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U.N. AIDS Meeting Calls for More Treatment Access, Fewer Child Infections

World leaders at a U.N. High Level Meeting on AIDS last week adopted a consensus declaration setting targets for global universal access to antiretroviral therapy and elimination of mother-to-child HIV transmission.

Calling the HIV/AIDS epidemic "an unprecedented human catastrophe," more than 3000 senior government officials, international organizations, and civil society representatives set a goal of providing antiretroviral therapy (ART) for 15 million people in developing countries by 2015.

They also affirmed a goal of reducing by half the number of new HIV infections transmitted through sex and injection drug use, and eliminating perinatal transmission by treating mothers and babies during pregnancy, delivery, and breast-feeding.

While the delegates agreed on the need for universal treatment, there was more contention regarding prevention. The final declaration included support for an array of prevention strategies including condoms and clean needles -- and efforts to target heavily impacted groups including sex workers, men who have sex with men, and drug users -- but not without strong opposition from countries controlled by religious conservatives.

Currently an estimated 6.6 million people with HIV are receiving antiretroviral treatment, according to a recent UNAIDS report -- a figure that must more than double to ensure universal access. Delegates agreed that an additional US $24 billion should be devoted to AIDS funding, but advocates expressed concern, given a history of unfulfilled promises.

"A new goal of reaching 15 million people is the bare minimum that is needed to begin to reverse the AIDS crisis by saving lives and preventing new infections. We are very glad to see the United States joining countries around the world to set this target," said Asia Russell of Health GAP. "Merely agreeing is not enough."

Below is an edited excerpt from a UNAIDS press release describing the meeting and the resulting declaration.

Bold New AIDS Targets Set by World Leaders for 2015

Unprecedented global participation at UN General Assembly High Level Meeting on AIDS leads to new commitments, targets, and momentum in the AIDS response

New York/Geneva -- June 10, 2011 -- The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes the bold new targets set by world leaders at the United Nations General Assembly High Level Meeting on AIDS which concluded in New York today. Countries agreed to advance efforts towards reducing sexual transmission of HIV and halving HIV infection among people who inject drugs by 2015.

They also agreed to push towards eliminating new HIV infections among children in the next five years. Leaders pledged to increase the number of people on life saving treatment to 15 million and to reduce tuberculosis related deaths in people living with HIV by half in the same time period.

"This Declaration is strong, the targets are time bound and set a clear and workable roadmap, not only for the next five years, but beyond," said Joseph Deiss, President of the United Nations General Assembly. "UN Member States have recognized that HIV is one of the most formidable challenges of our time and have demonstrated true leadership through this Declaration in their commitments to work towards a world without AIDS."

The bold targets come at a time when international assistance for the AIDS response has dropped for the first time since 2001. Member States agreed to increase AIDS-related spending to reach between US$ 22 billion and US$ 24 billion in low- and middle-income countries by 2015.

These far reaching goals are set in the Political Declaration on HIV/AIDS: Intensifying our Efforts to eliminate HIV/AIDS adopted by the General Assembly on 10 June, 2011. The declaration notes that HIV prevention strategies inadequately focus on populations at higher risk -- specifically men who have sex with men, people who inject drugs and sex workers, and calls on countries to focus their response based on epidemiological and national contexts.

"These are concrete and real targets that will bring hope to the 34 million people living with HIV and their families," said Michel Sidibé, Executive Director of UNAIDS. "Through shared responsibility, the world must invest sufficiently today, so we will not have to pay forever."

The declaration calls on all UN Member States to redouble their efforts to achieve universal access to HIV prevention, treatment, care and support by 2015 as a critical step towards ending the global AIDS epidemic. A pledge to eliminate gender inequality, gender based abuse and violence, and to increase the capacity of women and adolescent girls to protect themselves from HIV infection was also made.

The Declaration recognizes that access to sexual and reproductive health has been and continues to be essential to the AIDS response and that governments have the responsibility of providing public health services focused on the needs of families, particularly women and children. Member states also agreed to review laws and policies that adversely impact on the successful, effective and equitable delivery of HIV prevention, treatment, care and support programmes to people living with and affected by HIV.

With nearly 7000 new HIV infections each day, the declaration reaffirms that preventing HIV must be the cornerstone of national, regional and international responses to the AIDS epidemic. It calls for expanding access to essential HIV prevention commodities, particularly male and female condoms and sterile injecting equipment. Calling for intensifying national HIV testing campaigns; it urges countries to deploy new bio-medical interventions as soon as they are validated including earlier access to treatment as prevention.

Taking note of the UNAIDS strategy, the Declaration commends UNAIDS for its leadership role on AIDS policy coordination and support to countries and calls on the joint programme to revise indicators for success and support the Secretary-General of the United Nations in providing an annual report on the progress made by Member States in realizing the commitments made in the declaration.

6/17/11

Sources

UNAIDS. Bold New AIDS Targets Set by World Leaders for 2015. Press release. June 10, 2011.

Kaiser Family Foundation. U.N. High Level Meeting On AIDS Declaration Sets New Targets In Fight Against Disease. Kaiser Daily Global Health Policy Report. June 13, 2011.

HealthGap. World Makes Bold New 15 Million People AIDS Treatment Commitment in Bid to Halt AIDS -- AIDS Activists Demand the Bill Gets Paid. Press release. June 9, 2011.