Low marks on report card for global HIV/AIDS commitments

Four years after world leaders at the UN General Assembly Special Session (UNGASS) on AIDS pledged to scale up their fight against the disease, many countries are falling short of their targets, a new report has found. Under the Declaration of Commitment on HIV/AIDS of July 2001, UN member governments set time-bound goals for reversing the spread of the pandemic by scaling up treatment, prevention and care in their countries. Much still has to be done before the people directly affected realise the benefits of these commitments, noted the UN Secretary General's progress report on implementation of the targets, released earlier this week. "[The report] should be a wake-up call ... and is stating what we all know: there's still not enough being done, and key issues remain unresolved," Richard Burzynski, executive director of the International Council of AIDS Service Organisations, which has been monitoring the declaration, told PlusNews. However, some progress has been made: the number of people receiving counselling and testing services has doubled since 2001; the number of young people who have received AIDS education has also doubled. The declaration resolved that by the end of 2005, "HIV prevalence among young men and women in the most affected countries should be 25 percent lower than in 2001, and the proportion of infants infected with the virus should have fallen by 20 percent". With most countries "yet to embark on a concerted effort to address the factors that increase vulnerability to infection", many of the most affected countries "are at risk" of not meeting this promise, the report commented. Efforts to reduce the number of children born with HIV have been hampered by limited access to primary HIV prevention and health services for HIV-positive pregnant women. Globally, services to prevent mother-to-child transmission of HIV were reaching only 8 percent of pregnant women, and just 5 percent of pregnant women in Africa. World leaders also committed themselves to strengthening prevention interventions in the workplace, and among migrants, mobile workers and other vulnerable populations. The report warned that by failing to prioritise prevention initiatives that targeted those at greatest risk of infection, governments had missed a "critical opportunity" to prevent the epidemic from spreading to the general population. Since 2001, a global push to expand access to treatment has made the provision of antiretroviral (ARV) drugs in Africa, for the first time, an achievable goal. Nevertheless, more action was needed to lower the prices of ARVs and make treatment more widely available to children. Although most high-prevalence countries were making "considerable efforts" to protect orphans and vulnerable children, "available evidence indicates that national efforts and the level of donor support are currently not sufficient to address this growing crisis", the researchers emphasised. Many national AIDS responses and policies have set up safeguards to protect the human rights of people living with HIV/AIDS and eliminate discrimination, but these measures lacked the "specificity and enforcement mechanisms" needed to fight stigma and gender-based discrimination. The report warned that "if current spending trends continue, by 2007 there will be a significant shortfall between the funds available and the resources needed to finance a response that is comprehensive in both scope and coverage". In 2006, the General Assembly will receive a comprehensive report on whether the targets in the declaration have been met. Burzynski agreed that "2006 will be the big year - we will know where countries are at with the '3 by 5' campaign [World Health Organisation's initiative to place three million people in the developing world on ARVs by the end of 2005] and the declaration ... so we will know what governments are doing, and not doing". In the meantime, it was crucial for people living with HIV/AIDS, NGOs and civil society to keep pressuring countries to do more. According to Burzynski, "Just because a country says this today, doesn't mean they will actually do it. They have conflicted priorities ... and may forget about these targets." To access the report: http://daccessdds.un.org/ For the UNGASS Declaration of Committment on HIV/AIDS: www.un.org