The Philadelphia Inquirer
NEW YORK -- The United Nations General Assembly last night approved by acclamation a sweeping plan to combat AIDS around the globe. The plan sets timetables for reducing the prevalence of the disease among young people in the hard-hit countries of sub-Saharan Africa and cutting the transmission of the AIDS virus from pregnant women to their newborns.
In the document, the first in United Nations history to call for global action to combat an infectious disease, the 189 member nations commit themselves to an array of actions, including:
* Pursuing comprehensive HIV-prevention and -treatment programs, including anti-AIDS medicines.
* Approving antidiscrimination laws to protect the rights of people infected with HIV.
* Ending gender inequality that puts women at high risk of HIV.
* Promoting the use of male and female condoms to prevent the spread of HIV sexually and clean needles to prevent its spread through injected-drug use.
* Stepping up research into affordable AIDS vaccines.
* Canceling debt in the poorest countries to be hard hit by the epidemic.
U.N. Secretary-General Kofi Annan, speaking at a news conference, hailed the agreement as "a blueprint for which the whole of humanity can work," and said it properly put women's rights at the forefront of the battle.
"It is said that girl power is Africa's own vaccine against AIDS," Annan said. "That should be true for the whole world."
Nearly half of the more than 36 million people in the world living with HIV are women, including large numbers of adolescent girls. In sub-Saharan Africa, about 12.2 million women are infected, and 10.1 million men. The lack of basic human rights, including education, employment and the right to inherit property, make women especially vulnerable to HIV.
That's because women's dependence on men often gives them no power to negotiate in the bedroom or leave the relationship.
Although not legally binding, the document sets specific goals to which countries could be held accountable. The document also calls for a global AIDS fund that would increase AIDS spending in developing countries to $7 billion to $10 billion a year by 2005, up from $1.8 billion a year now.
The money is from various sources, including the national budgets of poor countries, foreign aid from rich countries, and financing by the World Bank.
Since April, the fund has generated pledges of more than $1 billion, and checks from private citizens are coming in. At his news conference, Annan held up a check for $1,000 from an unnamed citizen. "I am delighted to say it is my first installment" from a private citizen, he said.
Peter Piot, executive director of UNAIDS, which oversees the pandemic, said the fund would be lean on administrative staff and overhead; would be governed by a small board of representatives from governments, nonprofit organizations and U.N. agencies; and would have "a strong evaluation component" to insure that the money raised is used for its intended purpose.
Details of the fund's operation are to be worked out in a few weeks, U.N. officials said.
The declaration is the result of intense negotiations to resolve objections from Islamic countries that opposed language calling on countries to target prevention and treatment at those most at risk - men who have sex with men, commercial sex workers, and drug users who inject.
Under a compromise, European countries, which had been most vocal in wanting to name the risk groups, agreed instead to language that refers to the "most vulnerable" groups.
On the other hand, the Islamic countries appear to have given ground in the area of women's rights. The declaration is a virtual Bill of Rights for women. Countries agree to adopt, "as appropriate," measures to end discrimination against women in education, inheritance, employment, health care and other areas; they agree to step-up programs that give women control over their sex lives and reproductive health; and they agree to end violence against women and girls, including rape, battering, trafficking in prostitution, and "harmful traditional and customary practices," which are not spelled out.
The document also calls for the development of microbicides - chemicals that women could use without the knowledge of their male sex partners - to prevent sexual transmission of the virus. Such chemicals, which are still under study by scientists, are regarded as critical in the fight against HIV because many women don't have the power to get their male sex partners to wear condoms.
An array of special-interest groups - from pharmaceutical companies to humanitarian organizations to people living with HIV - expressed strong support for the declaration in interviews yesterday.
Richard Burzynski, head of the International Council of AIDS Service Organizations, said his group would work to implement the document even though it lost the battle to name those groups most at-risk of HIV. "It's not going to throw us off course," he said. "We know who the vulnerable groups are."
Still, in a passionate statement to the assembly, Burzynski criticized the Islamic bloc for invoking religion to condemn homosexuals and others most at-risk of HIV. "No God, in any religion, in any culture, could countenance the death and devastation this disease has caused," he said. "It is up to us, not to any deity, to stop this thing now."
Stu Flavell, head of the Global Network of People Living with HIV and AIDS, praised the document for including treatment and not just focusing on HIV prevention. "For those of us living with HIV, this is critical," he said.
The declaration also drew praise from both sides in the recent debate over access to generic AIDS drugs in developing countries. Doctors without Borders, an international humanitarian group, said the document put "AIDS treatment clearly on the map," including generic AIDS medicines.
Jeffrey Sturchio, a spokesman for Merck & Co., said the drug industry was pleased that use of generics and lower drug prices for poor countries will be within the framework of international law.
"That's what the pharmaceutical industry has been calling for all along," Sturchio said.
But the HealthGAP Coalition, a group of American AIDS activists, criticized the declaration for making only "the vaguest of gestures" toward naming at-risk groups, barely mentioning drug patents as a hindrance to drug access, and failing to insure that the bulk purchase of generic drugs will be included in the portfolio of the proposed global AIDS fund.
"It's a very weak tool for advocates to take home," said Paul Davis, a member of the Philadelphia chapter of ACTUP and a HealthGAP organizer.
Huntly Collins' e-mail address is hcollins@phillynews.com.
Proposed AIDS Global Fund
Total sought: $7 billion to $10 billion
Total pledged: More than $1 billion
Individual pledges:
* United Kingdom: $200 million
* U.S.: $200 million
* Ireland: $150 million*
* France: $127 million
* Norway: $110 million*
* Bill and Melinda Gates Foundation: $100 million
* Canada: $73 million
* Sweden: $60 million
* Nigeria: $10 million
* Uganda: $2 million
* Austria: $1 million
* Credit-Suisse: $1 million
* Zimbabwe: $1 million
* International Olympic Committee: $100,000
* U.N. Secretary-General Kofi Annan (Philadelphia Liberty Medal award): $100,000
* Liberia: $25,000
* Kenya: $7,800
* Nauro: $5,000
*Over five years.
SOURCE: UNAIDS, as of June 27.
To make a donation
To contribute to the global AIDS fund, write a check to UNF-Global Fund for HIV/AIDS Health. Send to:
UN Foundation
Attention Global Fund
Box 31001-1899
Pasadena, Calif. 91110-1899