, members of Parliament in the Senate and Lower House of Assembly debated resolutions to endorse the national strategic plan for HIV prevention and control for 2008 to 2013 and the Barbados national HIV policy.

As the Minister of Family with responsibility for HIV, I led the debate, and was heartened by the unanimous support shown for the content and budget of the national AIDS programme. There was a frank discussion of issues by our country's leaders and wide media coverage. That historic debate is part of the Government's plan to foster parliamentary leadership and to strengthen the involvement of legislators in the national, multisectoral response to the disease.

Barbados' new HIV policy is multisectoral, developmental and human-rights based. For the first time, we have been able to produce a holistic policy to address the scourge of HIV/AIDS, which will, inter alia, serve as a benchmark in the principal related areas of governance.

Lowering the age of medical consent from 18 to 16 is but one of the policies that my Government will be pursing. Evidence suggests that that action will facilitate greater access to sexual and reproductive health services by those youth who need those services but do not have the requisite parental support.

Our new national strategic plan represents a dynamic approach to addressing the HIV epidemic within the country. Built on the achievements of the national AIDS programme to date, our plan places human capital at the heart of the national response. In keeping with that idea, the Government will invest heavily in behaviour change communication interventions.

We reaffirm our unswerving support for and commitment to the realization of the 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS, which will help us achieve universal access. Our response as a community must always be ahead of the changing face of that disease.

The Acting President

I now give the floor to His Excellency Gennady Onishenko, Head of the Federal Service for Supervision of Consumer Protection and Welfare of the Russian Federation.

Mr. Onishenko (Russia)

Protecting the health of the population and reducing mortality are among the most important areas of State policy for the Russian Federation. In that context, addressing the global spread of the HIV/AIDS epidemic, which claims the lives of 3 million people every year, is acquiring special significance.

In combating the epidemic, the Russian Federation is guided by the Declaration of Commitment on HIV/AIDS, adopted at the twenty-sixth special session of the General Assembly in 2001. The international conferences on AIDS in Eastern Europe and Central Asia, held in Moscow in 2006 and 2008, reviewed the results of organizational and prevention activities in the region and charted a course to effectively combat the epidemic.

Among the other momentous international events in this field, I should mention the Group of Eight (G-8) Summit held in Saint Petersburg in July 2006. On Russia's initiative, that meeting analysed the issue of consolidating the efforts of the international community to combat the spread of infectious diseases -- especially HIV/AIDS -- as well as the G-8 report on the implementation of the commitments to combat HIV/AIDS, tuberculosis and malaria that was produced in 2007 on the initiative and with the direct participation of Russia.

In our country, the basis of State policy and strategy in this area is determined by the federal law on the prevention of the spread in the Russian Federation of diseases caused by the human immunodeficiency virus, which guarantees for all HIV-infected citizens access to a comprehensive array of services. The Governmental Commission on HIV Infection and the Coordinating Council on HIV/AIDS are working to implement those principles. Members of civil society and people living with HIV actively participate in those bodies.

The Russian Federation clearly recognizes the magnitude of the threat posed by HIV/AIDS and attaches priority importance to the issue. Significant progress has been made in the past two years to improve prevention and access to treatment, care and support for people living with HIV. To that end, major national programmes and projects have been carried out whose objectives are in line with the concept of universal access established by the Joint United Nations Programme on HIV/AIDS.

In the course of the implementation of our priority national project on health care, in 2007 and 2008 the federal budget alone allocated $450 million to diagnosing and treating HIV infection and to the implementation of prevention programmes. That figure is dozens of times larger than it was in the previous period.

In order to identify HIV infection, over 23 million tests are carried out annually. More than 35,000 HIV-infected patients are currently receiving antiretroviral therapy, with more than 90 per cent of HIV-infected pregnant women undergoing full prevention therapy. Those activities will be significantly scaled up this year.

Changes have been made to the system of organizing and providing medical assistance to people with HIV. New standards for treating people living with HIV have been adopted that are consistent with international standards. In 2007, we implemented more than 300 different prevention projects.

Financing has been increased for non-governmental organizations and civil society groups involved in combating the epidemic, above all as regards prevention. For the period 2008 to 2010, $50 million will be devoted to research into a vaccine against HIV infection and to the establishment of a mechanism to coordinate research in Eastern Europe and Central Asia and to harmonize that research with the work of the global HIV vaccine centre.

We attach great importance to international cooperation in the humanitarian field, especially with regard to public health. Combating infectious diseases -- especially HIV/AIDS -- has been made one of the priorities of the Russian Federation's policy on its participation in international development assistance, which was approved in June 2007. In that connection, in addition to the previous commitment to provide it $40 million, a decision was taken to reimburse the Global Fund to Fight AIDS, Tuberculosis and Malaria in the amount of an additional $217 million. Of that amount, $118.5 million has already been disbursed to the Fund to expand assistance to developing countries.

Our own experience with regard to cooperation with the Commonwealth of Independent States shows that efforts at the regional, subregional and local community levels are becoming critically important. Russia is ready to assume leadership in the region with regard to a number of aspects related to addressing the epidemic. Above all, we view that as a responsibility for expanding technical, financial and organizational assistance. I am confident that the political commitment demonstrated at this meeting, backed by practical measures, will open a new important chapter in the history of global partnership against HIV/AIDS.

The Acting President

I now give the floor to His Excellency The Honourable Trevor Mallard, Minister of the Environment of New Zealand.

Mr. Mallard (New Zealand)

Let me first thank the Secretary-General for his report (A/62/780) and acknowledge the work of the co-facilitators and the Joint United Nations Programme on HIV/AIDS (UNAIDS) in organizing this 2008 review. We also want to acknowledge the extraordinary leadership of Dr. Peter Piot and thank him for his commitment to our region.

New Zealand is very committed to achieving universal access to prevention, treatment, care and support for people affected by HIV and AIDS by 2010. However, we must all understand what needs to be done. We therefore strongly support the focus of UNAIDS under the theme "Knowing your epidemic". To build on the work done to date, we have to be brave enough to seek out the correct evidence and to know the truth about our epidemics. We need to have the right information to know the epidemic.

Our data collection cannot reflect reality when people are afraid to tell the truth: if, for example, a young sexually active woman or man says they are not sexually active out of fear that their parents and community will punish and condemn them; if, for example, a drug user cannot get access to clean needles out of fear of being discriminated against and imprisoned; if, for example, a man who has sex with another man says he got HIV from a woman out of fear of public condemnation; if, for example, an HIV-positive sex worker is forced to lie about her HIV status because she knows that there is no other way to feed her children; and if, for example, a wife cannot get the sexual and reproductive health services she needs because her husband does not support her wish to use condoms.

We have witnessed the feminization of HIV/AIDS. We recognize the vulnerability and inequality for so many women in all societies. Violence against women and negative and harmful practices that subordinate women are fuelling the HIV/AIDS epidemic.

Human rights approaches are essential. We in the global community must eliminate stigma and discrimination from the lives of people affected by, and infected with, HIV. We must integrate HIV and sexual and reproductive health programmes. Bringing HIV-related programmes into the mainstream of health systems and through multisectoral approaches will deliver cost-effective outcomes.

HIV/AIDS is a major obstacle to development and is a constraint to achieving the Millennium Development Goals. It cuts across all sectors. The response to HIV and AIDS is linked to the reduction in child and maternal mortality and gender equality. We believe that better coordination at the country level promotes stronger ownership and leadership.

An example of our approach can be seen in our support to countries in the Pacific region to implement the Pacific regional strategy on HIV/AIDS. That includes working with all partners to strengthen health systems and to build workforce capacity to sustain the progress made so far.

New Zealand is one of the world leaders in the area of evidenced-based prevention. We have one of the lowest rates of HIV prevalence. We have achieved that by putting human rights at the centre of our response -- by decriminalizing men who have sex with men and making discrimination on the basis of sexual orientation and HIV status illegal and by decriminalizing prostitution and establishing needle exchange programmes. That could happen only through true partnerships between civil society, especially people living with HIV, and the Government of New Zealand.

To make every person count, we must ensure that we count every person. The only way to do that is to eliminate stigmatization and discrimination. Let us act together in solidarity to ensure that, when we meet again in 2011, we have met the 2010 target of universal access to prevention, care, treatment and support. That way we can count our success and know that it is true.

The Acting President

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

Mr. Daraloy (Laos)

On behalf of the delegation of the Lao People's Democratic Republic, allow me at the outset to express our appreciation for the opportunity to participate in this high-level meeting on AIDS. We highly commend the United Nations for the initiative to organize this timely meeting to undertake a comprehensive review of the progress made in achieving our commitments with regard to HIV/AIDS.

The Lao People's Democratic Republic continues to be classified among countries with a low prevalence of HIV. The prevalence of HIV is less than 1 per cent among the general population. Between 2000 and 2007, the cumulative number of people living with HIV was about 2,500 -- with 1,600 having AIDS and 800 having already died.

Despite that low prevalence, we are not complacent. We realize that we are living in an era of regional and global integration. The Lao People's Democratic Republic is making the transition from landlocked country to land-linked hub. That brings both opportunities and challenges. That includes, for example, a rapid increase in the exchange of goods and persons, including migrant workers and tourists, the influence of inappropriate values and lifestyles and the phenomenon of human trafficking. All of that will make us vulnerable to the spread of HIV/AIDS and permanently expose us to the threat of the epidemic.

In order to face that threat, the Lao Government is fully committed to fighting HIV/AIDS and is involving its entire society in that undertaking. To that end, HIV/AIDS has been incorporated into our national growth and poverty eradication strategy, as well as other development policies of the Government. In the implementation of the strategy, we are focused on prevention through the promotion of safer sexual behaviour, while at the same time addressing treatment, care and support. All those activities are targeted at high-risk groups. By doing so, we believe that we can prevent an epidemic among the general population. There are indications that the overall prevalence of HIV among sex workers has stabilized, decreasing from 2 per cent in 2004 to 0.6 per cent this year. The prevalence of HIV among their clients has also dropped.

With regard to our national performance in achieving universal access, the Lao People's Democratic Republic is classified as a country on track, with some challenges ahead. Some progress has been made in that regard -- for instance, counselling and testing activities have been expanded, with the number of individuals tested having increased twofold between 2006 and 2007. The coverage of prevention activities among sex-workers is also high, with more than 70 per cent utilizing condoms.

We have also started prevention activities directed at men who have sex with men. We plan to expand those activities with the support of the Global Fund.

We have worked on the issue of preventing HIV among injecting drug users by creating a task force on HIV and drug use.

We are committed to treatment, care and support for people living with HIV. Two facilities are currently providing antiretroviral treatment, with three more planned for the next few years. Coverage in the antiretrovirals programme now stands at 60 per cent. There is no waiting list and everyone in need of antiretroviral treatment is enrolled.

In order to fully achieve the ambitious goal of universal access to coverage by 2010, there is a need for greater political commitment and external support. To date, the support provided by the Global Fund, the United Nations system, development partners and other stakeholders has proved that the universal access indicators can be achieved. In that regard, we would like once again to express our profound gratitude to the donor community for the continued support rendered to us. We hope that we will continue to enjoy such support.

The Lao People's Democratic Republic reaffirms its political commitment to fighting AIDS. AIDS is neither an exclusively global challenge nor one that only confronts a country like ours. We have to make the money work. We have to motivate and support a comprehensive multisectoral response, and we have to keep our focus on social protection, the strengthening of health systems and respecting human rights. We have to integrate HIV into our health system, as the country faces numerous health challenges.

We are pleased that the Lao People's Democratic Republic remains classified as a low-prevalence nation. We think that our national efforts to date have contributed to that low prevalence. However, we know that we are at risk as a nation. Continued action is necessary. We are committed to taking that action. However, the Lao People's Democratic Republic is one of the least developed nations in the world. Our economy is growing, but our resources are still limited. We request continued and increased support for our future efforts to remain a low-prevalence nation. A modest amount of support now can forestall a much greater problem in the future.

With such an approach and with determination, we will cooperate with all our partners in the greater Mekong subregion and in the Association of Southeast Asian Nations, as well as with neighbouring countries in the Western Pacific region and countries in other parts of the world. With such conviction, let us wish the high-level meeting full success.

The Acting President

I now give the floor to His Excellency Mr. Bernat Soria, Minister of Health and Consumer Affairs of Spain.

Mr. Soria (Spain)

It is an honour for me to participate for the first time in the deliberations of the General Assembly. I would like to begin by pointing out the relevant role of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and by expressing our appreciation to Dr. Piot, its Executive Director, and his entire team for the achievements made. His vision of the response necessary in the face of AIDS, the enormous capacity for work he has demonstrated and his political and cultural acumen have been crucial in defining how the world must respond to an epidemic.

I should first like to express my support for the statement made on behalf of the Slovenian presidency of the European Union and to explain how my country has met its commitments at the national and international levels.

Although Spain was the European country in which the epidemic had the greatest impact, we can nevertheless say that since the mid-1990s we have experienced a favourable evolution in its decline. That result was possible due to the framework we put in place to involve all stakeholders in acting in a coordinated way, as well as to the fact that there is universal coverage as regards prevention and treatment. The participation of non-governmental organizations (NGOs) and affected persons themselves in that framework was also crucial in developing preventive policies and ensuring access for the most vulnerable members of the population. Some of those NGOs are represented here today, and I express to them my heartfelt appreciation. Moreover, in the context of that framework, we continue to emphasize the need to renew our commitment to prevention, for the strategies we have put in place are continuing to prove their effectiveness. In that connection, I should like to underscore the effectiveness of harm reduction strategies, which have been at the centre of our prevention strategy.

Those programmes were put in place in Spain during the final decade of the twentieth century, as we understood and accepted the root cause of the problem. This is not a matter of changing the habits or sexual orientation of people; rather, it is about reducing risky behaviours and providing solutions that do not clash with reality and can be accepted by the most vulnerable groups. As the Assembly is aware, the availability of sterile syringes for all injecting drug users and the provision of opiate substitution treatment continue to be crucial to controlling HIV and the hepatitis-C virus.

We in Spain have just adopted -- unanimously and with the consent of all the relevant administrative bodies -- a new plan to combat HIV/AIDS infection that takes into consideration the efforts to be made in the next five years and relies on cooperation and consensus from all those affected. It is a plan in which combating stigmatization and discrimination are among the main priorities. Protecting human rights through solidarity, tolerance, respect for diversity, the defence of confidentiality and voluntary diagnostic testing has enabled early detection and a more adequate response.

My Government is pursuing the achievement of the Millennium Development Goals as a great opportunity to promote a global vision of progress. We have therefore bolstered our institutional presence and participation in cooperation programmes that prevent discrimination on the basis of age, gender, ethnic origin or social status.

Apart from being an ethical imperative, reducing the prevalence of AIDS and many other diseases that could become globalized is an essential joint task in achieving harmonious and sustainable human development. In order to reduce the burden created by those diseases and alleviate their devastating consequences, we must follow a medications policy that allows universal access to essential drugs.

In recent years, Spain has made a remarkable effort in the area of international cooperation. The goal has been to reduce the growing gap between needs and the resources available. Our official development assistance (ODA) for 2008 will exceed 5.5 billion, thereby making it possible for us to meet the commitment of devoting 0.5 per cent of our gross domestic product (GDP) to ODA and putting us on track to achieving the 0.7 per cent target by 2012.

Our development assistance committee recently determined that Spain was the donor to have most increased its assistance in 2007. That makes us the seventh largest donor in absolute terms, and ninth when our aid is viewed in relation to GDP.

Mr. Soria (Spain)

Our Government is also continuing to increase its contributions to other multilateral bodies, such as the International Drug Purchase Facility, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance. We know that many prevention and treatment needs are not being met. In that regard, we shall continue to work and to invest in cooperation until we have honoured the commitments we have undertaken.

I should like to conclude by acknowledging the efforts made by international organizations, Governments, NGOs and the private sector in the fight against this epidemic. UNAIDS and the Global Fund have multiplied their budgets many times over and intensified their technical and political efforts in order to improve results.

The special session of the General Assembly that we are marking today succeeded in making changes to many political agendas. The number of persons who have access to prevention and treatment services today cannot be considered an absolute success, but it can be viewed as great progress.

The Acting President

I now give the floor to His Excellency Mr. Abdallah Abdillahi Miguil, Minister of Health of Djibouti.

Mr. Miguil (Djibouti)

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