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Global AIDS: Amazing Gains, Monstrous Failures

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There has been amazing progress in addressing global AIDS over the past five years. Activist pressure and generic competition has driven the price of AIDS drugs down by more than 98 percent, making it possible for donors to invest money in treatment to keep people alive. An HIV-positive diagnosis is no longer an automatic death sentence. About 1.3 million people worldwide are now receiving treatment, a million more than five years ago, according to UNAIDS.

Prevention efforts are also making great headway in many places. Six of 11 African countries heavily affected by HIV report a decline of 25 percent or more in HIV prevalence among 15-24-year-olds in capital cities since 2001, for example.

And governments are spending more than $8 billion a year to address the problem.

There are many heroes in all that has been achieved, but these remarkable gains are really due to mobilized communities of people living with HIV in the Global South, and their activist allies in the rich countries. Groups like Health GAP (disclosure: I'm a board member) and the Global Aids Alliance have had quite remarkable influence on U.S. government policy, and helped maneuver so that the United States now spends billions to address global AIDS.

There are many heroes in governments, too, some famous names and many more second-tier or lower-level officials in countries rich and poor. They have helped push for a humane response to what is probably the worst pandemic the world has seen since the Black Death.

But governments by and large have been brought along kicking and screaming, and too often have been -- and remain -- obstacles to good policy. As a result, the global AIDS achievements fall far short of what could be done. Millions who should be receiving treatment are not, people with HIV/AIDS remain terribly stigmatized, and underfunded, inept and misguided prevention programs are allowing the pandemic to continue to spread needlessly.

The latest evidence of shameful government action and inaction comes from New York, where a meeting of the United Nations -- a follow-up to a special session five years ago -- is finishing up with a declaration that avoids firm commitments and refuses to acknowledge the needs of vulnerable populations, including gay men, sex workers and injecting drug users.

Here's the word from a coalition of activist groups:

Press release
June 2, 2006
For more information contact:
Asia Russell +1 (247) 4752645 asia@healthgap.org or Kieran Daly +1 (416) 2758413

International civil society denounce UN meeting on AIDS as a failure

Civil society groups from around the world denounced the final UN Political Declaration on HIV/AIDS, released after marathon negotiations during the UN High Level meeting on AIDS this week.

"Once more we are disappointed at the failure to demonstrate real political leadership in the fight against the pandemic" said The Most Revd Njongonkulu Ndungane, the Anglican Archbishop of Capetown. "Even at this late stage, we call on the world's political leaders to rise up and meet the challenges that the pandemic presents and to set ambitious targets at a national level to guarantee universal access to treatment, care, support and prevention."

UN Member States refused to commit to hard targets on funding, prevention, care and treatment. They rejected frank acknowledgement that some of the today's fastest growing HIV epidemics are happening among injecting and other drug users, sex workers and men who have sex with men. "The final outcome document is pathetically weak. It is remarkable at this stage in the global epidemic that governments can not set the much needed targets nor can they can name in the document the very people that are most vulnerable" said Sisonke Msimang of the African Civil Society Coalition.

"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" said Leonard Okello, Head of HIV/AIDS for Action Aid International. "The negotiation processes was guided by trading political, economic and other interests of the big and powerful countries rather than the glaring facts and statistics of the global AIDS crisis, seventy percent of which is in Sub-Saharan Africa."

African government delegations reneged on their promises in the 2006 Abuja Common position agreed to by African Heads of State. South Africa and Egypt, in particular, took a deliberate decision to oppose the setting of targets on prevention and treatment, despite the fact that both participated in the Abuja Summit that endorsed ambitious targets to be reached by 2010. "The continent that is most ravaged by AIDS has demonstrated a complete lack of leadership. It is a sad, sad day as an African to be represented by such poor leadership" said Omololu Faloubi of the African Civil Society Coalition.

But the African governments were not alone. The United States was particularly damaging to the prospects for a strong declaration. Throughout the negotiations they moved time and again to weaken language on HIV prevention, low-cost drugs and trade agreements and to eliminate commitments on targets for funding and treatment. "It's death by diplomacy," said Eric Sawyer, veteran activist and 25-year survivor of HIV/AIDS. "Hour after hour, my government fought for its own selfish interests rather than for the lives of millions dying needlessly around the globe"

There has however been a strong recognition in the declaration of the alarming feminization of the pandemic. Commitments were made to ensure that women can exercise their right to have control over their sexuality and to the goal of achieving universal access to reproductive health by 2015.

This progress was undermined however by regressive governments. "Syria, Egypt, Yemen, Iraq, Pakistan and Gabon blocked efforts to recognize and act to empower girls to protect themselves from HIV infection" said Pinar Ilkkaracan, President of Women for Women's Human Rights. "Their failure to commit to ensuring access to comprehensive sexuality education for young people, and promote and protect sexual rights will undermine the response to the HIV pandemic."

This was compounded by the declaration failing to acknowledge that some of the today's fastest growing HIV epidemics are happening among injecting and other drug users, sex workers and men who have sex with men, despite strong support from the Rio Group of countries. For example, governments have ignored the needs of injecting drug users by not stating the need for substitution drug treatment, putting them at further risk. "Failing to fully address the needs of these groups, and particularly to counter stigma and discrimination by decriminalizing drug use and sexual behaviors, will render them more invisible and ultimately lead to even higher rates of HIV/AIDS" said Raminta Stuikyte of the Central and Eastern European Harm Reduction Network.

Again the US, along with other governments, ensured that the final declaration text contains a substantially weaker reference to the AIDS funding need. It now only acknowledges that more money is needed, rather than committing to raising the needed funds. An estimated $23 billion is needed per annum by 2010 in order to fund AIDS treatment, care, prevention and health infrastructure. "At this stage in the pandemic, we expected government commitment to close the global funding gap," said Kieran Daly of the International Council of AIDS Service Organizations. "Instead they have tried to let themselves off the hook."

While there has been a failure of governments to face the realities of HIV/AIDS, civil society will be holding them to account. Civil society will hold governments to account to deliver on universal access. Civil society will make sure governments recognize and support vulnerable populations. The failure of governments to commit will not be accepted.

EDITORS NOTE: "Vulnerable populations" includes women and girls, youth, older people, men who have sex with men, injecting and other drug users, sex workers, transgenders, people living in poverty, prisoners, migrant laborers, orphans, people in conflict and post-conflict situations, indigenous peoples, refugees and internally displaced persons, as well as HIV/AIDS outreach workers and people living with HIV/AIDS.

Supporting organizations:
AAHUNG
ACT UP NY
Action Aid International
Advocates for Youth
AfriCASO
African Committee Services
AIDS Access Foundation
Aids Fonds
AIDS Foundation East-West
AIDS Law Project
AIDS Task Force, Africa Japan Forum
Asia Pacific Council of AIDS Service Organizations (APCASO)
Australian Federation of AIDS Organisations (AFAO)
Blue Diamond Society
CALCSICOVA (Cordinadora de Asociacia Ves de Lucha Contra el SIDA de la Cournida Valenciana
Catolicas por el Derecho a Decidir (Brasil)
Center for AIDS Rights, Thailand
Center for Health and Gender Equity
Central and Eastern European Harm Reduction Network (CEEHRN)
CESIDA - Coodinadora Espanalu en Sida
Colectivo Juvenil Decide/ Bolivia
European AIDS Treatment Group
GAT-Grupo Portugues de Activistas Sobre Tratamentos de VIH/SIDA
Gender AIDS Forum
Global AIDS Alliance
Global Youth Coalition on HIV/AIDS Eastern Africa Region
Global Network of People Living with HIV/AIDS (GNP+)
Health & Development Networks
Health GAP (Global Access Project)
HelpAge International
HIV Association Netherlands
Housing Works, Inc
ICW Latina
International Council of AIDS Service Organisations
International HIV/AIDS Alliance
International Women's AIDS Caucus & FEIM
International Working Group in Social Policies and Sexuality
International Parenthood Planning Federation (IPPF)
Journalists Against AIDS (JAAIDS/Nigeria)
Namibia Network of AIDS Service Organizsations (NANASO)
National AIDS Trust (UK)
National Association of PLWHA in Namibia (Lironga Eparu)
National Empowerment Network of PLWHA in Kenya
Nepal HIV/AIDS Alliance
New Ways
NNIWA
OSISA
Positive Action Movement, Nigeria
Positive Women's Network
Red Latinoamericana y Caribena de Jevenes pro la Derecliora Sexuales y Reproduction (REDLAC)
Red Tra Sex
RED2002 (Spain)
RSMALC
Rutgers Nisso Group, The Netherlands
Sensoa V2W
SEICUS
Share - Net
Stop Aids Liberia
Student Global AIDS Campaign
Tenemos Sida (Spain)
Treatment Action Group (TAG)
Treatment Action Movement, Nigeria
UK Coalition of People Living with HIV and aids
Unitarian Universalist United Nations Office
United Nations Association in Canada
VSO
Women for Women's Human Rights (WWHR)
World AIDS Campaign
World Population Foundation, Netherlands