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Note: This document is from the archive of the Africa Policy E-Journal, published by the Africa Policy Information Center (APIC) from 1995 to 2001 and by Africa Action from 2001 to 2003. APIC was merged into Africa Action in 2001. Please note that many outdated links in this archived document may not work.


Africa: AIDS Assembly Summary, 1

Africa: AIDS Assembly Summary, 1
Date distributed (ymd): 010703
Document reposted by APIC

Africa Policy Electronic Distribution List: an information service provided by AFRICA ACTION (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Find more information for action for Africa at http://www.africapolicy.org

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide
Issue Areas: +economy/development+ +health+

SUMMARY CONTENTS:

This series of three postings contains brief topical excerpts from the official United Nations Declaration of Commitment on HIV/AIDS, June 27, 2001, paired with related excerpts from parallel statements released by youth, African civil society groups, and international civil society groups at the UN General Assembly Special Session. Because of the exceptional importance of evaluating the outcome of this unprecedented global gathering, we are making an exception of sending out three postings for your reference.

This posting contains excerpts on prevention and treatment. Related postings focus on rights and discrimination and on resources.

The full UN Declaration is available at:
http://www.un.org/ga/aids/coverage/FinalDeclarationHIVAIDS.html

The full Youth Position Paper is available at:
http://www.africapolicy.org/adna/ung0106c.htm

"HIV/AIDS and Civil Society: Africa's Concerns and Perspectives" is available at:
http://www.africapolicy.org/adna/ung0106d.htm

"A Civil Society Perspective on the UNGASS Declaration of Commitment" is available at:
http://www.africapolicy.org/adna/ung0106.htm

+++++++++++++++++end profile++++++++++++++++++++++++++++++

PREVENTION AND TREATMENT

*UN Declaration, June 27, 2001*

Prevention must be the mainstay of our response.

[47] By 2003, establish time-bound national targets to achieve the internationally agreed global prevention goal to reduce by 2005 H.I.V. prevalence among young men and women aged 15-24 in the most affected countries by 25 percent and by 25 percent globally by 2010, and to intensify efforts to achieve these targets, as well as to challenge gender stereotypes and attitudes, and gender inequalities in relation to H.I.V./AIDS, encouraging the active involvement of men and boys. . . .

[52] By 2005, ensure that a wide range of prevention interventions which take account of local circumstances, ethics and cultural values is available in all countries, particularly the most affected countries, including information, education and communication in languages most understood by communities and respectful of cultures, aimed at reducing risk-taking behavior and encouraging responsible sexual behavior, including abstinence and fidelity; expanded access to essential commodities, including male and female condoms and disposable syringes; harm-reduction efforts related to drug use; expanded access to voluntary and confidential counseling and testing; safe blood supplies; and early and effective treatment of sexually transmissible infections. . . .

[54] By 2005, reduce the proportion of infants infected with H.I.V. by 20 percent and by 50 percent by 2010, by insuring that 80 percent of pregnant women accessing antenatal care have information, counseling and other H.I.V. prevention services available to them, increasing the availability of and by providing access for H.I.V.-infected women and babies to effective treatment to reduce mother-to-child-transmission of H.I.V., as well as through effective interventions for H.I.V.-infected women, including voluntary and confidential counseling and testing, access to treatment, especially antiretroviral therapy and, where appropriate, breast- milk substitutes and the provision of a continuum of care. . . .

[55] By 2003, ensure that national strategies supported by regional and international strategies are developed in close collaboration with the international community, including governments and relevant intergovernmental organizations, as well as with civil society and the business sector, to strengthen health-care systems and address factors affecting the provision of H.I.V.-related drugs, including antiretroviral drugs; inter alia affordability and pricing, including differential pricing; and technical and health care systems capacity. Also, in an urgent manner make every effort to: provide progressively and in a sustainable manner, the highest attainable standard of treatment for HIV/AIDS, including the prevention and treatment of opportunistic infections, and effective use of quality-controlled anti-retroviral therapy in a careful and monitored manner to improve adherence and effectiveness and reduce the risk of developing resistance; to cooperate constructively in strengthening pharmaceutical policies and practices, including those applicable to generic drugs and intellectual property regimes, in order further to promote innovation and the development of domestic industries consistent with international law;. . .

*Youth Caucus Position Paper, June 27, 2001*

Young people have a right to protect themselves against HIV, and our prevention efforts must use this as a basis for all activities geared toward stopping the spread of AIDS.

Youth commitments

+ We will address the power relations between young women and men as central to prevention, ensuring that all prevention programs are gender sensitive and provide young women with the skills to negotiate safer sex while teaching young men to respect the human rights of girls and young women.

+ We will obtain and provide full and complete sexual and reproductive education, information and services to allow youth to make informed decisions about sex.

+ Our prevention efforts will confront the range of situations in which young people may find themselves, in order to address all vulnerable youth, including but not limited to: young women, people confined to prisons and institutions, young people in refugee settings, homeless youth, unemployed youth, out of school youth, young people from ethnic minorities and/or stigmatized social groups, young people living with AIDS, rural youth, young injecting drug users, young commercial sex workers, young men who have sex with men and young people living in extreme poverty;

+ We will demand access to male and female condoms for all young people who are sexually active, and will support and encourage young people who choose to abstain from sex;

+ We will take HIV/AIDS tests and encourage our peers to find out their sero-status so that we can live healthy and productive lives.

HIV/AIDS treatment is a fundamental human right, and is indispensable for effective prevention.

+ We dedicate ourselves to work at community levels to develop programs in which young people assist their peers and women, who bear the brunt of caring for the sick and providing psycho-social support, in ways that promote community acceptance of HIV/AIDS, positive living, and the sharing of responsibility for the care and treatment of people living with HIV/AIDS.

+ We demand that governments adopt and implement trade agreements that will guarantee access to AIDS medicines.

+ We call on the private sector and governments to significantly scale up financing for infrastructure and treatment.

*African Civil Society Statement, June 26, 2001*

In addition to the major issues already highlighted in the Declaration, we call upon our Governments to prioritize re-investment in primary health care infrastructure and systems in rural areas, as a way of scaling up HIV/AIDS response in Africa.

  1. We recommend that an Essential Prevention and Care Package should be developed and made widely accessible. We recognize the importance of research in enhancing prevention, care and treatment, however, such research should not delay the implementation of prevention, care and treatment.
  2. The centrality of community-based responses in the African context for prevention and care needs to be recognized and nurtured.
  3. Civil society demands that there be full access to quality ARVs, and drugs for opportunistic infections for all, at affordable prices, taking into account the low purchasing power of vulnerable groups.
  4. We call for the review of TRIPS in relation to the production and distribution of ARVs, such that the central concern is saving lives rather than profit.

*Civil Society Statement, June 27, 2001*

Though the Declaration notes that prevention, care, support and treatment are mutually reinforcing elements of an effective response to the epidemic, it is necessary to link these components within a comprehensive approach that recognises the impact of HIV/AIDS on multiple sectors. Additionally, these measures should actively involve people living with HIV/AIDS and organizations working in the economic, social, legal, political and cultural sectors. Such an approach is essential to address one of the underlying contributory factors to the widespread advancement of the epidemic -- poverty.

The Declaration refers to making prevention programmes "available", or "efforts" to provide high standards of treatment--wording which implies a passive approach. This does not acknowledge the dominant role communities and self-empowerment efforts have played and continue to play in the response to HIV/AIDS. The role of communities, however, must be complemented by government programmes; governments must be held accountable for actual implementation of such programmes, in great part by actively empowering vulnerable groups and civil society in the design, implementation and monitoring of programmes within a human-rights framework.

Such empowerment, including the mobilization of financial and human resources, is a necessary condition for the success of programmes; only when people are aware that they have rights to prevention and care programmes and services can they adequately act to defend and implement those rights.

Prevention efforts for the most vulnerable groups should include:

  • full access to comprehensive sexuality and sexual & reproductive health education and services, regardless of race, gender, age, HIV status, socio-economic status and sexual orientation;
  • risk- and harm-reduction strategies, including the availability and accessibility of STI diagnosis/treatment, condoms, microbicides and lubricants, as well as needle and syringe exchange and drug substitution and maintenance programmes, for all people;
  • consideration of breast milk substitutes for babies of mothers living with HIV/AIDS only when they are acceptable, feasible, affordable, sustainable and safe; otherwise their use could lead to greater infant morbidity and mortality in resource-poor countries;
  • political leadership, commitment and action to address policies, legislative, cultural and economic factors that increase vulnerability to HIV/AIDS, including reviews of the extent to which current prohibition laws on illegal drugs and sex work contribute to the spread of HIV infection.

An effective response to HIV must include prevention, care and support (including treatment) and impact mitigation, especially the continuing support for orphans and vulnerable children.

In many countries, the burden of care has gone beyond the capacities of families, communities and institutions. Therefore, we insist that more attention be given to supporting care-givers, with special attention for women and older persons, who bear a disproportionate part of this burden.

Care packages should be comprehensive and relevant to the local context. Client-centred counselling and education on all the elements of promoting a healthy life, as well as nutritional support, constitute an essential component of treatment and support for people living with HIV/AIDS. Within this context, it is essential to provide ongoing education and training for health-care providers on internationally recommended treatment protocols and regimens, and on appropriate client-centred counselling.

Human rights are not negotiable: the global threat posed by HIV/AIDS does not allow people's health and lives to be traded against companies' intellectual property rights. Antiretroviral drugs and medications for the treatment of opportunistic infections must be made available and accessible to all people living with HIV/AIDS. The international community, governments, civil society and the business sector should take extraordinary initiatives to fully exploit existing trade agreements or adapt them where conditions require to do so, in order to guarantee access to treatment and care. The pricing of treatments should be differentiated and adapted, so that all countries have equitable opportunities to provide such treatment. These efforts must be integrated into national treatment and care programmes by 2003, not 2005 as stated in the Declaration.

Provision of treatment should be continuous and sustainable in order to avoid drug-resistance. This implies that governments should make investments in the health-care infrastructure and human resources to ensure such continuity and sustainability.


This material is being reposted for wider distribution by Africa Action (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Africa Action's information services provide accessible information and analysis in order to promote U.S. and international policies toward Africa that advance economic, political and social justice and the full spectrum of human rights.

URL for this file: http://www.africafocus.org/docs01/sum0106a.php