Draft Declaration of Commitment on HIV/AIDS

Revised 11 May 2001

DRAFT DECLARATION OF COMMITMENT ON HIV/AIDS

"Global Crisis – Global Action"

We, Heads of State and Government and Representatives of States and Governments, assembled at the United Nations, from 25 to 27 June 2001, for the 26th special session of the General Assembly convened in accordance with resolution 55/13 to review the problem of HIV/AIDS in all its aspects:

Deeply concerned that the global HIV/AIDS epidemic, through its devastating scale and impact, constitutes one of the most formidable challenges to human development and security which undermines social and economic progress throughout the world and affects all levels of society – national, community, family and individual;

Concerned also that the continuing spread of HIV/AIDS will constitute a serious obstacle to the realisation of the global development goals we adopted at the Millennium Summit;

Recalling and reaffirming our previous commitments on HIV/AIDS made through:

Recognising that Africa, in particular sub-Saharan Africa, is the worst affected region where HIV/AIDS is considered as a state of emergency, which threatens development, social cohesion, political stability, food security and life expectancy and imposes a devastating economic burden and that the dramatic situation on the continent needs an urgent and exceptional response;

Welcoming the pledge of African Heads of State or Government, at the Abuja Special Summit in April 2001, to set a target of allocating at least 15 per cent of their annual national budgets to fight the HIV/AIDS epidemic; and recognising that action to reach this target, by countries whose resources are limited, will have to be complemented by increased international assistance;

Recognising also that countries in other regions are seriously affected and confront similar threats and that the potential exists for a rapid expansion of the epidemic throughout the world;

Recognising that the epidemic affects all people, rich and poor, without distinction of age or gender, but that women, children and young adults are the most affected;

Noting with grave concern that poverty and underdevelopment exacerbate the spread of the epidemic and need to be addressed;

Noting with equally grave concern that conflicts and crises also exacerbate the spread of the epidemic;

Noting further that stigma, silence, discrimination and denial undermine prevention and care efforts and increase the impact of the epidemic on individuals, families, communities and nations and must also be addressed;

Noting with concern that obstacles of all kinds – cultural, legal, economic, social, political and financial - are hampering awareness, education, prevention and care and support efforts;

Acknowledging that prevention of HIV infection must be the mainstay of the national and international response to the epidemic; that care and support for those infected and affected by HIV/AIDS are inseparable elements of an effective response and must be integrated in a comprehensive approach to combat the epidemic;

Noting the importance of strengthening the basic national health and social infrastructures that are required for the effective delivery of prevention and care services;

Recognising that effective prevention and care strategies will require increased availability of and access to international public goods including vaccines, condoms, microbicides and drugs;

Recognising also that the cost, availability and affordability of drugs are significant factors to be addressed;

Welcoming the progress made in some countries to contain the epidemic, particularly through: leadership; effective use of available resources; successful prevention strategies; working in partnership with people living with HIV/AIDS; and the active promotion of human rights; and recognizing the importance of sharing and building, through both North/South and South/South cooperation, on our collective and diverse experiences;

Recognising the fundamental importance of strengthening national and regional capacities to address HIV/AIDS and that this will require increased human, financial and technical resources as well as increased regional and international co-operation;

Affirming that beyond the key role played by families and communities, strong partnerships involving Governments, the United Nations system, intergovernmental organisations, people living with HIV/AIDS, medical and scientific institutions, non-governmental organisations, the business sector, trade unions, media, parliamentarians, foundations, community and faith-based organisations are important;

Acknowledging the particular role and significant contribution of people living with HIV/AIDS and civil society actors in addressing the problem of HIV/AIDS in all its aspects and recognising that their full involvement is crucial to the development of effective responses to HIV/AIDS epidemic;

Acknowledging the Framework for Global Leadership on HIV/AIDS, adopted in December 2000 by the UNAIDS Programme Co-ordinating Board, comprising representatives of Governments, the United Nations system and non-governmental organisations, as a framework for the harmonisation of HIV/AIDS strategies at global, national and community levels; and recognising that this framework will assist Governments in implementing the outcomes of the special session;

Solemnly declare our commitment to address the HIV/AIDS crisis by taking action as follows:

LEADERSHIP

Strong leadership at all levels of society is essential for an effective response to the epidemic

Leadership by Governments needs to be complemented by leadership by civil society and the private sector

Leadership involves personal commitment and concrete actions

At the national level

By 2003, ensure the development and implementation of multisectoral, national strategies and financing plans for combating HIV/AIDS that: address the epidemic in forthright terms; confront stigma, silence and denial; involve partnerships with civil society and the business sector and the full participation of people living with HIV/AIDS; are resourced to the extent possible from national budgets; fully protect and promote human rights and fundamental freedoms for all, including the right of enjoyment of the highest attainable standard of physical and mental health; integrate a gender perspective; and address risk, vulnerability, prevention, care and reduction of the impact of the epidemic;

By 2003, integrate HIV/AIDS prevention and care and impact mitigation priorities into the mainstream of development planning, including in poverty reduction strategies, national budget allocations, and sectoral development plans;

At the regional and sub-regional level

Encourage regional organisations and partners to: take a greater interest in the crisis; intensify regional co-operation and co-ordination; and develop regional strategies and responses in support of expanded country level efforts;

Support the International Partnership against AIDS in Africa (IPAA) and the African Consensus and Plan of Action: Leadership to Overcome HIV/AIDS; the Abuja Declaration and Framework for Action; the CARICOM New Pan-Caribbean Partnership Against HIV/AIDS; the ESCAP Regional Call for Action to Fight HIV/AIDS in Asia and the Pacific; the Baltic Sea Initiative and Action Plan; and the Horizontal Technical Co-operation Initiative on HIV/AIDS in Latin America;

Encourage countries to consider the benefits of developing regional approaches and plans to address HIV/AIDS;

Encourage local and national organisations to expand regional partnerships, coalitions and networks.

At the global level

Support greater action and co-ordination in the United Nations system, including full implementation of the United Nations System Strategic Plan for HIV/AIDS;

Foster stronger collaboration between the private and public sectors and by 2003, establish and strengthen mechanisms that involve the private sector and civil society partners in the fight against HIV/AIDS;

PREVENTION

Prevention must be the mainstay of our response

By 2003, establish time-bound national targets to achieve the internationally agreed global prevention goal to reduce by 2005 HIV prevalence among young men and women aged 15-24 in the most affected countries by 25 per cent and by 25 per cent 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 HIV/AIDS, encouraging the active involvement of men and boys;

By 2005, strengthen the response to HIV/AIDS in the world of work by establishing and implementing workplace prevention and care programmes in productive and service sectors and establish specific strategies to address workers in the informal sector;

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 behaviour and encouraging responsible sexual behaviour, 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 counselling and testing; safe blood supplies; and early and effective treatment of sexually transmissible infections;

By 2005, reduce the number of infants infected with HIV by 20 per cent, and by 50 per cent by 2010, by: increasing the availability of and by providing access for HIV-infected women to effective treatment to reduce mother–to-child-transmission of HIV as well as through effective interventions for HIV-infected women, including voluntary and confidential counselling and testing, access to antiretroviral therapy and, where appropriate, breast milk substitutes;

CARE, SUPPORT AND TREATMENT

Care, support and treatment are fundamental elements of an effective response

By 2003, ensure that national strategies are developed in close collaboration with the international community, civil society and the business sector to increase substantially the availability of antiretroviral drugs and of essential drugs, for the treatment of HIV infection and opportunistic infections, by addressing factors affecting the provision of these drugs, including technical and system capacity, pricing, including differential pricing and by examining alternatives for increasing access and affordability of HIV/AIDS related drugs;

By 2005, develop and make significant progress in implementing comprehensive care strategies to: strengthen community based health care and health care systems and infrastructure to provide and monitor treatment to people living with HIV/AIDS and support individuals, households, families and communities affected by HIV/AIDS; improve the capacity of health care personnel, supply systems, financing plans and referral mechanisms required to provide access to affordable medicines and drugs and quality medical, palliative and psycho-social care.

HIV/AIDS AND HUMAN RIGHTS

Respect for human rights reduces vulnerability to HIV/AIDS

Respect for the rights of people living with HIV/AIDS drives an effective response

By 2003, complete policy reviews of existing non-discrimination legislation and protective laws, drawing as appropriate on the United Nations Guidelines on HIV/AIDS and Human Rights, in order to adopt new or strengthen existing legislation to protect the human rights of people living with HIV/AIDS, eliminate discrimination and ensure their equal rights in education, employment and services;

By 2005, ensure that national legislation is in place to promote, protect and respect the rights of people living with HIV/AIDS to information, quality care, support, confidentiality and privacy;

By 2005, develop and implement national strategies that: assist women to exercise control over and make their own decisions relating to their sexuality in order to protect themselves from HIV infection; and promote shared responsibility of men and women to ensure safe sex and prevent HIV infection;

By 2005, implement measures to increase capacities of women and young girls to protect themselves from risk of infection, principally through gender-sensitive prevention education and the provision of reproductive health services;

By 2005, develop and begin to implement national strategies to promote women’s full enjoyment of all human rights and reduce their vulnerability to HIV/AIDS through the elimination of all forms of violence against women and girls, including harmful traditional and customary practices, abuse and rape, battering, and trafficking in women and girls;

REDUCING VULNERABILITY

The vulnerable must be given priority

By 2003, have in place in all countries programmes that identify and begin to address those factors that make individuals or groups particularly vulnerable to HIV infection, including poverty, lack of education, migration, social exclusion, illiteracy, discrimination, lack of information or commodities for self-protection. These programmes should address the gender dimension of the epidemic, specify the actions that will be taken to address vulnerability and set targets for their achievement;

By 2003, develop national strategies, policies and programmes, through a participatory approach, to promote and protect the health of those most vulnerable to, and at greatest risk of HIV infection, such as: children in especially difficult circumstances, men who have sex with men, sex workers and their clients, injecting drug users and their sexual partners, persons confined in institutions and prison populations, refugees and internally displaced persons and people separated from their families due to work or conflict;

By 2003, develop strategies and programmes, which recognise the importance of the family and take account of cultural, religious and ethical factors, to reduce the vulnerability of children and young people by: promoting access of both girls and boys to primary and secondary education, including on HIV/AIDS in curricula for adolescents; expanding youth-friendly information and health services; strengthening reproductive and sexual health education programmes; and involving them in planning, implementing and evaluating HIV/AIDS prevention and care programmes;

CHILDREN ORPHANED BY HIV/AIDS

Children orphaned and affected by HIV/AIDS need special assistance

By 2005, develop and begin to implement national policies and strategies to: build family and community capacities to provide for orphans and vulnerable children in a supportive environment under the care and protection of a responsible adult; increase the availability of appropriate counselling and psycho-social support; ensure that orphans and children in families affected by HIV/AIDS are enrolled in school and have access to health and social services on an equal basis with other children; and protect orphans and vulnerable children from abuse, exploitation and discrimination;

Direct special assistance to sub-Saharan Africa to support programmes for children orphaned HIV/AIDS;

ALLEVIATING SOCIAL AND ECONOMIC IMPACT

To address HIV/AIDS is to invest in productivity and economic growth

By 2003, review the impact of the HIV/AIDS epidemic on all productive and service sectors, and develop strategies to: address the impact at the individual, family, community and national levels; adjust and adapt national poverty reduction strategies to address the impact of HIV/AIDS on households income, livelihoods, and access to basic social services, with special focus on individuals, families and communities hardest hit by the epidemic; review the impact of HIV/AIDS on women and the elderly, particularly in their role as caregivers and in families affected by HIV/AIDS and address their special needs; adjust and adapt development policies to address the impact of HIV/AIDS on economic growth, provision of essential economic services, labour productivity, government revenues, and deficit-creating pressures on public resources;

By 2003, develop a national legal and policy framework that protects the rights and dignity of working persons affected by HIV/AIDS in consultation with representatives of employers and workers, in accordance with established international guidelines on HIV/AIDS in the workplace;

RESEARCH AND DEVELOPMENT

With no cure for HIV/AIDS yet found, further research and development is crucial

Support and encourage increased investment in HIV/AIDS-related research including biomedical, operations, social and behavioural research and in traditional medicine to: improve prevention and therapeutic approaches; accelerate access to prevention and care technologies for HIV/AIDS and sexually transmitted diseases, including female controlled methods and microbicides, diagnostics and in particular HIV vaccines; and improve our understanding of factors which influence the epidemic and actions which address it;

Support the development of research infrastructure, improved data collection and training of basic and clinical researchers, health care providers and technicians, with a focus on the countries most affected by HIV/AIDS, particularly in sub-Saharan Africa, and those countries experiencing or at risk of rapid expansion of the epidemic;

Strengthen international cooperation, both North/South and South/South, related to transfer of relevant technologies, the exchange of researchers and research findings;

HIV/AIDS IN CONFLICT AFFECTED REGIONS

Conflicts are fertile ground for the spread of HIV/AIDS

By 2005, implement measures that incorporate HIV/AIDS prevention, care and awareness interventions in humanitarian assistance programmes to ensure that humanitarian workers and United Nations personnel in conflict affected areas and the populations affected by conflict: refugees, internally displaced persons, and in particular, women and children, are protected from HIV infection;

By 2003, have in place well-defined and applicable strategies to address the rapid spread of HIV/AIDS amongst national uniformed services in the most affected countries and use the uniformed services as a force for prevention and awareness;

Support the early finalisation by the United Nations of a revised Code of Conduct for United Nations peacekeeping operations and for peace operations to include codes on personal behaviour in relation to HIV/AIDS; expand HIV/AIDS education and protection for UN Peacekeepers;

By 2003, develop and implement HIV/AIDS awareness and training, which includes a gender component, for defence personnel and other personnel involved in international peace operations, to promote HIV/AIDS awareness in the field and promote compliance with the Code of Conduct;

RESOURCES

The HIV/AIDS challenge cannot be met without new and additional resources

By 2005, through a series of incremental steps, reach an overall target of annual expenditure on the epidemic of between US$ 7 and US$ 10 billion in low and middle income countries for prevention, care and treatment and mitigation of the impact of HIV/AIDS. This amount would include money from: national budgets, international development assistance and private expenditure

Increase national budgetary allocations for HIV/AIDS programmes as required and ensure that adequate allocations are made by all relevant ministries;

Call on the developed countries that have not yet done so to achieve as soon as possible the agreed target of 0.7 per cent of their Gross National Product for overall development assistance, recognising that: such assistance, by helping countries alleviate poverty and achieve sustainable development, will strengthen their national capacity to combat HIV/AIDS; and that where developing countries commit to increase national funds to fight the HIV/AIDS epidemic, such effort and commitment should be complemented and supplemented by increased development assistance to the countries most heavily affected by HIV/AIDS, particularly in Africa, where resources to deal with the crisis are seriously limited;

Integrate HIV/AIDS concerns in all development assistance programmes and poverty reduction strategies and encourage more efficient and effective use of all resources allocated;

Call for the full, speedy and effective implementation of the enhanced Heavily Indebted Poor Country Initiative (HIPC) and urge creditor countries that have not yet done so to consider the full cancellation and equivalent relief of the bilateral official debts of HIPC countries and the application of debt relief measures to address the needs of poor countries seriously affected by the HIV/AIDS epidemic, particularly in Africa;

Encourage increased investment in HIV/AIDS-related research, both nationally and internationally;

Support the establishment of a special fund to finance an urgent and expanded response to the epidemic and to assist governments with the implementation of the commitments contained in this Declaration, with due priority to the most affected countries; mobilize contributions to the fund from public and private sources with a special appeal to foundations, the business community, and the private sector, philanthropists and wealthy individuals;

Direct increased funding to regional commissions and organisations to enable them to assist Governments at both the national and regional level in their efforts to respond to the crisis;

Provide the UNAIDS Co-sponsoring Agencies and the UNAIDS Secretariat with the resources needed to support the implementation of the measures and initiatives in this Declaration;

FOLLOW UP

Maintaining momentum and monitoring progress are essential

At the national level

Conduct national periodic reviews on progress achieved in realizing these commitments and ensure wide dissemination of the results of these reviews;

At the regional level

Include HIV/AIDS on the agenda of regional meetings at the ministerial and Head of State and Government level;

Support data collection and facilitate periodic reviews by Regional Commissions and regional organizations of progress in implementing regional strategies and addressing regional priorities and ensure wide dissemination of the results of these reviews;

Encourage the exchange between countries of information and experiences in implementing the measures and commitments contained in this Declaration, and facilitate intensified South-South cooperation;

At the global level

Devote one full day of the annual General Assembly Session to review and debate a report of the Secretary-General on progress achieved in realizing the commitments set out in this Declaration;

Ensure that HIV/AIDS issues are included on the agenda of all appropriate United Nations conferences and meetings.

Support initiatives to convene conferences, seminars, workshops and training courses to follow up issues raised in this Declaration and in this regard encourage participation in and wide dissemination of the outcomes of: the forthcoming Dakar Conference on Access to Care for HIV Infection; the Sixth International Congress on AIDS in Asia and the Pacific; the XII International Conference on AIDS and Sexually Transmitted Infections in Africa; the XIV International AIDS Conference;

We recognise and express our appreciation to those who have led the effort to raise awareness of the HIV/AIDS epidemic and to deal with its complex challenges;

We look forward to strong leadership by Governments, the United Nations and the entire multilateral system, civil society and the private sector;

And finally, we call on all countries to take the necessary steps to implement this Declaration, in strengthened partnership and co-operation, with other multilateral and bilateral partners and with civil society.