Declaration Lacks the Teeth to Take a Stronger Bite Out of HIV/AIDS

John W. Foster

Coinciding with the 25th anniversary of the first diagnosed AIDS case in North America, the UN General Assembly assessed progress against the pandemic since the 2001 Special Session on HIV/AIDS in a three-day session May 31-June 1, and issued a political declaration. Negotiations were complex and long-drawn, concluding only on the eve of the final day with the arrival of ministers.

The final declaration of the Assembly included:

- Recognition that while at least $23 billion (US) annually will be needed to fight the international pandemic by 2008, only $8.3 was spent last year. The declaration recognizes the need for increased investment by 2010 in saving lives.

- Specific mention of condoms, harm reduction efforts and sex education.

- A strong recognition of the feminization of the pandemic, along with commitments to make sure that women can exercise their right to control their sexuality and the goal of achieving universal access to reproductive health by 2015.

- Clear agreement that HIV/AIDS response must be include human rights protection and be supported by enhanced health systems with adequate human resources.

- A commitment to research in key preventive and treatment elements including microbicides, treatment combinations for children and youth and vaccines.

- A commitment to encourage countries needing affordable drugs to utilize all the "flexibilities" in WTO Intellectual Property provisions (TRIPS) and to support them in doing so.

- A commitment to continued review of progress through review events in 2008.

Overall, the declaration lacked the targets and timelines that many sought. It was weaker on the kind of resource commitments that a successful combat against the disease requires, including the need to cancel debt. It did not address the constant expansion of TRIPS plus guarantees for big pharmaceuticals contained in bilateral and regional trade agreements.

More positively, the Special Session itself included an interactive session between governments and civil society organizations, including many people living with HIV/AIDS on both official and NGO delegations. There was a striking convergence of civil society priorities and demands. UN Secretary-General Kofi Annan provided strong verbal and practical leadership highlighting people living with HIV/AIDS and specifying vulnerable groups.

"Death by Diplomacy"

A significant number of civil society groups denounced the final declaration as "pathetically weak". The United States' role was "particularly damaging", opposing strong language on prevention, low-cost drugs and trade agreements, as well as targets for funding and treatment.

Others were very critical of the role played by a number of Islamic governments in terms of opposition to the mention of specific vulnerable groups and resistance on gender issues, including empowering young women to protect themselves and the need for comprehensive sexual education.

African governments had just completed a comprehensive approach to HIV/AIDS in Abuja, Tanzania, but failed to press the approach in New York, eliciting disappointment and outrage from the many African civil society representatives at the UN. As one of them stated, "African governments have displayed a stunning degree of apathy, irresponsibility, and complete disrespect for any of the agreements they made in the last few months."

Mr. Annan himself, rather unusually, criticized the declaration for its lack of specific reference to such vulnerable groups as women and girls, migrant labourers, prisoners, refugees, indigenous peoples, sex trade workers, injection drug users, and men who have sex with men who are of key concern in many non-African countries where the pandemic is "taking off".

UK Development Minister Hilary Benn told the General Assembly "I wish we could have been a bit more frank in our document about telling the truth. Abstinence is fine for those who are able to abstain, but human beings like to have sex, and they should not die because they do have sex."

Anglican Archbishop Ndungane of Capetown expressed overall "disappointment at the failure to demonstrate real political leadership in the fight against the pandemic."

Canada: Excellent Marks and Missing Specifics

Canada's Minister of International Cooperation, Josée Verner hit many positive notes in her address: a strong emphasis on human rights, gender equality and sexual and reproductive rights; the need to "reach everyone in need with the complete continuum of prevention, care and treatment interventions"; voluntary testing with counseling; the priority of addressing the needs of affected children and orphans; access to condoms; strengthened health systems; research into vaccines and female-controlled prevention methods such as microbicides along with treatment formulations for children. She summarized Canada's previous financial commitments to Global Fund, UNAIDS and the WHO 3 by 5 campaign.

Given this strong opening some new initiatives might have been expected:

- The need to meet the challenge of human resources for health was mentioned. Canada is one of the leading countries scooping up health workers from developing countries. No counter-measures were mentioned.

- Canada's commitment to "make rapid progress toward the goal of 'universal access' was stated, but clear commitment to the target of universal access by 2010 and leadership to get there was not.

- While Canada's existing contributions were mentioned, no new pledge of resources to get us to universal access was made.

- While the issue of specific mention of vulnerable groups was a major concern of civil society organizations in Canada and globally, the Minister, unlike the Secretary-General, did not choose to mention them.

More positively, Ms. Verner made strong reference to the importance of involvement of civil society and people living with HIV/AIDS in policies and programs, and proudly noted the presence of two civil society representatives in the Canadian government delegation.

The General Assembly review is not the last word on global AIDS response in 2006. The 16th International AIDS Conference will bring more than 20,000 experts, politicians and civil society representatives to Toronto in August. If the government wishes to stake out new and welcome leadership initiatives in the global fight against the pandemic, it could hardly have a better stage.

John W. Foster is Principal Researcher at the North South Institute and attended the General Assembly review on behalf of the Social Watch.