World AIDS Experts Call for Urgent Action, Say Leaders Must Demonstrate Financial and Political Commitment

AIDS: The Time to Act

AIDS is a crisis of unprecedented proportions. It is the most devastating pandemic in human history. 36 million people around the globe are living with HIV, 22 million men, women and children have died, there are 15,000 new infections every day. If current trends do not change, by 2010, in Africa alone, more than 40 million children will have been orphaned by AIDS.

In the worst affected countries, the epidemic is eroding decades of development gains, undermining economies, threatening security and destabilising societies.

In sub-Saharan Africa, where the epidemic has already had a devastating impact, the worst is yet to come. Overall, the epidemic is in its early and mid stages, particularly in Asia where the majority of world's population lives.

But the world is not powerless to respond. We now have an historic opportunity to commit the political will and the billions of dollars required to change the course of the epidemic. Investment now will prevent tens of millions of new infections and extend the lives of millions already living with HIV.

Over two decades of experience we have developed tools of prevention, treatment and support. Their effectiveness has been shown in many communities, and in diverse national contexts including Brazil, Thailand, Uganda and Senegal.

We have learnt that prevention and care are inextricably linked. Prevention, medical treatment and social support are all critical components of effective responses. Their effectiveness is immeasurably increased when they are used together. They must also meet the unique needs of men and women and address the underlying causes that make some people more vulnerable to HIV than others.

Inexpensive and effective drugs to treat and prevent opportunistic infections exist. They are urgently needed and should be made rapidly available, together with broader care and support, including in the poorest countries.

Where it has been available, antiretroviral therapy has reduced mortality and prolonged healthy lives. Recent reductions in prices create an historic opportunity to extend this benefit across the globe. Antiretroviral therapy can and should be made widely available in all countries. The degree to which poor countries are able to extend access to antiretroviral therapy varies, but in every case a beginning can be made. The poorest countries need donor resources to extend this capacity. In all cases, antiretroviral therapy must be used in a careful and monitored manner, to improve adherence and reduce the risk of resistance.

While the changed global environment has increased attention to the treatment side of the equation, the core strategy of all countries must continue to emphasise widespread and effective prevention, including education, information and condoms. However the scale of this work must be dramatically increased, especially among young people.

Building on existing programmes, many countries, and many of the poorest, have shown political commitment and made detailed preparations and are ready for greatly scaled up treatment and prevention programmes. What they lack are the resources.

In view of the urgent need and opportunity, the recent call to action by Secretary-General and the decision of the UN General Assembly to hold a special session on AIDS, is especially appropriate. We agree the time to act is now.

Based on an analysis of the cost of effective responses, we estimate that global funding for AIDS in middle and low-income countries should rise to not less than $7 billion per year within 5 years. This commitment must be sustained for at least a decade.

At the forthcoming UN General Assembly Special Session on AIDS we call on the world's political leaders to commit the financial resources and the political will to bring this epidemic under control. We call on citizens around the world to lend their support. We will not succeed until leaders in every sector of society come together in a historic global response to this most urgent of crises.

The time to act is now.

* UNAIDS, including its Cosponsoring agencies UNICEF, UNDP, UNFPA, UNDCP, UNESCO, WHO, and the World Bank, convened a meeting together with the International AIDS Society and the Bill and Melinda Gates Foundation, from May 6th-8th at Mont Pèlerin, Switzerland, with the following individuals, at the meeting in their personal capacity as medical, behavioural and policy experts: Professor Peter Aggleton, University of London, UK; Professor Roy Anderson, Imperial College, UK; Dr Stefano Bertozzi, Instituto Nacional de Salud Publica, Mexico; Dr Mabel Bianco, Ministry of Health, Argentina; Rev. Gideon Byamugisha, Church of Uganda; Dr Hoosen M. Coovadia, University of Natal, South Africa; Dr Tim Evans, The Rockefeller Foundation; Dr Margaret Gachara, National AIDS Control Council, Kenya; Dr Duff Gillespie, USAID, USA; Dr J. Edward Greene, Assistant Secretary-General, The Caribbean Community & Common Market; Mr Anand Grover, Lawyers Collective HIV/AIDS Unit, Mumbai/Delhi, India; Mr Moustapha Gueye, African Council of AIDS Service Organisations, Sénégal; Dr Scott M. Hammer, Columbia University, USA; Dr Catherine Hankins, Institut national de santé publique de Quebec & McGill University, Canada; Professor Michel Kazatchkine, Agence Nationale de Recherches sur le SIDA, France; Professor Marie Laga, Institute of Tropical Medicine, Belgium; Ms Marina Mahathir, Malaysian AIDS Council, Malaysia; Dr Purnima Mane, The Population Council; Dr Nancy Padian, University of California San Francisco, USA; Dr Gordon Perkin, Bill & Melinda Gates Foundation; Professor Praphan Phanuphak, Thai Red Cross Society, Thailand; Mr J.V.R. Prasada Rao, Ministry of Health & Family Welfare, India; Professor Jeffrey Sachs, Harvard University, USA; Mr Eric L. Sawyer, HIV/AIDS Human Rights Project, USA; Mr Wojciech Tomczynski, Badz Z Nami, Poland; Ms Sandra Thurman, The International AIDS Trust, Washington D.C., USA; Dr Stefano Vella, President, International AIDS Society; Ms Wendy Wertheimer, National Institutes of Health, USA; Dr Alex Wodak, St Vincent's Hospital, Australia.