U.N. Secretary-General Kofi Annan Urges Increased Government Action in New Report on AIDS

Calling HIV/AIDS "the most formidable development challenge of our time," U.N. Secretary-General Kofi Annan laid out a set of goals and objectives for governments of all nations in a new report released yesterday by UNAIDS. The Washington Post reports that the 29-page report aims to "set the tone" for the upcoming General Assembly special session on AIDS to be held in New York in June (Lynch, Washington Post, 2/21). Annan said that governments of countries "hardest hit" by the virus need to "exert more leadership" in fighting HIV, while wealthy nations need to step up funding of antiAIDS efforts in developing nations, especially by financing costly antiretroviral drugs. By calling on Western governments to use their financial resources to combat AIDS, the report "aims to build a political consensus for greatly increased financing from the West" (Collins, Philadelphia Inquirer, 2/21). While different nations may have different roles to play in fighting the epidemic, unity from all governments is the key to successfully combatting AIDS, Annan said. He added, "Until recently, the response to AIDS lacked an essential element: political recognition and commitment at the highest global and national levels. ... The basic lesson learned for any national AIDS plan is that ... single, isolated activities do not yield sustained results" (Agence France-Presse, 2/21).

Seven Challenges for Governments
The report noted that about 36.1 million people worldwide are currently infected with HIV, a number 50% higher than the figure projected a decade ago (AP/Excite News, 2/20). To quell the rapid spread of the epidemic, governments from all countries must address seven "critical challenges," the report states. Governments must provide "effective leadership and coordination," as well as the "necessary level of financial resources." In addition, nations must work to alleviate the "social and economic impact" of HIV, reduce the "vulnerability" of groups such as women and young people, achieve "agreed targets" for HIV prevention, ensure that HIV-positive individuals receive care and support and develop "relevant and effective international commodities." Annan stressed the importance of strong government leadership in achieving these goals, stating, "Leadership is fundamental to an effective response. One of the key issues facing the global community is developing and sustaining such dedicated leadership, vital if the nature of the epidemic is to be clearly understood throughout society and a national response mobilized" (UNAIDS release, 2/20). To adequately respond to HIV, governments need to make the epidemic central in their planning strategies, Annan said. "One important way of ensuring that national budgets are reallocated toward HIV prevention is to make sure that HIV/AIDS priorities are properly integrated into the mainstream of development planning, including poverty reduction strategies, public investment plans and annual budget processes," he said (Agence France-Presse, 2/21). Diplomats from countries around the world are expected to begin discussion on the report at a preparatory meeting on Monday (Washington Post, 2/21).

Financing Drug Treatment
In the report, Annan "commended" recent efforts by the pharmaceutical industry to offer discounted antiretroviral drugs to developing nations, and also praised companies offering cheaper generic medicines (Philadelphia Inquirer, 2/21). However, he added that the affordability of antiretroviral therapy and medicines for opportunistic infections remains "one of the greatest barriers to improving access to care" (UNAIDS release, 2/20). To increase availability of antiretroviral drugs, Annan suggested the implementation of "tiered" pricing systems between wealthy and developing countries, subsidies by the public and private sector and the "effective use of health safeguards in trade agreements." Annan "praise[d]" local generic drug production efforts such as those underway in Brazil (Capella/Meikle, Guardian, 2/21). Antiretroviral treatment that reduces the risk of vertical HIV transmission is an especially important prevention strategy, the report stated (UNAIDS release, 2/20). In addition to financing existing AIDS drugs, countries must also step up research efforts to develop microbicides and HIV vaccines, Annan added. Despite the success of drug therapy, prevention and education efforts are still essential to combating the virus. The report stated that community-based responses have been shown to be successful, as have those involving HIV-positive individuals. In addition, all nations must work to combat the "stigma ... denial and shame" still attached to HIV, Annan concluded (UNAIDS release, 2/20). To view a copy of the report, go to http://www.unaids.org/whatsnew/others/un_special/SGreport1.doc.