The incidence of HIV/AIDS, tuberculosis and other infectious diseases is higher on this continent than on any other.

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1 UNITED NATIONS THE SECRETARY-GENERAL -- ADDRESS TO THE AFRICAN SUMMIT ON HIV/AIDS, TUBERCULOSIS AND OTHER INFECTIOUS DISEASES Abuja, 26 April 2001 Excellencies, Dear friends, This is a conference about Africa's future. The incidence of HIV/AIDS, tuberculosis and other infectious diseases is higher on this continent than on any other. Of course, this fact is connected to Africa s other problems. Africans are vulnerable to these diseases because they are poor, undernourished, and too often uninformed of basic precautions, or unwilling to take them. Many are vulnerable because they have neither safe drinking water nor access to basic health care. They are vulnerable, in short, because their countries are underdeveloped. And therefore the best cure for all these diseases is economic growth and broad-based development. We all know that. But we also know that, in the best of cases, development is going to take time. And we know that disease, like war, is not only a product of underdevelopment. It is also one of the biggest obstacles preventing our societies from developing as they should. That is especially true of HIV/AIDS, which takes its biggest toll among young adults - the age group that normally produces most, and has the main responsibility for rearing the next generation. That is why AIDS has become not only the primary cause of death on this continent,

2 but our biggest development challenge. And that is why I have made the battle against it my personal priority. In short, my friends, we are here to face a continent-wide emergency. We cannot afford to treat it as just one aspect of the battle for development, because it will not wait for us to win that battle. The cost - whether measured in human misery today, or in loss of hope for tomorrow - is simply too high. We have to turn and face it head on. First, let us be clear what our objectives are. I believe they can be put very simply, under five headings: Number One: Prevention. Our first objective must be to halt and reverse the spread of the virus - as all world leaders resolved to do at last year's Millennium Summit - and so to save succeeding generations from this scourge. Prevention can save many millions of lives, and in several African countries it has been shown to work. Everyone who is not yet infected must know what they need to do to avoid infection. We must give young people the knowledge and power to protect themselves. We need to inform, inspire and mobilise them, through an awareness campaign such as the world has never seen - using radio, television and professional marketing techniques, as well as more conventional tools of education. That campaign must reach girls as well as boys. At present, in sub-saharan Africa, adolescent girls are six times more likely to be infected than boys. That is something which should make all of us African men deeply ashamed and angry. And once they know what they need to do, young people must have the means to do it. That means they must have support from their families and communities, as well as access to voluntary counselling and testing and - when appropriate - to condoms. 2

3 Number Two: We must prevent the cruellest, most unjust infections of all - those that pass from mother to child. All mothers must be able to find out whether they are HIV-positive or not. And those who are must have access to short-term anti-retroviral therapy, which has been shown to halve the risk of transmission. In some cases, the risk can also be reduced by alternatives to breast-feeding. But these must be approached with caution, since breast-feeding is the best protection against many other diseases. Number Three: we must put Care and Treatment within everyone's reach. Even a year ago few people thought that effective treatment could be brought within reach of poor people in developing countries. Those already infected with HIV were condemned to be treated like lepers in earlier times as people from whom the healthy had to be protected, but for whom nothing could be done. Now, however, there has been a world-wide revolt of public opinion. People no longer accept that the sick and dying, simply because they are poor, should be denied drugs which have transformed the lives of others who are better off. Earlier this month I met the leaders of six of the world's biggest pharmaceutical companies. They now accept the need to combine incentives for research with access to medication for the poor. They are ready to sell drugs to those countries at greatly reduced prices. This crisis is so grave that developing countries must face it by exploiting all options to the full - including the production and importation of "generic" drugs under licence, within the terms of international trade agreements. Everyone who is infected should have access to medicine and medical care. Now we know that that is possible, it is surely an ethical imperative. It is also essential to any successful prevention strategy - because, so long as testing positive is a death sentence without hope, many people will not even want to know their HIV status. 3

4 In short, we cannot and should not choose between prevention and treatment. We must do both. Number Four: we must deliver Scientific Breakthroughs. We are still a long way from finding a cure for HIV/AIDS, and a long way from finding a vaccine against it. We must make sure that the search is given the highest priority in scientific budgets, and be ready, as soon as it produces results, to make them available where they are most needed -- not only to those who can afford them. And finally, Number Five: we must protect those made most vulnerable by the epidemic, especially orphans. Millions of children, because they have lost one or both parents to AIDS, are growing up malnourished, under-educated, marginalised, and at risk of being infected themselves. We must break this cycle of death. And we must not wait for parents to die before we intervene. We must help them secure their children's future while they are still fit enough to do so. Agreeing on those five objectives should not be difficult. But what are the means we need to achieve those ends? First of all, we need leadership. And my friends, that must start with you, the leaders of Africa. Only you can mobilise your fellow-citizens for this great battle. Only you can give it the priority in deserves in your national budgets. Above all, you must take the lead in breaking the wall of silence and embarrassment that still surrounds this issue in too many African societies, and in removing the abuse, discrimination and stigma that still attach to those infected. The epidemic can be stopped, if people are not afraid to talk about it. 4

5 Secondly, we need to involve local communities. It is ultimately at that level that the battle will be fought and won. It is only with the fullest support of their families and communities that young people will be able to change their behaviour and protect themselves. Above all, we must involve those already living with HIV-AIDS in the struggle against it. They, after all, are the ultimate experts. Thirdly, we need a deep social revolution that will give more power to women, and transform relations between women and men at all levels of society. It is only when women can speak up, and have a full say in decisions affecting their lives, that they will be able to truly protect themselves - and their children - against HIV. Fourth, we need stronger healthcare systems. This should be obvious, but both governments and development agencies often lose sight of it when setting their budgets and priorities. If our aim is to make care and treatment available to all those infected, we need a far more efficient and extensive system of public health than most African countries even begin to provide at present. Cheaper anti-retroviral drugs, however vital, will not by themselves provide the answer. Without proper health care, they may even do more harm than good - for example, if potentially life-threatening side effects are not addressed, or if the therapy is interrupted, leading to drugresistant forms of HIV. And too many patients still do not have access even to relatively cheap antibiotics and other effective drugs for the many illnesses that prey on their weakened immune systems. Finally, we need money. The war on AIDS will not be won without a war chest, of a size far beyond what is available so far. Money is needed for education and awareness campaigns, for HIV tests, for condoms, for drugs, for scientific research, to provide care for orphans, and of course to improve our healthcare systems. At a minimum, we need to be able to spend an additional seven-to-ten billion dollars a year on the struggle against HIV/AIDS in the world as a whole, over an extended period of time. 5

6 It sounds a lot, and it is a lot. Somehow we have to bring about a quantum leap in the scale of resources available. But it is not at all impossible, given the amount of wealth in the world. In fact it is little more than one per cent of the world's annual military spending. We just have to convince those with the power to spend - public and private donors alike - that this would be money well spent. We need to mobilise the widest possible range of donors -- who must all agree on the same broad objectives -- and we need to win their commitment for the long haul. Over the past few weeks and months, there have been several exciting suggestions for a new fund or funds from a variety of people -- Governments, private foundations and academics. All these initiatives must now converge towards a common vision of what we are trying to achieve. I propose the creation of a Global Fund, dedicated to the battle against HIV/AIDS and other infectious diseases. This Fund must be structured in such a way as to ensure that it responds to the needs of the affected countries and people. And it must be able to count on the advice of the best experts in the world - whether they are found in the United Nations system, in civil society organisations, or among those who live with HIV/AIDS or are directly affected by it. I intend to pursue this idea with all concerned over the next few weeks, and I hope that in the very near future the Fund will be up and running. My dear friends and colleagues, The ideas I have put to you today are the fruit of extensive consultations within the United Nations system, with member states, with philanthropic foundations, with private companies, and with civil society. I believe we can all agree on them, and that they can be the foundations of a common strategy. I certainly hope so, because this battle can be won only if we mobilise and focus the efforts of a wide range of stakeholders: national leaders like yourselves, 6

7 donor governments, the United Nations system, pharmaceutical and other companies, foundations, and voluntary groups - especially those that represent people living with HIV. In other words, we need a complete mobilisation of society at large. Everyone has his or her part to play. Let us now lay aside all turf battles and doctrinal disputes. The battle against HIV/AIDS is far more important than any one institution or project. Our success will not be measured by resolutions passed, appointments made, or even funds raised. It will be measured in the lives of succeeding generations. In the last year or so the world has begun to realise that HIV/AIDS is indeed a world-scale pandemic, which has spread fastest and furthest in Africa. So this is a moment of hope, and potentially a turning point. Africa is no longer being left to face this disaster alone. Its plight has caught the attention, and the conscience, of the whole world. I believe the world is ready to come to our aid. But it will do so only if we convince the world that we ourselves are making the war against AIDS our personal priority, and have a clear strategy for waging it. In two months' time, delegates from all over the world will gather in New York for a Special Session of the United Nations General Assembly on HIV/AIDS. They will draw up a global strategy for the war against this global scourge, and I hope by then we shall have firm commitments for our war chest. Will that strategy respond to the needs of Africa? It depends, in large part, on the signal that goes out to the world from this conference. For my part, I promise you the full support of the United Nations family. Working together, my friends, we can defeat the scourge of HIV/AIDS. For the sake of Africa's future, we must. Thank you very much. 7