|
Statement of Dr Peter
Piot, Executive Director of UNAIDS,
on the occasion of the
Security Council meeting on HIV/AIDS in Africa
Thank
you, Mr. Vice President, and Mr Secretary-General for this
opportunity to address this body today. Twenty years ago, the
global community had not heard of AIDS. Today it is discussed
in the UN Security Council because AIDS is not a health or
development problem, like any other. It has become, in Africa
at least, an issue of human security.
Like no other
contemporary disease, aside from the magnitude of its spread,
its erosion of human capital, weakening and then killing men
and women in their most productive years, AIDS brings with it
a stigma unprecedented in modern times. From coast to coast in
Africa, HIV is undermining the stability of families and
communities of rich and poor, skilled and unskilled alike. For
most of us, comprehending the scale of the epidemic is almost
impossible. As many as one out of every four has the virus -
and will have a life cut short because of AIDS. We have heard
the Secretary General talk of 11 million orphans. We would be
shortsighted to underestimate the long-term impact of their
personal tragedies on the development and stability of Africa.
These demographic shocks bring with them social and
economic shocks, the real magnitude of which we still do not
fully comprehend. Visibly, the epidemic is eroding the social
fabric of many communities; but the longer-term macro impact -
the systemic damage to the political and economic fabric of
Africa - are still evolving.
Certainly we have seen
enough to be able to state with authority that in its
demographic, social and economic impact, the epidemic is
rapidly becoming more devastating than war. Inter-ethnic,
intrastate, interstate and international in nature, these
conflicts took the lives of 200,000 people in 1998. But
HIV/AIDS took the lives of over ten times more -- 2.2 million
-- in the same year. War is the instrument of AIDS and rape is
an instrument of war. Conflict and the resulting movements of
people, whether armed combatants, or refugees, fuel the
epidemic. In one study, 17 percent of raped women, previously
negative, became sero-positive. Refugee men and particularly
women, become highly vulnerable to HIV infection. Indeed,
another study showed that refugee women were six times more
likely to become infected in camps than the outside
population.
Humanitarian aid workers, educators,
health workers and military and police forces that are well
trained in HIV prevention and behaviour change can be a
tremendous force for prevention as long as it is made one of
their priorities. And this can apply to their service within
and outside their own countries, as well as, in the case of
military personnel, when they return home for demobilization.
War fuels the epidemic. But undoubtedly, the epidemic
itself is now, as the Secretary General has already argued,
causing social and economic crises which in turn threaten
political stability, particularly when set against a
background of complex and fragile geo-political systems.
Indeed, an important part of UNAIDS work is developing
strategies for the control and mitigation of AIDS in countries
in crisis.
But we are far from powerless against this
epidemic. In countries where strong political leadership,
openness about the issues, and broad, cross-cutting responses
come together, the tide is turning and clear success is being
demonstrated. In Uganda, the rate of new infections is
falling: the infection rate among pregnant women in towns has
fallen by more than half. In Senegal, HIV infections have been
rolled back significantly as a result of massive information
and prevention campaigns. We now know what works: two decades
of experience have identified the essential elements of
effective strategy:
1. visibility and openness, and
countering stigma;
2. addressing core vulnerability
through social policies;
3. recognizing the synergy
between prevention and care;
4. targeting interventions to
those most vulnerable;
5. encouraging and supporting
strong community participation in the response;
6.
focussing on young people, the future of the continent.
Internationally too, the tide is turning. In June 1999
the international community responded to global AIDS epidemic
by negotiating a new international development target. The
United Nations General Assembly Special Session set a target
for 2005 of reducing new infections by 25 percent in 15-24
year olds in the world's 25 most affected countries, 24 of
which are in Africa.
Over the last year, many African
leaders have spoken out in unprecedented ways, breaking the
silence and the stigma of the epidemic. The challenge is
formidable. In financial needs alone, we are a long way short
of the mark. In 1997, the international community mobilized
only $150 million for AIDS prevention for the most affected
countries. Here, that would buy less than twelve kilometers of
four lane highway - less than the cost of a single jumbo jet.
To sustain and expand the success stories of Uganda and
Senegal, we need to mobilize between $1 and $3 billion a year.
It is worth pondering how the international community
successfully mobilized hundreds of billions of dollars over
the last few years to minimize the impact of that 'other'
virus - Y2K.
Over the last year, African governments,
the UN, international donors, civil society and the private
sector have come together to form a new international
Partnership against AIDS in Africa. Last month, the Secretary
General tasked us to formulate a response commensurate with
the epidemic.
What do we need from each constituency
of the Partnership?
From African Governments:
the commitment to create the environment for effective action;
to be aggressive in protecting and promoting human rights so
that stigma can be reduced; to ensure that, through
decentralization, local responses can flourish, with adequate
financial and human resources to support them; commitment to
increase their own investment and to ensure the productive
investments of others.
From the UN System,
particularly the UNAIDS Cosponsors, WHO, UNICEF, UNESCO,
UNFPA, UNDP and UNDCP, and the World Bank: responding to the
epidemic has already brought the UN together in unprecedented
ways. But there is still much more to be done. We need to
mobilise additional and reorient existing resources to respond
to the epidemic; to demonstrate concerted action in support of
governments and civil society, ensuring the technical and
programmatic resources that governments required are.
We need to continue to involve people living with
HIV/AIDS in AIDS prevention programmes and in efforts to
reduce discrimination, to support efforts to reduce
mother-to-child transmission, to develop and make available
female-controlled prevention methods, to promote national
business councils on HIV/AIDS as well as to increase
involvement of the private sector to become the leading
players in helping their stakeholders - customers, employees
and the community - face the challenge of the epidemic.
From donor governments: to take concerted
action to work together at country level under nationally
owned strategic plans; to mainstream AIDS in setting
priorities, and to accept the challenge - following the
example of our US colleagues - to urgently treble assistance
for HIV/AIDS in Africa as a first step for more rational
financing of the international response.
From the
private sector: to work in concert with governments to
balance the difficult issues of intellectual property rights
with the urgent need to develop and make available at
affordable prices key life-saving commodities, to act
immediately to strengthen work place and community outreach
interventions, including an intensification of the efforts of
organized labor in addressing the epidemic.
From
the NGO sector, including religious organisations: to
carry on and intensify work at the front line of the epidemic,
recognizing that to do so they need enabling systems to access
financial and human resources at community level.
The
message that I bring you this morning is therefore one of
urgency and one of opportunity. The resources are being
mobilised, and the world is responding. But we are at the ten
percent mark. Shifting to the fifty, and then seventy five
percent and upwards must be the ambition of all of us here.
In the response to the epidemic, the bottom line for
the future, is that we must develop and make available safe
and affordable vaccines and other technologies required for
preventing HIV infections. The bottom line for today, is that
we must do everything in our power to apply what we know
works; to reduce vulnerability, to prevent HIV infection
through behaviour change, and to support wide-scale
implementation of efforts to provide care and access to the
drugs and services required to prolong and improve life.
At the start of this new century, I believe that there
are no development problems that more urgently command a
collective response from the international community. That in
the first month of the millennium the UN Security Council sees
fit to discuss AIDS in Africa is surely symbolic. I believe
that it signals our collective will to stop this epidemic and
our pledge to history that we will not turn our backs, and let
HIV/AIDS devastate another generation of young African women
and men.
|
Search the site