HIV/AIDS, rights and political commitment

The framework

Article 25: 1: Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…
Universal Declaration of Human Rights

Article 12: 1: The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
International Covenant on Economic, Social and Cultural Rights


Setting the bar: Kofi Annan challenges the Millennium General Assembly (2000)

I recommend that the Millennium Summit adopt as an explicit goal the reduction of HIV infection rates in persons 15 to 24 years of age – by 25 per cent within the most affected countries before the year 2004 and by 25 per cent globally before 2010.

To that end, I recommend further that governments set explicit prevention targets.

I challenge the developed countries to work with their pharmaceutical industries and other partners to develop an effective and affordable vaccine against HIV.

From: Kofi A. Annan, Secretary-General of the United Nations,
We the Peoples: The Role of the United Nations in the 21st Century.
New York, UN-DPI, 2000.


Heads of government respond: Milennium Development Goals (2000)

By 2015, all 189 United Nations Member States have pledged to:

  • halt and begin to reverse the spread of HIV/AIDS
  • halt and begin to reverse the incidence of malaria and other major diseases

From the Millennium UN General Assembly, 2000


United Nations General Assembly Declares Commitment on HIV/AIDS (2001)

Strong leadership at all levels of society is essential for an effective response to the epidemic.

38. By 2003, integrate HIV/AIDS prevention, care, treatment and support and impact mitigation priorities into the mainstream of development planning

39. By 2003, establish time-bound national targets to achieve the internationally agreed global prevention goal to reduce by 2005 HIV prevalence among young men and women aged 15-24 in the most affected countries by 25 per cent and by 25 per cent globally by 2010…

Care, support and treatment are fundamental elements of an effective response

55. By 2003, national strategies…to strengthen health care systems and address factors affecting the provision of HIV-related drugs, including anti-retroviral drugs, inter allia affordability and pricing, including differential pricing, and technical and health care systems capacity. Also in an urgent manner make every effort to: provide progressively and in a sustainable manner, the highest attainable standard of treatment for HIV/AIDS, including the prevention and treatment of opportunistic infections, and effective use of quality-controlled anti-retroviral therapy…

Realization of human rights and fundamental freedoms for all is essential to reduce vulnerability to HIV/AIDS

58. By 2003, enact, strengthen or enforce as appropriate legislation, regulations and other measures to eliminate all forms of discrimination against, and to ensure the full enjoyment of all human rights and fundamental freedoms by people living with HIV/AIDS and members of vulnerable groups…

59. By 2005 bearing in mind … that globally women and girls are disproportionately affected by HIV/AIDS, develop and accelerate the implementation of national strategies that: promote the advancement of women and women’s full enjoyment of all human rights; promote shared responsibility of men and women to ensure safe sex; empower women to have control over and decide freely and responsibly on matters related to their sexuality to increase their ability to protect themselves from HIV infection. And much more…

From Declaration of Commitment on HIV/AIDS: “Global Crisis – Global Action”, United Nations General Assembly, 26th Special Session, June 25-27, 2001.


Evaluating implementation

The Declaration (Para. 100) states that the UN Secretary General will prepare an annual progress report to be reviewed and debated at an annual session of the UN General Assembly that will last at least one full day.

The Global Fund

The formation of the Global Fund to Fight AIDS, Tuberculosis and Malaria was announced in May, 2001 by Kofi Annan. The target for the fund was estimated to be US $10.5 billion a year “to mount massive prevention programs, reduce mother to child transmission, and care for the 40 million people living with AIDS.”¹ (Health GAP)

As we publish, only approximately $2.1 billion has been pledged, over five years!

The Fund has approved over 100 projects from 60 countries, totalling $866 million, but pledges are far below the targeted needs. Richard Feachem, Executive Director of the Global Fund, comments “The current situation requires a substantial front-loaded capital investment… The programs are ready. Any delay now will be measured by millions of lives lost and billions of dollars of additional cost to later respond to the expanded epidemics.”


Total resources required for scaling up the response to will grow to US$10.5 billion by 2005 and to US$15 billion by 2007. This amount of funding assumes a rapid scale up of services within existing capacity as well as increases in capacity to deliver health care services. Cost for personnel, training, drugs and commodities are included but additional infrastructure costs (buildings, equipment) are not included in this estimate.

US President Bush pledged new resources from the US in his 2003 State of the Union address, committing $10 billion to be spent over five years beginning in 2004. Although the funds depend on support from Congress, the pledge was welcomed by many. However, only $200 million a year is to be directed to the Global Fund, the great majority of funds going to US bilateral aid projects. Based on estimates from the Global Fund, US activists are calling for a commitment of $3.5 billion a year. There is a long way to go.²

Ed.

The official website of the Global Fund is: www.globalfundatm.org/

Putting communities first

ALLOCATION OF RESOURCES: Communities in action know how
to make effective use of limited resources

Resources of all kinds are scarce – the equitable allocation of limited resources is a global challenge. The ICASO network calls for stronger political commitment to the equitable allocation of resources from governments world-wide.

  • Communities working with HIV/AIDS must be involved in setting priorities for national and international programmes. Grassroots communities should be closely involved in the formation of assistance programmes. ICASO calls for the direct participation of community groups in national and international policy dialogues.

  • The ICASO network calls for increased international and national funding to be channelled directly to community organisations. Valuable resources are dissipated in international agencies where they are spent on administration and other bureaucratic functions, far removed from effective grassroots activities. Funding and other resources should be distributed to those who are making the best use of them and who need them the most.

  • New funding schemes need to be developed and implemented to build and sustain the work of community-based organisations. Community-based organisations are efficient and accountable, and they adhere to stringent monitoring.

  • The world is not putting sufficient resources into the fight against HIV/AIDS. ICASO calls on governments to meet their obligations to pass money and expertise on to the community groups working on HIV/AIDS. To achieve these aims, it is essential that HIV/AIDS issues are integrated into government structures and decision-making bodies.

  • Militaries and armaments continue to receive more financial and technical resources than public health crises like the HIV/AIDS epidemic. Governments are fighting the wrong wars.
    •

From a policy statement of the International Council of AIDS Services Organizations (ICASO) www.icaso.org


1& 2 The Global Fund Observer (GFO) Newsletter, #5 30 January, 2003 www.aidspan.org/gfo/archives/newsletter/issue5.htm