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As General Assembly Reviews Implementation of Declaration on HIV/AIDS, Secretary-General Calls for Universal Access to Health Care

GA/11515

Sixty-eighth General Assembly
Plenary
91st & 92nd Meetings (AM & PM)

Member States Also Adopt Text Creating Mandela Prize for Outstanding Achievement

Despite progress in the worldwide fight against HIV and AIDS, the international community should not let confidence turn to complacency, the United Nations Secretary-General warned the General Assembly today.

The headway made in the implementation of the Political Declaration on HIV/AIDS was the focus of the day’s meeting, with delegates reflecting on advancements made, while lamenting the enormous challenges that remained in the battle against the disease.

Between 2011 and 2012 alone, the number of people accessing HIV treatment globally increased nearly 20 per cent and the world was on track to provide antiretroviral therapy to 15 million people by 2015. However, the world must not fail the people who needed help the most, including young people, women and girls, sex workers, the lesbian, gay, bisexual, transgender, and intersex community and those who injected drugs. “Human rights and access to health care were for all — and not just for some,” said Mr. Ban.

Antiretroviral treatment was inaccessible to nearly half of those who needed it and there was a “glaring gap” in access to paediatric treatment. The intersection of HIV and non-communicable disease was also of great concern, said John Ashe ( Trinidad and Tobago), President of the General Assembly.

The representative of South Africa, speaking on behalf of the African Group, expressed alarm that the AIDS response was failing among youth. Only half of children in need of treatment received it and HIV mortality rates among adolescents had increased 50 per cent since 2005. Prevention, diagnosis, treatment and strong surveillance systems must be at the core of the international community’s efforts, while universal access to HIV/AIDS treatment remained paramount.

Victory over HIV would be difficult and would require the eradication of extreme poverty, as the two issues were inextricably connected, said Rose-Anne Auguste, Minister-Delegate to the Prime Minister of Haiti on Human Rights and the Fight against Extreme Poverty. There was a good reason why HIV, tuberculosis and malaria were called the “infectious illnesses of poverty”, she noted.

At the outset of the meeting, the Assembly adopted a draft resolution by consensus that established the United Nations Nelson Rolihlahla Mandela Prize, an honorary award given to individuals exhibiting outstanding achievements and contributions to the purposes and principles of the United Nations.

Also speaking today were representatives of European Union; Trinidad and Tobago, on behalf of the Caribbean Community (CARICOM); Malawi, on behalf of the Southern African Development Community (SADC); Myanmar, on behalf of Association of South-East Asian Nations (ASEAN); France; Australia; United Kingdom; Ukraine; Japan; Russian Federation; Brazil; Barbados; Zimbabwe; Norway; Kenya; India; Botswana; El Salvador; Bahamas; Armenia; and the United States.

Background

Meeting this morning to consider the implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS, the General Assembly had before it the Secretary-General’s report “Towards ending the AIDS epidemic: meeting the 2015 targets and planning for the post-2015 era” (document A/67/825). It was also expected to take action on a draft resolution titled “United Nations Nelson Rolihlahla Mandela Prize” (document A/68/L.48).

Action on Nelson Mandela Draft

At the outset of the meeting, the Assembly adopted the draft resolution titled “United Nations Nelson Rolihlahla Mandela Prize” (document A/68/L.48) by consensus. By its terms, the Assembly established the honorary Prize as a tribute to the outstanding achievements and contributions of individuals to the purposes and principles of the United Nations and asked the Secretary-General, in consultation with the Assembly President, to establish within six months of adopting the present resolution the criteria and procedures for bestowing the Prize, to be adopted by the Assembly no later than 30 November 2014.

BAN KI-MOON, Secretary-General of the United Nations, congratulated the Assembly on adopting the Prize, noting that the international community was still mourning Mr. Mandela’s death. The world had paid solemn tribute to his humanity and integrity, remarkable strength and the example he left of the power of an individual to transcend hatred and achieve justice. Having suffered enormous deprivation and pain for the cause of democracy and equality, Mr. Mandela left behind a “shining legacy of true peace”. But the struggle continued as racism and inequality in the world still remained. The best tribute to Nelson Mandela was not found in words or ceremonies — but in actions that took up Mr. Mandela’s torch.

“The United Nations has a proud record of acting against apartheid and for Nelson Mandela. From the early days of sanctions to the recent declaration of 18 July as Nelson Mandela International Day, the Assembly has placed itself on the right side of history — with the people who need us most,” he said. Today, the Assembly took another step forward in carrying on Mr. Mandela’s lifelong work through this meaningful Prize.

JEREMIAH NYAMANE KINGSLEY MAMABOLO ( South Africa) said that by adopting the resolution, the General Assembly was showing its support for Nelson Mandela’s work and outstanding contribution to the creation of a democratic South Africa. Mr. Mandela had left a legacy that would inspire generations to come and served as an example for all of mankind. Despite his years of captivity, he left prison with a heart that was fuelled not by revenge, but by a search for truth and reconciliation. His courage had changed the world.

THOMAS MAYR-HARTING, Head of the European Union Delegation, said the prize was an important initiative that would carry forward Mr. Mandela’s lifelong work. He taught us all important lessons about how to live our lives and for millions, his life was a source of inspiration. While the prize would ensure that Mr. Mandela was never forgotten, there was no better way to honour his legacy than to uphold commitments to democracy and human dignity.

Implementation of Political Declaration on HIV/AIDS

JOHN ASHE ( Trinidad and Tobago), President of the General Assembly, underscoring the “clear message” in the Secretary-General’s report, said global solidarity and international joint efforts were yielding significant gains towards ending the AIDS epidemic. Nonetheless, because the “scourge” would remain a challenge beyond 2015, sustained commitment was needed.

The global progress, he went on to say, had been “truly remarkable”, recalling a time when an HIV diagnosis had been a death sentence. Yet, due to antiretroviral treatment advances, which more than 10 million people in low- and middle-income countries were receiving, new HIV infections and AIDS-related deaths were declining around the world. Particularly noteworthy was the reduction of the number of children born with HIV and a decreasing mortality rate of their mothers.

However, he stressed, despite such significant gains, the epidemic was far from over, with new infections “unacceptably high”, at 2.3 million in 2012. More than half of people in need of antiretroviral treatment could not get access to it and there was a “glaring gap” in access to paediatric treatment. Women and girls, young people and marginalized populations were at higher risk of HIV infection, and the intersection of HIV and non-communicable disease were also of great concern, especially in light of the growing number of older adults living with HIV and age-related health issues.

He called for accelerated action to provide effective HIV response through the promotion of gender equality and addressing stigma and discrimination, both in law and in practice, among others. Resources must be available and utilized efficiently through all avenues, including education, social protection and strengthening health and community health systems, to name a few. The ongoing deliberations on the post-2015 agenda offered opportunities to make ending the AIDS epidemic a priority. It was a moral imperative to “get the job done,” he stated, urging all stakeholders to take a giant step towards creating a “healthier and more prosperous human family, living on a sustainable planet”.

Mr. BAN said the number of people accessing HIV treatment globally increased nearly 20 per cent between 2011 and 2012, and the world was on track to providing antiretroviral therapy to 15 million people by 2015. The world was making headway in meeting some of the targets and commitments from the 2011 Political Declaration, such as expanding access to treatment, eliminating HIV infections among children and keeping their mothers alive and mobilizing resources. At the same time, the Global Fund to Fight AIDS, Tuberculosis and Malaria was strengthened.

However, the international community could not let confidence turn to complacency, he said. Two out of three children who needed treatment did not get it, death rates among adolescents were increasing and stigma, discrimination and the criminalization of people who were the most vulnerable to HIV was getting worse in parts of the world. Countries must accelerate access to early HIV testing and get people on treatment early and consistently. The world could not fail the people who needed the most help; including young people, women and girls, sex workers, the lesbian, gay, bisexual, transgender and intersex (LGBTI) community and people who injected drugs. Human rights and access to health care were for all — and not just for some.

EDEN CHARLES (Trinidad and Tobago), speaking on behalf of the Caribbean Community (CARICOM), said regional gains, including a reduction in HIV incidence by 49 per cent, a drop in AIDS-related deaths to 11,000 in 2012 from 24,000 in 2001, increases in antiretroviral coverage and a virtual elimination of mother-to-child transmission, reflected substantial investments in strengthening health systems and scaling up efforts. Strengthened national programmes had improved capacity to implement prevention, treatment and care interventions.

However, despite those gains, more remained to be done to achieve goals and targets with a view of “getting to zero”, he said. Challenges included stringent requirements limiting access to resources, which were hampered by the World Bank designating many CARICOM States as “middle-income”. Obstacles to treatment were exacerbated by stigma and discrimination. The post-2015 agenda should, among other things, take a people-centred approach that accommodated the varied development realities of the countries and region. To achieve new goals and targets aimed at reducing and eventually eliminating HIV, Governments must efficiently allocate adequate resources, develop plans for sustainability with national strategies, perform cost analyses of different scenarios of action and address barriers to universal access to treatment and care.

CHARLES P. MSOSA (Malawi), speaking on behalf of the Southern African Development Community (SADC) and associating himself with the African States, said the HIV epidemic was reversing social gains that had been earned over many decades and posed great challenges to national health services. Economic productivity in both households and countries was being compromised by the epidemic. Some countries had made great strides in the fight against HIV, including the implementation of condom promotion and distribution, behaviour-changing counselling, the expansion of testing and treatment and campaigns to prevent mother-to-child transmission.

Although the region had suffered, he said the lessons learned had put countries in a good position to address the epidemic, with a view towards preventing future generations from suffering. Prevention measures, including condom use and behaviour changes, had reduced the spread of HIV. Still, women and girls in the region continued to bear the brunt of the epidemic and inequalities between men and women continued to exacerbate the problem. More attention needed to be paid to the gender aspects of HIV and assistance needed to be given to children who were orphans or in single-parent households as a result of the epidemic.

Mr. MAMABOLO (South Africa), speaking on behalf of the African Group, pointed to the Group’s step to address the pandemic at various levels including the African Union’s adoption of the 2012 road map on shared responsibility and global solidarity for AIDS, tuberculosis and malaria . That document called on African Union members to strength ownership, accountability and partnerships to accelerate progress to achieve clear deliverables under financing, access to medicines and enhanced governance in order to help countries build long-term, sustainable solutions. The Union’s July 2013 Special Summit made a strong commitment to the Abuja Actions, which called for accelerating antiretroviral treatments, strengthening measures, preventing mother-to-child transmission of HIV and strengthening prevention measures. A decision by African States to allocate 15 per cent of their respective national budgets to the health sector illustrated the continent’s resolve to address the scourge. The Secretary-General’s report showed that new HIV infections and AIDS-related deaths had declined in sub-Saharan Africa. Despite continuing economic challenges, the total resources available for HIV/AIDS in low- and middle-income countries continued to grow.

He expressed alarm that the AIDS response was failing among youth as only half of children in need of treatment received it, and HIV mortality among the segment had increased 50 per cent since 2005. It was vital to protect women, children and girls. He expressed concern that in sub-Saharan Africa HIV/AIDS rates were higher among girls. Donor-funded condoms for low- and middle-income countries had fallen since 2012 as had support for social and behavioural HIV prevention programmes. Prevention, diagnosis, treatment and strong surveillance systems must be at the core of the international community’s efforts. Universal access to HIV/AIDS treatment remained paramount. The Group was concerned that stigma and negative attitudes towards those living with HIV/AIDS continued to undermine an effective AIDS response. People living with the disease must be treated fairly. More focus was needed on efforts to combat drug use. He welcomed the development of quality, accessible and affordable treatments. The “HIV treatment for 15 million people” target set by the Secretary-General was only achievable if the gains made in HIV prevention and antiretroviral treatment were sustained. In that regard, he called on partners to support the business plan for implementing the Pharmaceutical Master Plan for Africa.

JAN PIROUZ POULSEN, representative of the European Union Delegation, said the report underlined that although several targets for 2015 were within reach, AIDS would remain a significant global challenge. The need for countries to invest in HIV prevention in an integrated and comprehensive way was evident, as was the need to scale up services for key populations and support human rights-based initiatives that would strengthen access to them. The continued stigmatization of women and girls affected those most at risk of contracting HIV. As the report clearly spelled out, it was time to take an integrated approach to prevention and roll treatment services into national health-care systems. The Union welcomed the efforts of low- and middle-income countries to reduce their dependence on international funding, yet much remained to be done. The Union called on countries to urgently and significantly scale up effort to establish universal access to affordable and quality health care for those affected by HIV.

KYAW TIN (Myanmar), speaking for the Association of South-East Asian Nations (ASEAN), said that reducing the AIDS death toll had been a major joint responsibility of the Association’s member States. Its Task Force on AIDS, set up to provide a coordinated regional response, had already completed three work programmes and was currently implementing its fourth. In addition, it had developed the first regional report on HIV, documenting the status of the virus in ASEAN member States and their response efforts. Highlighting the main drivers of the disease and those populations most vulnerable to infection had helped the Task Force to implement initiatives and support member States to reach key affected populations. Many countries were reaching their targets in treatment coverage, but because most of the Association’s members were still dependent on international assistance, the Task Force was supporting the fast-tracking accreditation for licensing towards producing affordable generic antiretroviral drugs.

Another challenge, he said, was developing a policy environment for HIV programme response. Conflicting laws and policies still existed, particularly for HIV prevention among drug users, sex workers and homosexuals. Among several strategies being implemented was boosting private-sector participation with the ASEAN Socio-Cultural Blueprint and forging closer ties with multilateral, bilateral and other international organizations, including United Nations bodies. With enhanced international assistance, ASEAN would be able to scale up efforts towards universal access to prevention, treatment, care and support programmes.

ROSE-ANNE AUGUSTE, Minister-Delegate to the Prime Minister on Human Rights and the Fight against Extreme Poverty of Haiti, associating herself with CARICOM, said Haiti had seen significant reductions in the number of infections and deaths from HIV and AIDS. The world realized that through goodwill and necessary resources, that scourge could be conquered and all people could live in a world characterized by greater well-being and justice. There was a long way to go and the international community needed to work together to eliminate the HIV and AIDS scourge. Progress made thus far was not uniform and efforts must be redoubled. Only collective action would produce victory.

Noting her country’s renewed commitment to dignity for all citizens, and despite major challenges, including natural disasters and other social and political handicaps, Haiti had stayed the course. Its strategy to combat HIV and AIDS was rooted in the fight against extreme poverty, and success would be difficult without eradicating extreme poverty. There was a good reason why AIDS, tuberculosis and malaria were called the “infectious illnesses of poverty”. The link between AIDS and development was undeniable. The world must be even more aggressive and tear down barriers such as inequalities and exclusion. Leaders must tackle weaknesses, such as economic vulnerability, by taking advantage of all available tools. It was wrong for hundreds of millions of people to live in complete poverty and to die of hunger.

FABIENNE BARTOLI ( France) said that her country was the second largest contributor to the Global Fund and the leading contributor to UNAIDS. She stressed the importance of scientific advances such as the latest recommendations of the World Health Organization (WHO) for early treatment. It was vital to continue to implement policies to combat AIDS, founded on respect for human rights. She expressed concern that stigma and criminalization of those living with the disease still existed. Greater attention was needed for prevention and treatment of adolescents. HIV/AIDS was the number two cause of death among adolescents. Health systems must be strengthened and universal treatment must be provided. Risks among the most vulnerable groups must be reduced. She called for greater mobilization of programmes and funds to combat HIV/AIDS.

GARY QUINLAN ( Australia) said with 12 months to the deadline set for a world free of AIDS, stark challenges remained. Among issues to be addressed were declining condom distribution — between 2011 and 2012 1 billion fewer condoms were distributed than in the previous year. Meanwhile there were increasing numbers of AIDS-related adolescent deaths. “This is a damning indication that we are not doing what we know works,” he said. “Fifty adolescent girls contract HIV each hour. That means 150 during our session this morning. It is unforgivably irresponsible not to provide access to HIV prevention programmes for young people.” Targeted services and protecting the human rights of key populations, particularly LGBT people, were needed since punitive laws criminalizing them were incompatible with the United Nations Charter.

MARTIN SHEARMAN ( United Kingdom) said his country was developing a new programme on sexual and reproductive health in emergency response and recovery, which included services to reduce the transmission of HIV. The United Kingdom was a leader in the global HIV response and had increased its annual contribution to UNAIDS by 50 per cent. A strong health system was an important way of improving the reach, efficiency and resilience of services and the country supported recommendations for further integration of HIV services. Community engagement and quality information and education were also a vital part of the HIV response.

YAROSLAV GOLITSYN ( Ukraine) noted that the introduction of substitution therapy for injected drug users in his country, among other steps, had prevented new HIV infections. As a result, the number of new infections among such users had gradually declined from 2006 to 2013. Infection among young people had dropped as had mother-to-child transmissions. Such results were also due to close collaboration with non-governmental organizations, and the introduction of social support harm-reduction programmes and substitution therapy. With the launch in 2004 of a large-scale antiretroviral treatment programme, the AIDS mortality rate had fallen by 12 per cent in 2013. As of January 2014, more than half of those in need of antiretroviral therapy were receiving treatment. The Government was studying various options to mobilize sustainable financing, such as national HIV trust funds. Ukraine had adopted a 2014-2018 nationwide social programme to combat the scourge. The recent unjustified events in Crimea would directly impact the HIV/AIDS situation on the peninsula. He said Ukraine’s Ministry of Health and health-related non-governmental organization were seriously concerned by the total ban of harm-reduction packages, as well as the abolishment of opiate substitution treatment in Crimea that had been provided by Ukraine. The State Service on Social Diseases had set up an expert task group to address the issue.

KATSUHIKO TAKAHASHI ( Japan) said that through his country’s national health programme, universal medical care insurance, all people living with HIV now had access to the necessary health-care services they required. However, on a global platform, the lack of equitable access to lifesaving HIV treatment, especially for women and children, needed to be dealt with. Prejudice, discrimination and stigma continued to be an obstacle in the fight against HIV/AIDS and it was critical that every effort be made to eliminate those challenges through a “people-centred approach” of human security. Towards that end, among others, Japan had contributed last year $1.86 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria for supporting the HIV/AIDS response. An additional $800 million would be contributed to the Global Fund this year as well.

DMITRY I. MAKSIMYCHEV ( Russian Federation) said his country’s efforts to combat the spread of HIV were significant and had seen great success. National legislation had provided for free and voluntary HIV testing, while infected people had access to free, high-quality health-care services. The vertical transmission of the virus had virtually stopped in the Russian Federation, and the country remained committed to implementing the WHO strategy on HIV, as well as reducing the cost of antiretroviral drugs. His country was actively combating the spread of HIV and AIDS throughout the world, while in 2013, several Russian-funded projects were implemented throughout Eastern Europe and Asia. Cooperation through regional and subregional organizations, where the spread of the disease had similar characteristics, had seen success. In that regard, the Russian Federation had increased its technical and financial assistance to countries in the Commonwealth of Independent States region.

ANTONIO DE AGUIAR PATRIOTA ( Brazil) said he could not “overstress the disturbing implications” arising from national laws being adopted against homosexuals. Not only did it encourage prejudice and violence against minorities, but it prevented the lesbian, gay, bisexual and transgender community from accessing proper prevention methods or treatment. Such laws did not reduce but increase the spread of HIV/AIDS. Further, Member States had agreed at the fifty-eighth session of the Commission on the Status of Women that women and girls have universal access to comprehensive prevention, affordable treatment, care and support services for HIV/AIDS, among others, free of stigma and discrimination. His country’s policy, based on that universal approach, guaranteed access to medication and to social security benefits in case of illness, among others. In addition, the Brazilian Government’s goal was to ensure universal access to information and prevention materials so that young people could make informed decisions. The budgetary challenges being faced by HIV/AIDS organizations and entities should be overcome and he called on the industrialized countries to keep their promises and expand their donation pledges towards effectively saving human lives.

JOSEPH GODDARD ( Barbados), associating himself with CARICOM, said that his country’s expansion of the national treatment plan and access to antiretroviral drugs, free at the point of delivery, had significantly reduced new infections. With the prevalence of HIV in the general population estimated at 1.2 per cent, mortality rates among people living with the virus had dropped from 10 per cent to 2 per cent, and an estimated 86 per cent who needed antiretroviral treatment were receiving it. In addition, in the past seven years, there had been no reported cases of mother-to-child transmission. Efforts to combat stigma and discrimination had been implemented through strengthened and enforced national policies and programmes, which sought to empower women and girls and to initiate national conversations regarding sex workers and transgender people. However, while welcoming partnerships and assistance from all stakeholders, he highlighted the significant challenge of being classified as a middle- or high-income country, which curtailed access to concessionary financing necessary for funding and implementing national HIV programmes. Although resources would continue to be mobilized domestically, international cooperation was also urgently needed.

ROFINA TSINGO CHIKAVA ( Zimbabwe) said HIV continued to cause untold suffering to many in her country. The epidemic had lowered life expectancy and had disproportionately impacted women and girls. Poverty compelled women and girls to resort to risky behaviour such as prostitution. The empowerment of women through education, life skills and support for entrepreneurial activities could extend their lifespan. Zimbabwe’s response to HIV/AIDS had been carried out in difficult circumstances due to sanctions. The country had adopted a multifaceted approach that promoted abstinence, condom use and a general change in risky behaviour. Zimbabwe had made great strides to extend access to treatment for all, and it appreciated the support from the Global Fund. Improved access had given people the ability to lead a normal life. That must be sustained. It was vital to further strengthen global cooperation for the AIDS response. There was no one-size-fits-all approach. Extensive politicization of issues must not overshadow the HIV/AIDS response, as had occurred during the recent session of the Commission on the Status of Women.

Mr. MAMABOLO ( South Africa) said his delegation was encouraged by the progress made in the fight against HIV and AIDS, particularly in Africa, and hoped that would inspire more rigorous efforts to combat the epidemic. Key to the fight against the disease was the availability of resources; therefore, previous commitments must be honoured. No one country could win the fight on its own, so enhanced international cooperation was key to reaching the world’s collective goals. It was also important to share lessons learned in the fight against HIV and AIDS. Women’s empowerment and gender equality had been instrumental to combating the scourge in South Africa. Other prevention efforts that had seen significant results in his country were campaigns to encourage male circumcisions and educational outreach efforts regarding condom use.

TINE MØRCH SMITH ( Norway) said that in order to bring the epidemic under complete control, response shortfalls must be tackled. Shared responsibility for financing was also important as was the need to spend available funds more efficiently. Because the rate of new infections was still too high, primary prevention efforts must be re-emphasized. Furthermore, it was unacceptable that infected children were half as likely as adults to have access to antiretroviral therapy. Child-friendly medication was on the market and should be available to those in need. Young people, especially young women, were more likely to get infected and die from AIDS. Youth needed information, including comprehensive sexuality education, access to services and participation in decisions affecting them. Focusing on the “key populations” disproportionally affected was crucial, whereas criminalizing those and other marginalized groups was the wrong approach. HIV thrived in poverty and inequity, violence, gender inequality, human rights violations and discrimination. Strong political leadership would ensure that the post-2015 global AIDS response be evidence-based. That was the only way scarce resources could produce the biggest impact.

KOKI MULI GRIGNON (Kenya) said that in sub-Saharan Africa, the campaign to fight AIDS was still suffering from a serious shortfall in resources, causing the number of those infected to continue rising. Only 56 per cent of those infected in the region had access to HIV treatment. She expressed concern that funding for the HIV/AIDS response was not proportionate to the magnitude of the epidemic and that stigma and discrimination continued to undermine the fight to combat the scourge. She called for greater collaborative initiatives linked to the broader development agenda to address those challenges, and stressed the role of partnerships, political leadership and proper legislation to ensure affordable prices for medicines. For its part, her Government planned to earmark 1 per cent of its revenue to a national HIV trust fund. It had launched the first National Gender Action Plan to fight the virus. Kenya’s HIV prevalence rate had fallen from a high of 14 per cent in the 1990s to 6 per cent at present. Thanks to the Government’s prevention of mother-to-child transmission strategy, new infections in children had fallen to 36 per day.

BHAGWANT BISHNOI ( India) said over the last decade, the National AIDS Control Programme in his country had resulted in a reduction in adult HIV prevalence, fewer new infections of the virus and a decline in AIDS-related mortality. The Government had undertaken interventions for high-risk groups and developed comprehensive information, education and communications packages for specific communities. Despite encouraging gains, the overall scenario remained bleak. Among the biggest challenges facing the world today was the lack of affordable medical treatment, particularly in developing countries. “Such North-South divide is simply unacceptable,” he said. “The narrow consideration of commerce and profitability should not be allowed to deny the most basic and fundamental human right — the right to life,” he said.

CHARLES NTWAAGAE (Botswana), associating himself with the African Group and SADC, expressed concern over the epidemic’s enormous toll on young people, as well as the world’s failure to address the needs of children living with HIV and the gap in efforts to reduce sexual transmission. “AIDS is far from being over. The world should, therefore, not be lulled into complacency by some of these seemingly impressive results,” he said, calling on Governments to redouble efforts to build on the gains, eliminate stigma, and ensure predictable funding for a sustained response. He welcomed the international donors’ pledge in December 2013 of $12 billion to the Global Fund and the continued aid provided by the United States President’s Emergency Plan for AIDS Relief. Discussions on the post-2015 development agenda was an opportunity to ensure HIV/AIDS remained a top priority.

RUBÉN ARMANDO ESCALANTE HASBÚN ( El Salvador) said his Government joined the Latin American and Caribbean Coordinating Board on HIV/AIDS in January. The number of new infections registered in El Salvador had fallen from six per day in 2007 to four in December 2013. As part of its health-care reforms from 2009 to 2014, national testing for HIV/AIDS had increased. In El Salvador, the epidemic was most prevalent among men who had sex with men, female sex workers and transsexuals. He welcomed the Secretary-General’s report for its recognition of the fight against violence and discrimination of lesbian, gay, bisexual and transgender people. A television programme on prevention of mother-to-child transmission, attention to populations in border areas, the distribution of condoms and HIV/AIDS prevention and treatment material had been used to combat the scourge. As a result, HIV prevalence had fallen to 0.4 per cent. National health services aimed to end stigmatizing and discrimination of people living with the virus. Twenty hospitals provided antiretroviral therapy. In consultation with civil society, the Government had formulated a new law on preventing HIV. Last week, El Salvador and other Latin American countries discussed ways to achieve regional goals to fight HIV/AIDS. El Salvador had received $2.5 million from the United States Government’s PEPFAR [President’s Emergency Plan for AIDS Relief] programme to strengthen its health-care system.

SASHA DIXON (Bahamas) said the key to sustained and exponential progress in building on current gains depended on continued commitment to caring for those living with HIV and addressing the challenges of stigma, discrimination and social injustice. Providing an update on her country’s progress in meeting its 10 national targets to, among others, reduce HIV incidence, she said scaling up efforts towards and beyond 2015 required monitoring and evaluation. It was also important to integrate HIV care into community clinics, when appropriate, and unite efforts made by countries and stakeholders. Urgent support, training and practical approaches were also needed to implement project scale-ups in resource-limited settings. “HIV is a global scourge, requiring global solutions,” she said, adding, “we cannot face it alone”.

SAHAK SARGSYAN ( Armenia) said he was concerned about increasing HIV infections and AIDS-related deaths in Eastern Europe, where antiretroviral therapy access was among the lowest in the world. Armenia’s national response included targeting high-risk groups and integrating HIV counselling and testing into the health-care system. Noting that more than half of registered HIV cases in Armenia were labour migrants infected outside his country, he said a special targeted programme had been designed for those individuals and their sex partners. Looking ahead, he said that the AIDS response must remain high on the agenda when shaping the post-2015 development goals.

JILL DERDERIAN (United States) welcomed the recognition in the Secretary-General’s report of the continued challenge of stigma, discrimination and punitive approaches facing the lesbian, gay, bisexual and transgender community. Landmark scientific advances, coupled with success in implementing effective programmes in recent years had put an AIDS-free generation in sight. The Blueprint for Creating an AIDS-Free Generation, launched on World AIDS Day 2012, showed the strong, sustained commitment of the President’s Emergency Plan for AIDS Relief to fight the disease. Achieving an AIDS-free society was a shared responsibility of partner Governments, civil society, people living with HIV, donor nations and multilateral institutions. Last year, the United States’ Congress extended the relief plan’s critical authorities and strengthened oversight and reporting. It was contributing to the global target supporting more than 6.7 million people who had received lifesaving treatment in 2013. As a public health programme, it strove to reach all affected populations with core HIV services, prioritize high-impact scientifically proven interventions, and focus resources where they would have the greatest impact on controlling the epidemic. Her country would continue to support global efforts to ensure that the momentum to scale up HIV care required to reach the Millennium Development Goals was maintained and increased.

For information media • not an official record