U.N. General Assembly to Vote Today on Declaration of Commitment
Following Monday's long day of debate over draft language that included references to specific HIV "vulnerable groups," such as sex workers, homosexuals and intravenous drug users, a finalized version of the United Nations' Declaration of Commitment for fighting HIV/AIDS on a global scale was submitted last night to delegates of the U.N. General Assembly special session on HIV/AIDS, who are expected to vote to adopt the document this afternoon at the conference's closing session, the Washington Post reports. Islamic groups and the Vatican had objected to the inclusion of such groups in the 20-page document, saying it would be "difficult" for them to endorse a plan that referred to behavior that is "illegal and against religious norms" in their countries. The language was removed after a lengthy debate that threatened to "overshadow" the conference's achievements and replaced with references to "risk behaviors, including sexual activity and drug use," the Post reports (DeYoung, Washington Post, 6/27). Some objected to the changes. Speaking on PBS' "NewsHour with Jim Lehrer," Dr. Paulo Teixeira, director of Brazil's national HIV/AIDS program, said that even in more tolerant societies it is "very difficult" to address sexual behavior and drug use and that the best way to address the problem is to put "all the questions and all the aspects" on the table. "That is the only way that we have to provide people with the good information ... about how to prevent themselves from infection and how to support ... HIV-affected people," he said (Ifill, "NewsHour with Jim Lehrer," PBS, 6/26). "Such a decision on language guts the whole declaration," Scott Long, a spokesperson for the International Gay and Lesbian Human Rights Commission, said (Ewing, Associated Press, 6/27).
While Monday's debate centered on the attention paid to "vulnerable groups" in the declaration's main body, yesterday's debate was primarily over a "brief suggestion" in the document's preamble that nations "might want to refer to the five-year-old U.N. 'guidelines' for how they can respect [the] human rights" of those with HIV/AIDS. Those guidelines ask members to "review" laws "criminaliz[ing]" homosexuality and prostitution "with the aim of repeal" and "suggest" that officials provide prison inmates with condoms and clean hypodermic needles (Washington Post, 6/27). The mention of the old guidelines "infuriated" members of the Organization of Islamic Countries, who said they could not "possibly reconcile that language with their legal and religious systems." But yesterday evening, European ministers, who had backed the inclusion of the reference, "backed down and agreed to drop the preamble."
A 'Tough' Deal on Women's Rights
As a compromise, all groups agreed to include a "tough" clause on women's rights, which asks nations by 2005 to "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; [and] 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." Danish Minister for Development Cooperation Anita Bay Bundegaard told the General Assembly that the European ministers were "disappointed by the continuing controversy surrounding human rights for girls and women," adding that such gender inequities "lie at the very heart of the HIV/AIDS pandemic." Iranian Deputy Minister of Health and Medical Education Ali-Akbar Sayyari, speaking for the OIC, said, "[I]n so far as sexual relations are concerned, from our point of view, the imperative of moral choice and behavior, the centrality of the family as the basic unit of society and responsible individual conduct are indispensable to the healthy state of relations in any society" (Garrett, Newsday, 6/27). Michael Southwick, a U.S. deputy assistant secretary of state for international organizations and a member of the U.S. delegation, said that even with the new language, the revised declaration "by and large has some good positive things in it" and will act as a "kind of a pep rally" to help the international community "get its act together" with regard to HIV/AIDS (Washington Post, 6/27). The declaration also calls for the establishment of "national strategies to combat the spread of HIV." By 2003, nations are expected to have plans for "integrat[ing] HIV prevention, care, treatment and support for patients and families," as well as for dealing with AIDS orphans.
Support for the Fund
The declaration also endorses the proposed $7 billion to $10 billion Global AIDS and Health Fund (Altman, New York Times, 6/27). It is still unclear how the fund will be administered, but Andrew Cassels of WHO said that a "new nonprofit" may be created for the job and it is "likely" that the World Bank will act as the fund's broker (Zimmerman/Harris, Wall Street Journal, 6/27). Yesterday, more money was added to the fund, with Sweden committing $60 million, Nigeria offering $10 million, Zimbabwe donating $1 million and Kenya contributing $7,000 (Sternberg, USA Today, 6/27). Clare Short, British secretary for international development, continued her criticism of the assembly yesterday. In an interview with the Guardian, she said, "[N]obody could administer such a fund," adding that the "hyperbole around the scale and purpose" of the fund was "a piece of nonsense" (Boseley, Guardian, 6/27).
Treatment Versus Prevention
Observers expected debate to focus on whether to spend fund assets on prevention or treatment, but that issue has "barely rippled the surface," as it has been overshadowed by the document language regarding vulnerable groups, the Post reports. "Everybody now says it's all woven together," Southwick explained (Washington Post, 6/27). But advocacy groups have continued to push for antiretroviral drug access. Activists shaking pill bottles filled with pennies protested during one of the sessions. "We believe it is unconscionable that we will prevent AIDS but not treat it," Oxfam President Raymond Offenheiser said (Wall Street Journal, 6/27). Still, others said too much emphasis has been placed on drug access. "The lack of drinking water is a much bigger priority in most countries than antiretroviral treatments," Vijay Rajkumar, an AIDS adviser for Save the Children in Nepal, said. "I fear that a major chunk of the global health fund will go to drugs. And that means money for drug companies and not for infrastructure," he added (Steinhauer, New York Times, 6/27). Advocates of treatment point to a new treatment initiative in Botswana as a "model" of how the fund can help treat AIDS patients in developing countries with poor resources. "If it succeeds, it will give heart to absolutely every country worldwide," Stephen Lewis, the U.N. special envoy for AIDS in Africa, said (Farley, Los Angeles Times, 6/27). Advocates also used yesterday's meetings to call for the establishment of a fund to eventurally procure a not-yet-created HIV vaccine for developing countries at an "affordable" cost. Seth Berkley, president of the International AIDS Vaccine Initiative, asked delegates to endorse the creation of a global vaccine fund, so that when a vaccine is created it can be purchased in bulk quickly for developing nations. "Without concerted, immediate action, the time will come when, despite the existence of an effective vaccine, millions in developing countries will become infected with HIV," he said. He also asked for more money to fund research and "regulatory reform" to "speed approval" of vaccine candidates (Collins, Philadelphia Inquirer, 6/27).
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