AIDS experts, speaking ahead of a U.N. General Assembly one-day session on HIV/AIDS scheduled for Monday, have said that the promise of additional funds, including President Bush's five-year, $15 billion AIDS initiative, "cannot curb the disease as long as political and social barriers hamper the fight," the AP/Las Vegas Sun reports. UNAIDS Executive Director Peter Piot said that the "denial and lack of urgency" by some governments has limited the effectiveness of international efforts to fight HIV/AIDS, the AP/Sun reports. Richard Feachem, head of the Global Fund to Fight AIDS, Tuberculosis and Malaria, added that many governments lack the funds or the will to provide HIV/AIDS patients with antiretroviral medications, although the treatments cost only $300 per patient per year for people in developing nations. Feachem said, "If in 1982, when we became aware of the virus, we had decided to do nothing in order to observe its course without intervention, the world would be roughly where it is today." However, Piot disagreed, saying that substantial progress has been made but that "far more" should have been invested in "development, security and political issues." In addition, epidemiologists said that the five-year, $15 billion proposed by Bush is a "fraction of what is needed" to fight AIDS worldwide and "overlapping programs with conflicting policies could muffle its impact," the AP/Sun reports (Rosenblum, AP/Las Vegas Sun, 9/20).
Julian Hunte, minister of external affairs of Saint Lucia and president of the 58th General Assembly, said that he hopes that the plenary meeting on AIDS will "serve as [a] driving forc[e] for action-oriented solutions" to the pandemic, according to Xinhua News Agency (Xinhua News Agency, 9/16). The special session will include 136 speakers, as well as panel discussions on AIDS-related issues. In addition to several African leaders, French President Jacques Chirac and U.S. Secretary of State Colin Powell will speak. Chirac is seen as a "prime mover" in convincing other European nations to contribute to the Global Fund, according to Reuters (Leopold, Reuters, 9/21). The session will also feature luncheon roundtables hosted by Carol Bellamy, executive director of UNICEF; Dr. Thoraya Obaid, executive director of the U.N. Population Fund; Noeleen Heyzer, executive director of the U.N. Development Fund for Women; and Dr. Jong-Wook Lee, director general of the World Health Organization (UNAIDS Infonote, 9/22).
Two years after the U.N. General Assembly Special Session on HIV/AIDS, many U.N. member states will not meet the prevention and care goals established at the 2001 meeting, according to reports released Monday by UNAIDS and U.N. Secretary General Kofi Annan. The reports are based on an analysis of surveys of 103 countries -- representing more than 90% of the people living with AIDS worldwide -- which examined 18 global and national indicators of progress toward implementing the goals established in the Declaration of Commitment adopted at the 2001 meeting. Although 93% of the 103 countries surveyed have set up comprehensive national HIV/AIDS strategies and national coordinating bodies and 88% have increased public HIV/AIDS awareness, the current pace of country-level activity is "insufficient" to meet 2005 prevention and treatment goals, according to a UNAIDS release. Other findings of the reports include:
- Funding: Despite a doubling in total domestic spending between 1999 and 2002 and an expected 20% total funding increase for programs in low- and middle-income countries between 2002 and 2003, current spending is less than half of the $10 billion required for an effective response to AIDS in 2005 alone.
- Prevention: Less than 1% of pregnant women in heavily affected countries receive information and treatment to prevent mother-to-child HIV transmission, and fewer than 5% of injection drug users receive recommended HIV prevention services. In addition, only 25% of sub-Saharan African countries report that at least 50% of people with sexually transmitted diseases are appropriately diagnosed, counseled and treated.
- Treatment: Only 300,000 people in low- and middle-income countries are receiving antiretroviral treatments out of the estimated five million to six million HIV-positive people who need treatment. In sub-Saharan Africa, only 1% of the 4.1 million people needing antiretroviral treatment had access to the medications at the end of 2002. In addition, while 80% of responding countries had policies to improve access to AIDS-related treatment, more than 33% of countries in the Asia-Pacific region have yet to adopt such policies. No countries in that region reported treatment coverage above 5%.
- Orphans: Thirty-nine percent of countries with generalized AIDS epidemics have no national policy for providing support to AIDS orphans or children affected by the epidemic, and the number of AIDS orphans worldwide is expected to increase from 14 million to 25 million by 2010.
- Discrimination: Thirty-eight percent of the countries have not yet adopted AIDS-related antidiscrimination legislation and only 36% have instituted policies protecting groups at high risk of HIV infection, such as sex workers and injection drug users. In addition, nearly 33% of the countries lack policies ensuring women's equal access to prevention and care services.
The reports recommend that countries take action to ensure that their HIV policies comply with the declaration's provisions for 2003. The reports also recommend that resources to address the epidemic in low- and middle-income countries be doubled by 2005 and tripled by 2007 and that political leaders -- especially in Eastern Europe and the Asia-Pacific region -- become more involved in anti-AIDS efforts (UNAIDS release, 9/22).
A kaisernetwork.org HealthCast of select portions of the General Assembly meeting will be available online after 5 p.m. ET on Sept. 24.
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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2003 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.