The President of the General Assembly
H.E. Mr Srgjan Kerim (center) chaired the
interactive civil society hearing.

Representatives of civil society organizations addressed Member States and observers on Tuesday 10th June in an interactive hearing at the High-level Meeting on AIDS entitled Action for Universal Access 2010: Myths and Realities.

The hearing was chaired by the President of the General Assembly and the UN Secretary-General made opening remarks. Following the opening, civil society speakers brought frontline experiences to the session, addressing the challenging issues that underlie the spread of the epidemic. They stressed the importance of accountability and involvement to fulfil targets set on the Declaration of Commitment and Universal Access.

Representatives of civil society organizations
addressed Member States and observers on
Tuesday 10th June in an interactive hearing
at the High-level Meeting on AIDS

The speakers also highlighted some of the myths that have become barriers to an effective response to the epidemic. The hearing provided an open forum to discuss these myths and realities and the urgent work needed to achieve universal access by 2010.

Civil society speakers addressed issues related to achieving universal access from a number of different perspectives such as HIV and human rights, sex workers, sexual minorities, people who use drugs, women and girls, children, access to treatment, HIV-related travel restrictions, mobility and migration, workplace responses and civil society involvement and AIDS accountability. 

Following an open call for nominations, which yielded more than 250 proposed speakers, the civil society Task Force recommended speakers to the President of the General Assembly. The selection was based on criteria established by the Civil Society Task Force, which included experience, people living with HIV, gender and regional diversity.

2008 High-level Meeting on AIDS, General
Assembly, United Nations, New York.
10-11 June 2008

The 2008 High-level Meeting on AIDS opens today at the United Nations General Assembly in New York.

Over the next two days the President of the General Assembly Srgjan Kerim, UN Secretary-General Ban Ki-moon, approximately 6 Heads of State and Government and over 80 ministers, senior officials, representatives of international organizations and civil society will meet to review progress towards the targets agreed in the UN’s 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS.

The UN Secretary-General will present his analytical report on the progress made and the challenges that remain in the global response to AIDS. The report is based on 147 national progress reports submitted to UNAIDS at the end of January 2008.

The High-level Meeting will provide an important forum for leaders from government, international organizations and civil society. In addition to reviewing progress, discussions are expected to cover the remaining challenges and explore sustainable ways of overcoming them.

The availability of affordable commodities,
including quality medicines and diagnostics,
is a key factor for moving towards universal
access

As part of the 2008 High level Meeting on AIDS, a special event entitled “Universal access to affordable diagnostics, prevention and treatment: In search for sustainable solutions” will be held on 9th June in the United Nations Headquarters, New York.

The event, co-organized by UNAIDS, UNOHRLLS and UNOSAA aims to explore potential actions to improve availability of affordable commodities for the achievement of the Millennium Development Goals (MDGs).

The availability of affordable commodities, including quality medicines and diagnostics, is a key factor for moving towards universal access. Despite that antiretroviral coverage rose by 46.5 per cent in 2007, reaching 3 million people in low-income and middle-income countries - approximately 30 per cent of those in need - the price of newer drugs and diagnostics are still high in many parts of the world. Furthermore, an increasing number of people on HIV treatment will need to switch from first-line antiretroviral treatment to second- and third-line combinations in the near future.

HIV Prevention efforts are equally affected by affordability issues, jeopardizing efforts to scale up implementation strategies to prevent mother to child transmission, ensure blood safety, and ensure wide access to preventive measures such as condoms and harm reduction measures.

Countries are trying to deal with these challenges, with varying degrees of success. Between 1997 and 2004, Brazil succeeded in reducing the average cost of antiretroviral drugs to almost one fifth of the original cost, through the use of multiple strategies, such as the local production of generic drugs and price negotiations with pharmaceutical companies. There are also several examples of global collaboration towards improving the availability of affordable commodities, such as the Clinton Foundation, which has been highly successful in negotiating price reduction for antiretroviral drugs in over 60 countries.

However, as countries move to scale up their national AIDS responses, many continue to face difficulties and have expressed frustration in negotiating better access to commodities. Much remains to be done, especially with regards to issues of intellectual property rights, product development processes, demand forecasting, procurement systems, and legislation.

The meeting will be opened by Mr. Cheick Sidi Diarra, Under-Secretary-General and High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States, followed by a keynote address by H.E. Mr. Faure Gnassingbe, President of Togo.

Following the presentation, a panel discussion will be moderated by UNAIDS Deputy Executive Director Mr. Michel Sidibe. This panel will further discuss the challenges faced by countries in accessing affordable commodities. Speakers at the discussion panel will include H.E. Ms. Nilcea Freire, Minister of Women’s Affairs, Brazil, H.E.Dr. Brian Chituwo, Minister of Health, Zambia, Ms. Rolake Odetoyinbo, Positive Action for Treatment Access (PATA), Nigeria and Mr. Jeffrey L. Sturchio, Vice President, Merck.

The Commission on HIV/AIDS and
Governance in Africa (CHGA) will present
its final report "Securing Our Future" to UN
Secretary-General Ban Ki-moon

The Commission on HIV/AIDS and Governance in Africa (CHGA) will present its final report "Securing Our Future" to UN Secretary-General Ban Ki-moon on 9 June 2008 at UN Headquarters. This will be followed by a high-level panel discussion on “Regional lessons in the progress towards universal access.”

UN Secretary General Kofi Annan established the Commission in 2003 under the leadership of the Executive Secretary of the UN Economic Commission for Africa, K.Y. Amoako and 20 Commissioners, including UNAIDS Executive Director Dr Peter Piot.

The Commission’s brief was to advise African governments on the extent of the AIDS epidemic’s impact on African social, political and economic institutions and on the appropriate policy responses and programmes that need to be taken in order to address the unique challenges posed by the multiple ways in which the epidemic impacts upon development and governance on the continent.

The 280 page report includes an analysis of findings and a series of key recommendations. It is the culmination of a wide consultation by the CHGA Commission¬ers in Africa and beyond. The findings and recommenda¬tions reflect the views of the more than 1,000 Africans—including policymakers, advocacy groups, nongovernmental organizations, community-based organizations, people living with HIV, research organizations and UN agen¬cies—who took part in the consultation process.

Secretary-General Ban Ki-moon addresses the launch of the report of the Commission on HIV and AIDS and Governance in Africa and high-level panel discussion on "Keeping the promise: Lessons in the progress towards universal access."
Credit: UN Photo/Eskinder Debebe 

During its lifespan the Commission held five sub-regional consultations to engage with a wide range of stakeholders and constituencies. Each interactive session provided an opportunity to share experiences and discuss the way forward in their sub-regional context.

AIDS has already had limiting consequences on social and economic development in Africa. The Commission concludes that the epidemic will have dire implications for governance for years to come unless decisive actions deepen the commitment and leadership to the AIDS response. This includes leadership within each African society at national and local level, by governments and political leaders, donors, civil society, tradi¬tional and community leaders and people living with HIV.

The final discussion panel of 2008 High-level meeting on AIDS will examine aspects of financing the response to AIDS, including sources of funding, resource allocation, and spending, “making the money work”, accountability and predictable and multi-year funding.

The panel will consider specific steps which can be taken to ensure predictable funding into the future, from all sources, without imposing excessive burdens on poor nations and the poorest communities.

This panel will be broadcast via live internet webcast at 19:00 GMT 

Current situation

Responding to the call for increased resources to support the global AIDS response in 2001, new initiatives by multilateral institutions such as the World Bank’s Africa Multi-Country HIV/AIDS Program and by bilateral donors, such as the United States President’s Emergency Plan for AIDS Relief (PEPFAR) were launched to mobilize international resources in response to the spread of the AIDS epidemic.

The Global Fund to Fight AIDS, Tuberculosis and Malaria was established to provide low- and middle-income countries with additional financing. Prices of some AIDS medicines have been greatly reduced and now millions of people are on antiretroviral treatment.

The Chair of this panel is H.E. Mr. Gudlaugur Thor Thordarson, Minister of Health (Iceland); and panelists are H.E. Mr. Daniel Kwelagobe, Minister, Presidential Affairs and Public Administration (Botswana), Mr. Vladimir Zhovtyak of Eastern European and Central Asian Union of People Living with HIV/AIDS (Ukraine), Mr. Michel Kazatchkine, Executive Director, Global Fund to fight AIDS, Tuberculosis and Malaria.

The Chair’s summary of this discussion will be published after the event, please check back to access it.

In many countries, the people who are most in need of HIV prevention, treatment, care and support are not able to reach these services as they are already vulnerable and stigmatized in society.

On 10 June, as part of 2008 High-Level meeting on AIDS, a discussion panel will look at how the obstacles preventing everyone—especially those who are seen as being on the margins of society—having access to services can be removed.

Panelists will consider actions which can be taken by countries with concentrated epidemics to increase the political will and leadership to address the main barriers to access HIV prevention, treatment, care and support services.

This panel will be broadcast live via internet webcast at 20:30 GMT 

Concentrated epidemics

In many regions of the world, including Europe, Asia, Latin America and West Africa, most countries are experiencing concentrated HIV epidemics where HIV has spread rapidly in one or more defined subpopulations but is not well-established in the general population.

Due to a combination of biological and behavioural factors, some people are at higher risk of acquiring and/or transmitting HIV, including sex workers and their clients; people who inject drugs; men who have sex with men; and people in prison settings.

Others, including those already with sexually transmitted infections, migrant workers who spend long periods away from their partners, uniformed services personnel and ethnic minorities may also be more likely to be exposed to HIV, depending on the local situation.

It has been shown that concentrated HIV epidemics can be prevented, stabilized and even reversed using a comprehensive programme of HIV prevention, treatment, care and support activities.

Current situation

The 2008 Secretary-General’s Report on the Declaration of Commitment on HIV/AIDS and the 2001 Political Declaration on HIV/AIDS show some progress but many remaining challenges. For example, more than 80% of all HIV infections in Eastern Europe and Central Asia are due to the use of contaminated injection equipment.

Also only around one third of reporting countries have protection against discrimination for sex workers, men who have sex with men and people who inject drugs.

In half of all reporting countries there are laws or policies which actually impede access by the most-at-risk populations to HIV prevention, treatment, care and support.

The panel is composed of H.E. Mr. Elias Antonio Saca Gonzales, President (El Salvador); H.E. Ms. Rigmor Aasrud, State Secretary of Health and Care Services (Norway); Ms. Sonal Mehta of India HIV/AIDS Alliance (India); Mr Antonio Maria Costa, Executive Director, United Nations Office on Drugs and Crime (UNODC).

The Chair’s summary of this discussion will be published after the event, please check back to access it.

The fourth panel discussion of the 2008 High-level meeting on AIDS is set to examine the multigenerational challenge of the AIDS response.

Many factors from poverty to tuberculosis are proving to be obstacles to a long term response to AIDS in some instances turning back advances already gained. The efforts that will be required over future generations depend on actions taken now.

The response to AIDS requires long-term investment in strengthening health systems. More research and investments are also required, while scaling up of proven and effective HIV prevention tools and strategies is urgent. Social protection for the most vulnerable populations must remain a priority.

This panel will be broadcast live via internet webcast at 15:30 GMT  

The panel will consider specific actions on how progress towards reversing the HIV epidemic is central to meeting the Millennium Development Goals; how to help mitigate the impact of HIV on families and communities; how HIV responses that integrate tuberculosis prevention and treatment programmes can help address the challenges of these co-infections; the need for health system strengthening to improve the range of chronic health systems problems; and how scientific research remains vital for securing the future.

This discussion “AIDS: A Multigenerational Challenge – Providing a Robust and Long-Term Response” will be chaired by H.E. Dr. Tabita Botros Shokai, Minister of Health (Republic of the Sudan) and the panelists are H. E. Ms. Maret Maripuu, Minister of Social Affairs (Estonia); Mr. Gregg Gonsalves (US), Global Network of People Living with HIV/AIDS (GNP+); Ms. Ann Veneman, Executive Director, United Nations Children’s Fund (UNICEF).

The Chair’s summary of this discussion will be published after the event, please check back to access it.

The first panel discussion on the second day of the 2008 High-Level meeting on AIDS is on the topic of gender equality and AIDS.

This panel will be broadcast live via internet webcast at 14:00 GMT  

Overview

Globally, women comprised half of adults living with HIV in 2007 and in sub-Saharan Africa, 61% of people living with HIV are women.

A range of biological, cultural and economic factors make women vulnerable to HIV and disproportionately burden them with the epidemic’s impact. Vulnerability can start even before women become adults as many girls under the age of 18 experience early sexual initiation, unsafe sex, early marriage and widespread sexual exploitation and violence.

The widely-held beliefs, expectations, customs and practices within a society that define ‘masculine’ and ‘feminine’ attributes, behaviours and roles and responsibilities lead to gender inequality. This inequality often results in women and girls having less access to education, health services and income-earning opportunities than men and boys.

Women and girls also are the main providers of care and support to household members with AIDS.

Current situation

Government commitments in the 2001 Declaration of Commitment on HIV/AIDS and in the 2006 Political Declaration on HIV/AIDS acknowledged that HIV services and programmes reaching women and girls need to be scaled up if the course of the epidemic is to be reversed.

However, much still needs to be done. For example, only 34% of women living with HIV are provided with antiretroviral treatment to prevent mother-to-child transmission, far below the 80% target.

Women’s participation in decision-making helps make HIV services and programmes more sensitive to gender inequalities however opportunities are often limited and they are often absent from dialogues that shape global and national AIDS policies and programmes.

Some specific actions that may make a difference include: the importance of cross-sectoral national strategies that reach beyond health to include social and economic empowerment; prioritizing young women and girls’ access to HIV prevention and other sexual and reproductive health services; inclusion of HIV-positive women in the planning and design of AIDS policies and programmes.

The Chair of this discussion is Ms. Anna Marzec–Boguslawska, Head of the National AIDS Centre (Poland) and the panelists are H.E. Mr. Francisco Duque III, Minister of Health (Philippines); Ms. Rosa González (Honduras), LACASSO - ICASO3; Ms. Thoraya Obaid, Executive Director, United Nations Population Fund (UNFPA).

The Chair’s summary of this discussion will be published after the event, please check back to access it.

The Global Leaders Forum is supported by
UNAIDS, the World Bank, WHO, the Global
Fund to Fight AIDS Tuberculosis and
Malaria and the Stop TB Partnership who
are the co-sponsors of the initiative.

The first HIV/TB Global Leaders' Forum will be held on 9 June 2008 at the United Nations in New York and will bring together heads of government, public health and business leaders, heads of UN agencies and activists.

The meeting, endorsed by the UN Secretary General, Mr Ban Ki-moon, will be held on the eve of the UN General Assembly High-level Meeting on AIDS taking place 10-11 June 2008.

Speakers, who include UNAIDS Executive Director Dr Peter Piot and WHO Director General Dr Margaret Chan, will discuss the health, socio-economic and human security impacts of the TB and HIV joint epidemics and call for opportunities for bold leadership and col¬laboration to ensure an effective response to TB and HIV.

TB and HIV: a lethal combination

TB is the leading infectious killer of people living with HIV, and accounts for the deaths of an estimated a quarter of million people living with HIV each year AIDS. It is the number one cause of death among people living with HIV in Africa. Since most TB deaths are among adults of working age HIV/TB coinfection risks being a major constraint to economic development.

HIV and TB are so closely connected that they are often referred to as co-epidemics or dual epidemics that drive and reinforce one another: HIV activates dormant TB in a person, who then becomes infectious and able to spread the TB bacillus to others.

Recently new TB strains, extensively drug resistant TB (XDR TB), have emerged, which are particularly lethal as they are virtually untreatable using currently available anti-TB drugs. Greater investment in TB services, improved community case finding and adherence support, and more effective infection control are essential in preventing the development and spread of drug resistant TB.

In addition, the drugs, diagnostics and vaccines currently available are not appropriate for people with HIV/TB co-infection and so new tools are needed that work in the presence of coinfection.

The Global Leaders Forum is supported by UNAIDS, the World Bank, WHO, the Global Fund to Fight AIDS Tuberculosis and Malaria and the Stop TB Partnership who are the co-sponsors of the initiative.

It is expected that the Forum, will produce a Call for Action to drastically cut the number of deaths associated with HIV/TB co-infection and the outcomes of the event will be reported to the UN High-Level Meeting on AIDS.

The 2008 High-Level meeting on AIDS begins 10 June at the General Assembly in New York. In addition to the plenary meetings, a series of panel discussions will be held over the next two days.

These discussions will cover a range of topics from gender equality to concentrated epidemics and the multigenerational challenge of AIDS. The discussions will be open to representatives of Member States, observers and civil society representatives and presentations will be followed by an interactive dialogue.

The panels will also be broadcast live via internet webcast.

Panel 1: Building on results and accelerating progress towards universal access

During the 2006 High Level Meeting on HIV/AIDS, countries committed to set ambitious national targets for scaling up towards universal access to HIV prevention, treatment, care and support by 2010.

The 2008 Secretary-General’s Report on the Declaration of Commitment on HIV/AIDS and Political Declaration on HIV/AIDS confirms that countries have used the universal access process as a catalyst to accelerate their national AIDS responses. Examining findings from the national progress reports, the panel will look at results as well as the gaps and will identify actions that should be taken at country, regional and global levels.

Improving national leadership and coordination

Countries that have made good progress towards achieving universal access have shown strong political leadership and coordination of the AIDS response. The panel will explore possible catalysts that could enhance political will in countries with less engaged leadership and weaker coordination mechanisms.

Addressing obstacles

The 2008 reports submitted by 147 countries to UNAIDS, in compliance with the 2001 Declaration of Commitment on HIV/AIDS, indicate that progress has been achieved when national AIDS strategies identified and unblocked obstacles including health systems strengthening, affordable commodities, sustainable financing, stigma and discrimination and lack of integration of HIV into other health services.

The Chair of this discussion will be H. E. Mr. Nimal Siripala De Silva, Minister of Healthcare and Nutrition (Sri Lanka)and the panelists are H.E. Ms. Nilcéa Sreire, Minister of Women’s Affairs (Brazil); Dr Lydia Mungherera of The AIDS Service Organisation (TASO)(Uganda) and Dr Margaret Chan, Director General, World Health Organization (WHO)

The Chair’s summary of this discussion will be published after the event, please check back to access it.