Your Excellency, Vice President of the Republic of Zambia, Vice President of Malawi, Prime Minister of Mozambique, Vice Prime Minister of Swaziland, Professor Luo, Honourable Ministers, colleagues, friends, comrades in arms.

It is once again a great privilege and pleasure to speak at the opening ceremony of the International Conference on AIDS in Africa, which I have attended each time since we started back in 1985.

That said, I have to admit that my pleasure evaporates when I take stock and realize that the past 15 years give us little cause for self-congratulation.

How can we, when the epidemic kills more people than ever?

When there is HIV prevalence of over 30% among women in some cities?

When AIDS activist Gugu Dlamini can be beaten to death - so far with impunity - simply for being open about her serostatus.

When a teacher in Côte d'Ivoire dies from AIDS every school day.

When letters arrive in my office from Africa almost every day from HIV-positive people asking for therapy they cannot afford.

When in 1997, only US$ 150 million went to HIV prevention in sub-Saharan Africa - when countries need funding of a completely different order of magnitude.

The current situation should make us incredibly angry or incredibly sad. Certainly we have all worked hard, and much has been accomplished.

But congratulations are not yet called for.
Not yet…
But perhaps sometime soon.

In the past year, I see changes that confront my anger and sadness with a tinge of hope.

First, I see growing awareness that AIDS in Africa is a crisis in development - a massive development catastrophe requiring an emergency response.

Second, at the highest level in virtually all African countries, I see commitment to mobilizing against the epidemic. We have only to look around in this room for evidence: in addition to the familiar faces of so many who have played important roles in the response against AIDS, I note the welcome presence of some of the continent's most respected leaders. If you'll pardon a military metaphor: The heavy artillery is at last beginning to arrive.

Third, people living with HIV are ever more organized and involved in the response, with support groups being established everywhere. Yes, there is a resistance. But there is also persistence. I saw extremely moving evidence of that recently: in Addis Ababa at the launch of the "Dawn of Hope" by the President and the Patriarch of Ethiopia; and then a couple of weeks ago in Namibia, when the President and the Catholic Archbishop welcomed a group of people living with HIV in Windhoek's Cathedral.

Fourth, AIDS has finally become an institutional priority for an increasing number of international partners, including the Cosponsors of UNAIDS and major bilateral agencies present here, as you heard from the World Bank, the World Health Organization, the European Community and the United States of America. That is a lot of financial and technical leverage. Fifth, there is visible momentum towards increasing resources for AIDS prevention and care. Not enough, but it is growing. Our intention is to build further on this momentum and to make sure that these resources reach local or district-level communities, as it is there that a difference can be made.

Finally, I am happy to say that through the International Partnership Against AIDS in Africa we are now building a broad coalition of governments, multilateral organizations, bilateral development agencies, NGOs and the corporate sector. The Partnership is now the top priority for UNAIDS, and my personal priority.

With all these hopeful developments, it is hard to believe that we are still severely hampered by our old enemy, stigma. If anyone doubts that stigma is alive and powerful as it was fifteen years ago, they need only remember what happened to Gugu Dlamini, and what happens every day to millions of people living with HIV. For we too often forget that stigma remains our most significant challenge in AIDS.

It makes prevention through education very difficult.
It discourages people from seeking testing and counselling.
It makes it extra hard for an infected person to share the news with a partner.
It keeps people from accessing care, even where care is available.

And stigma undermines the political support we know is so necessary. Eliminating stigma must therefore be central in the response to AIDS. It is a key way to break the silence and to move the response forward.

But let us be clear: breaking the silence means breaking the secrecy around AIDS.
It does not mean breaking confidentiality about HIV.
Let me make one last point.

With each passing day, the gap between rich and poor countries in caring for people with HIV is becoming morally more reprehensible.

I'm aware that a gap in access to all kinds of care is not new; it was there long before AIDS erupted. But AIDS in Africa poses a special challenge. First let us not neglect that with generic medicines we can do a lot to treat and prevent opportunistic infections, and to reduce pain. And this must be part of the community standard of care everywhere. But tragically, access to even the most basic of generic medicines is woefully inadequate.

The care gap must be bridged from several different directions. Within those different directions, we cannot ignore the high end of the drug market.

Everyone agrees that the price of antiretroviral drugs must come down far more dramatically in order to have a positive impact on many people's quality of live and access to care. We in the United Nations system and in a growing number of countries are negotiating and working with the pharmaceutical industry to make these drugs more accessible. There has been progress, but progress to date has been insufficient.

Therefore, mechanisms such as compulsory licensing, transfer of technology, parallel import of drugs, and joint procurement by several countries also are being investigated. While we must respect international treaties on trade and intellectual property, we surely have compelling justification: AIDS is an unprecedented crisis, requiring special measures.

Those measures should also include the humanitarian entrepreneurship of innovators within the pharmaceutical industry to be more creative in finding ways to bring the power of science to the service of the people.

As requested by the Community Forum yesterday, and as stated in the political declarations approved this morning:
The time is now to declare AIDS in Africa a state of emergency requiring emergency type efforts and resources.

You have all heard the saying that "It takes a village to raise a child". It will take this entire continent - to defeat the epidemic which threatens the future of Africa.

It will take the whole world to support Africa in this struggle.

Together, we will succeed.

I wish you a successful conference.

Thank you.