Pubdate: Sat, 3 Jun 2006 Source: New York Times (NY) Copyright: 2006 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Authors: Lawrence K. Altman and Elisabeth Rosenthal Bookmark: http://www.mapinc.org/topics/United+Nations Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) U.N. STRENGTHENS CALL FOR A GLOBAL BATTLE AGAINST AIDS UNITED NATIONS -- The General Assembly adopted a strongly worded declaration on Friday aimed at pressing the nations of the world to strengthen their battle against AIDS, a global pandemic that Secretary General Kofi Annan called "the greatest challenge of our generation." The language of the document surprised even anti-AIDS groups, which said that while it did not satisfy all their objectives, they had feared it would be watered down. In turn, United Nations officials credited the advocacy groups for strengthening the draft in behind-the-scenes struggles during an extraordinary three-day plenary session. The nonbinding declaration reaffirms commitments made in 2001, when the United Nations defined AIDS as far more than a medical issue, framing it in terms of politics, human rights and economic survival. At the time, few felt that effective delivery of the antiretroviral therapy now provided to some people in poor countries was possible, and there was little money for the program. The new document is a political blueprint, not a plan of action. It calls for a strong commitments to bolster the rights of women and girls so they can protect themselves from infection with H.I.V., the virus that causes AIDS. The document also acknowledges the role of men in spreading the disease and their responsibility to respect women. The declaration calls on countries to use scientifically documented prevention strategies, including condoms; to make clean needles accessible to drug users; and to take steps to provide universal access to prevention programs, care and antiretroviral drugs. It includes politically charged terms like "condoms" and "vulnerable groups," though those groups are not specified. Many advocates have urged the United Nations to acknowledge frankly that some of today's fastest-growing H.I.V. epidemics are among intravenous drug users, prostitutes and gay men. Countries will be expected to measure their progress over the next five years against targets to be determined by the United Nations. To achieve these and other goals, the declaration said, the world will need to spend up to $23 billion a year by 2010, almost triple the $8.3 billion spent last year. The challenge is for governments to follow through after delegates go home, the General Assembly's president, Ian Eliasson of Sweden, said at a news conference. In the 25 years since the first case was discovered, AIDS has become one of the worst pandemics in history, infecting 60 million people and leading to 25 million deaths. Earlier in the day, Mr. Annan delivered a gloomy assessment, saying the world was losing the battle. "The epidemic continues to outpace us," he told a packed session of the General Assembly. "There are more new infections than ever before; more deaths than ever before; more women and girls infected than ever before." His dark tone diverged markedly from the upbeat speeches by world leaders at the start of the three-day session on Wednesday, and from the positive speech given Friday morning by Laura Bush, the first lady. Mrs. Bush said the United States contributed more money than any other country to fight AIDS, which "respects no national boundaries; spares no race or religion; and devastates men and women, rich and poor alike." Mrs. Bush noted that her husband had put forth a plan in 2003 that contributes $15 billion over five years to fight AIDS internationally. Her speech steered away from many of the criticisms that have been leveled against the administration, notably that it promotes sexual abstinence over scientifically proven strategies, particularly condom use. Indeed, she said, the "ABC" model -- the initials stand for abstain, be faithful and use condoms -- had brought sharp declines in infections in Africa. Britain's secretary of state for international development, Hilary Benn, noting policy differences between his country and the United States, said in an interview that abstinence alone did not work. Mr. Benn, whose country contributes the second-largest amount to fight AIDS, criticized the declaration for not spelling out the ways the virus is transmitted through sex and through contaminated needles used to inject drugs, and from mother to infant through birth and nursing. "Abstinence is fine for those who are able to abstain, but human beings like to have sex and they should not die because they do have sex," Mr. Benn told the assembly. Dr. Mark Dybul, the acting United States global AIDS coordinator, said in an interview that the United Nations had passed "a fine declaration" in which he had not found any weak points. Adrienne Germain, president of the International Women's Health Coalition, said the document could be used "to make significant progress in going forward" in the fight. But some advocacy groups said the document did not satisfy all their objectives. The Center for Health and Gender Equity, which says it represents nearly 70 international advocacy groups, denounced the document for failing to show greater political leadership; refusing to make a commitment to more definitive targets on financing, prevention, care and treatment; and rejecting frank acknowledgment that some of today's fastest-growing epidemics are occurring among injecting drug users, prostitutes and gay men. Dr. Peter Piot, the executive director of the United Nations program, said that while no document could make anyone "100 percent happy," the final version was "a major advance" and far stronger than the weaker drafts circulating earlier in the week. - --- MAP posted-by: Richard Lake