HIV/AIDS Pandemic Outpacing Efforts To Curb Its Spread, Annan Says at U.N. General Assembly High-Level Meeting

The global response to HIV/AIDS has not matched the pandemic "in scale," and the disease continues to outpace efforts to contain it, U.N. Secretary-General Kofi Annan said Thursday at the 2005 U.N. General Assembly High-Level Meeting on HIV/AIDS in New York City, the AP/Boston Globe reports (Lederer, AP/Boston Globe, 6/3). Representatives from about 127 countries, including more than 30 ministers from HIV/AIDS programs worldwide, on Thursday met to review the fight against the disease since targets were set at the 2001 U.N. General Assembly Special Session on HIV/AIDS. The targets include reducing HIV prevalence rates among people ages 15 to 24 by at least 25% by the end of 2005, providing young people with prevention services, reducing by 20% the number of infants who are born HIV-positive and expanding treatment. According to a report released by Annan in advance of the meeting, progress against the pandemic has been made in Cambodia, Thailand, the Bahamas, several African countries and Brazil. However, there were 4.9 million new HIV infections and 3.1 million AIDS-related deaths in 2004, and only 12% of the six million people worldwide in need of treatment had access to antiretroviral drugs by the end of 2004. In addition, prevention services were available to only 16% of commercial sex workers, 11% of men who have sex with men, 20% of homeless children and fewer than 5% of the world's injection drug users, according to the report (Kaiser Daily HIV/AIDS Report, 6/2).

Annan Remarks
In his opening address to the meeting, Annan said the global efforts to fight the disease have been "significant," but they have been "insufficient," according to the AP/Globe. "Last year saw more new infections and more AIDS-related deaths than ever before. Indeed, HIV and AIDS expanded at an accelerating rate on every continent," Annan said (AP/Boston Globe, 6/3). Annan added that only 12% of people who need antiretroviral treatment worldwide are receiving it, antiretroviral drugs are still too expensive for most of the HIV-positive people in the world, and effective prevention, counseling and testing services were the "exception to the rule," Reuters reports (Leopold, Reuters, 6/3). He also said that curbing the spread of HIV is a prerequisite for meeting all other U.N. Millennium Development Goals. "That is why the fight against AIDS may be the great challenge of our age and our generation. Only if we meet this challenge can we succeed in our efforts to build a humane, healthy and equitable world. Let us ensure we are equal to the task," Annan added (Lederer, Associated Press, 6/2). He also praised UNAIDS, the Global Fund To Fight AIDS, Tuberculosis and Malaria and other organizations for making drugs more widely available in developing countries. However, he said such countries need to develop comprehensive action plans to fight the pandemic and establish national AIDS coordinating authorities as well as monitoring and evaluation systems (AFP/Yahoo! News, 6/2).

MDG No Longer Realistic, Piot Says
Following Annan's address, UNAIDS Executive Director Peter Piot said that it is "no longer realistic to hope" that the world can meet the MDG target of reversing the spread of the virus by 2015, the AP/Globe reports. He added that although some countries will be able to control the disease, the pandemic is still spreading "far ahead" of efforts to curb it in "crucial" regions of the world, including Eastern Europe, Africa and Central America, the AP/Globe reports. "What we are faced with is multiple epidemics and that the epidemic is still expanding. We are actually still moving into the globalization of the AIDS epidemic," Piot said (AP/Boston Globe, 6/3). However, Piot said that HIV prevalence rates appear to be declining among 15- to 24-year-olds in some areas otherwise "ravaged" by the pandemic, according to the New York Times. The capital regions of Ethiopia, Rwanda, Zambia and Kenya all are seeing declines in HIV/AIDS prevalence among adolescents and young adults in large part because of extensive education and prevention programs aimed at young people, Piot said. However, he added that there is "something going on there that we don't pretend we fully understand" when prevalence rates decline in some areas but not in others. There also are "acute" shortages of skilled health care workers needed to expand prevention and treatment programs in developing countries, Piot said (Altman, New York Times, 6/3).

Funding, Political Commitment
Piot also called for a "quantum leap" in financial commitments from meeting delegates, saying that for universal access to treatment and other HIV/AIDS-related services to "become a reality, we must close huge funding gaps." Piot said between $14 billion and $16 billion should be spent on HIV/AIDS each year, compared with the $8 billion pledged to combat the pandemic in 2005 (Lederer, Associated Press, 6/2). Piot added that national efforts and financing for children who have lost one or both parents to the disease also are insufficient, although political commitments to address the pandemic have "increased significantly" since the 2001 meeting, according to the Times. However, in some countries where the pandemic is beginning to emerge, political commitments still are deficient, he added (New York Times, 6/3). Global Fund Executive Director Richard Feachem, who also attended the meeting, said the fund aims to attain "absolutely rock-solid, predictable and sustained" financing but added that funding gaps still exist. Feachem said that the fund needs $2.33 billion in 2005, $3.5 billion in 2006 and $3.6 billion in 2007, although pledges for those years fall "far short" of what is needed, according to Washington File (Aita, Washington File, 6/2).

Vaccine, Microbicide Development
Meeting delegates also discussed research into HIV/AIDS vaccines and vaginal microbicides, which include gels, films, sponges and other products that could help prevent the sexual transmission of HIV and other sexually transmitted diseases, the Associated Press reports. According to Gareth Thomas, U.K. undersecretary for international development, a microbicide could be available in five to six years and a vaccine is at least 20 years away (Melia, Associated Press, 6/2). He added that an additional $350 million annually should be made available for vaccine research and development (Reuters, 6/3). "Stopping the epidemic will require development of microbicides to protect women and a vaccine," Piot said (New York Times, 6/3). U.N. General Assembly President Jean Ping told delegates to make recommendations for the fight against the pandemic to the U.N. General Assembly meeting in September, which will focus on implementing the MDGs (Melia, Associated Press, 6/2).

A kaisernetwork.org webcast of the vaccine and microbicides discussion will be available online after 1 p.m. ET on Friday.