http://www.latimes.com/wires/winternat/20010623/tCB00V2415.html

 

U.N. Holds Special Session on AIDS

Associated Press Writer

     UNITED NATIONS-- Twenty years after the discovery of AIDS, the U.N. General Assembly is holding its first special session on a health crisis that has claimed over 22 million victims and left 36 million others facing a death sentence.
     "Everyone has come to this late," said Stephen Lewis, the U.N. special envoy on HIV/AIDS in Africa. "The world has been seized and galvanized only over the last 18 months or so."
     With the killer disease ravaging Africa and spreading quickly through Asia, Latin America and Eastern Europe, high-level representatives from 180 countries will meet at U.N. headquarters starting Monday to adopt new targets for a global campaign to halt and start reversing the AIDS epidemic.
     But governments, health experts, and activists remain divided on what should get the lion's share of funds and attention -treatment or prevention. And Muslim and Western nations are still at loggerheads over naming groups most vulnerable to AIDS -such as homosexuals and prostitutes -because of religious and cultural sensitivities.
     Nonetheless, Lewis and other U.N. officials believe that a constellation of recent events offers the first real chance to turn a doomsday scenario around, albeit slowly and painfully.
     The Security Council declared last year that AIDS poses a threat to peace and security. Secretary-General Kofi Annan made the fight against AIDS his personal priority and helped put a global spotlight on the issue. Prices for drugs have plummeted, opening new options for treatment. And in Africa, which has been hardest-hit by the disease, leaders have shown a determination in the past year to confront the epidemic.
     Although the U.N. General Assembly special session on HIV/AIDS is not a summit, two dozen presidents and prime ministers are coming, the vast majority from Africa, including some of the worst-hit countries -Ethiopia, Kenya, Nigeria, Botswana, Lesotho and Swaziland.
     However, President Thabo Mbeki of South Africa -which has the largest number of people living with HIV or AIDS, 4.1 million -will not attend, a presidential spokesman said Saturday, saying senior officials will be sent instead. Mbeki caused an international uproar more than a year ago when he courted the view of some scientists who question the link between HIV and AIDS and believe HIV testing should be stopped.
     More than 3,000 government officials, activists and business leaders will also be at the United Nations for the three-day session. Secretary of State Colin Powell heads the large U.S. delegation.
     "It's leadership that will ultimately be the driving force that will reverse and eventually halt the devastation of this epidemic," said Peter Piot, executive director of the Joint U.N. Program on HIV/AIDS (UNAIDS), which operates in over 100 countries.
     There is a new momentum among political leaders and public health officials to tackle the AIDS crisis, he said, "but what is truly astounding is the leadership we are seeing at the community level, and in grassroots organizations."
     For example, people living with HIV in Burundi, Uganda and the Caribbean have set up support groups that have become major players in AIDS prevention and care. Youth sports programs in Nairobi and university students in India are promoting AIDS prevention. In the Philippines, legislators passed a law spelling out what the government, local communities and religious groups need to do to fight AIDS -and this model is now being adopted by many countries, Piot said.
     In addition to leadership, the resource needed most to defeat AIDS is money.
     At last September's U.N. Millennium Summit, over 150 world leaders made a commitment to stop the spread of HIV/AIDS by 2015.
     The declaration to be adopted at the close of the special session on Wednesday calls for interim targets, including a 25 percent reduction in HIV infections among 15 - to 24 -year-olds in the most affected countries by 2005 and globally by 2010. It also calls for at least 90 percent of 15 - to 24 -year-olds to have access to information and services to reduce their vulnerability by 2005, and a 20 percent reduction in the proportion of infants infected with HIV by that date.
     To do this, Annan said an annual war chest of $7 to 10 billion is needed.
     A study published Friday in the journal Science said the world's poorest countries will need $9.2 billion a year to deal with AIDS - $4.4 billion to treat people with the illness and $4.8 billion to prevent new infections.
     Part of this money will be raised by governments themselves, but Annan hopes most will come from the international community and has called for a global fund. Even before it has been formally established, the fund has received pledges of $528 million -and more are expected during the special session.
     Already, there are differences over how the money should be spent -prevention or treatment.
     The Health Gap Coalition, a network of U.S.-based AIDS activists, wants the fund to buy bulk drugs at the best world price, regardless of their patent status. Pharmaceutical companies and some governments object to this approach.
     Thoraya Obaid, executive director of the U.N. Population Fund, wants the global AIDS fund to finance the purchase of condoms. U.N. officials say there is a serious shortage of condoms because the Population Fund hasn't received adequate funding to buy them.
     "Prevention is the main key to ensure that this disease does not spread in other regions as a pandemic," she said. Prevention is cheap because it mainly involves changes in behavior to promote abstinence, one sex partner, delaying the age of sexual relations, or safe sex with condoms.
     Negotiators are also still trying to bridge differences in the final declaration over references to human rights, the empowerment of women, and explicitly identifying groups most susceptible to HIV.
     "Moral squeamishness shouldn't stand in the way of finding solutions to this terrible crisis," said Kenneth Roth, executive director of Human Rights Watch. "At a conference devoted to fighting AIDS, governments must not replicate the silence and denial that have driven the spread of the disease."

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