[procaare] UNGASS - Final Declaration of Commitment on HIV/AIDS

[ProCAARE <procaare@usa.healthnet.org>]

UNGASS - Final Declaration of Commitment on HIV/AIDS
*****************************************************

United Nations General Assembly
Twenty-sixth Special Session
Doc: A/s-26/L.2

[adopted Wednesday 27th June 2001, New York]

Declaration of Commitment on HIV/AIDS

"Global Crisis - Global Action"

1. 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 twenty-sixth special
session of the General Assembly convened in accordance with resolution 55/13, as a matter
of urgency, to review and address the problem of HIV/AIDS in all its aspects as well as to
secure a global commitment to enhancing coordination and intensification of national,
regional and international efforts to combat it in a comprehensive manner;

2. Deeply concerned that the global HIV/AIDS epidemic, through its devastating scale and
impact, constitutes a global emergency and one of the most formidable challenges to human
life and dignity, as well as to the effective enjoyment of human rights, which undermines
social and economic development throughout the world and affects all levels of society -
national, community, family and individual;

3. Noting with profound concern, that by the end of the year 2000, 36.1 million people
worldwide were living with HIV/AIDS, 90 per cent in developing countries and 75 per cent
in sub-Saharan Africa;

4. Noting with grave concern that all people, rich and poor, without distinction of age,
gender or race are affected by the HIV/AIDS epidemic, further noting that people in
developing countries are the most affected and that women, young adults and children, in
particular girls, are the most vulnerable;

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

6. Recalling and reaffirming our previous commitments on HIV/AIDS made
through:
- The United Nations Millennium Declaration of 8 September 2000;
- The Political Declaration and Further Actions and Initiatives to Implement the
Commitments made at the World Summit for Social Development of 1 July 2000;
- The Political Declaration and Further Action and Initiatives to Implement the Beijing
Declaration and Platform for Action of 10 June 2000;
- Key Actions for the Further Implementation of the Programme of Action of the
International Conference on Population and Development of 2 July 1999;
- The regional call for action to fight HIV/AIDS in Asia and the Pacific of 25 April 2001;
- The Abuja Declaration and Framework for Action for the Fight Against HIV/AIDS,
Tuberculosis and other Related Infectious Diseases in Africa, 27 April 2001;
- The Declaration of the Ibero-America Summit of Heads of State of November 2000 in
Panama;
- The Caribbean Partnership Against HIV/AIDS, 14 February, 2001;
- The European Union Programme for Action: Accelerated Action on HIV/ AIDS, Malaria and
Tuberculosis in the Context of Poverty Reduction of 14 May 2001;
- The Baltic Sea Declaration on HIV/AIDS Prevention of 4 May 2000;
- The Central Asian Declaration on HIV/AIDS of 18 May 2001;

7. Convinced of the need to have an urgent, coordinated and sustained response to the
HIV/AIDS epidemic, which will build on the experience and lessons learned over the past 20
years;

8. Noting with grave concern that Africa, in particular sub-Saharan Africa, is currently
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 urgent and exceptional national, regional and international action;

9. Welcoming the commitments of African Heads of State or Government, at the Abuja Special
Summit in April 2001, particularly their pledge to set a target of allocating at least 15
per cent of their annual national budgets for the improvement of the health sector to help
address the HIV/AIDS epidemic; and recognizing that action to reach this target, by those
countries whose resources are limited, will need to be complemented by increased
international assistance;

10. Recognizing also that other regions are seriously affected and confront similar
threats, particularly the Caribbean region, with the second highest rate of HIV infection
after sub-Saharan Africa, the Asia-Pacific region where 7.5 million people are already
living with HIV/AIDS, the Latin America region with 1.5 million people living with
HIV/AIDS, and the Central and Eastern European region with very rapidly rising infection
rates; and that the potential exists for a rapid escalation of the epidemic and its impact
throughout the world if no specific measures are taken;

11. Recognizing that poverty, underdevelopment and illiteracy are among the principal
contributing factors to the spread of HIV/AIDS and noting with grave concern that HIV/AIDS
is compounding poverty and is now reversing or impeding development in many countries and
should therefore be addressed in an integrated manner;

12. Noting that armed conflicts and natural disasters also exacerbate the spread of the
epidemic;

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

14. Stressing that gender equality and the empowerment of women are fundamental elements
in the reduction of the vulnerability of women and girls to HIV/AIDS;

15. Recognizing that access to medication in the context of pandemics such as HIV/AIDS is
one of the fundamental elements to achieve progressively the full realization of the right
of everyone to the enjoyment of the highest attainable standard of physical and mental
health;

16. Recognizing that the full realization of human rights and fundamental freedoms for all
is an essential element in a global response to the HIV/AIDS pandemic, including in the
areas of prevention, care, support and treatment, and that it reduces vulnerability to
HIV/AIDS and prevents stigma and related discrimination against people living with or at
risk of HIV/AIDS;

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

18. Recognizing the need to achieve the prevention goals set out in this Declaration in
order to stop the spread of the epidemic and acknowledging that all countries must
continue to emphasize widespread and effective prevention, including awareness-raising
campaigns through education, nutrition, information and health-care services;

19. Recognizing that care, support and treatment can contribute to effective prevention
through increased acceptance of voluntary and confidential counselling and testing, and by
keeping people living with HIV/AIDS and vulnerable groups in close contact with
health-care systems and facilitating their access to information, counselling and
preventive supplies;

20. Emphasizing the important role of cultural, family, ethical and religious factors in
the prevention of the epidemic, and in treatment, care and support, taking into account
the particularities of each country as well as the importance of respecting all human
rights and fundamental freedoms;

21. Noting with concern that some negative economic, social, cultural, political,
financial and legal factors are hampering awareness, education,prevention, care, treatment
and support efforts;

22. Noting the importance of establishing and strengthening human resources and national
health and social infrastructures as imperatives for the effective delivery of prevention,
treatment, care and support services;

23. Recognizing that effective prevention, care and treatment strategies will require
behavioural changes and increased availability of and non-discriminatory access to, inter
alia, vaccines, condoms, microbicides, lubricants, sterile injecting equipment, drugs
including anti-retroviral therapy, diagnostics and related technologies as well as
increased research and development;

24. Recognizing also that the cost availability and affordability of drugs and related
technology are significant factors to be reviewed and addressed in all aspects and that
there is a need to reduce the cost of these drugs and technologies in close collaboration
with the private sector and pharmaceutical companies;

25. Acknowledging that the lack of affordable pharmaceuticals and of feasible supply
structures and health systems continue to hinder an effective response to HIV/AIDS in many
countries, especially for the poorest people and recalling efforts to make drugs available
at low prices for those in need;

26. Welcoming the efforts of countries to promote innovation and the development of
domestic industries consistent with international law in order to increase access to
medicines to protect the health of their populations; and noting that the impact of
international trade agreements on access to or local manufacturing of, essential drugs and
on the development of new drugs needs to be further evaluated;

27. Welcoming the progress made in some countries to contain the epidemic, particularly
through: strong political commitment and leadership at the highest levels, including
community leadership; effective use of available resources and traditional medicines;
successful prevention, care, support and treatment strategies; education and information
initiatives; working in partnership with communities, civil society, people living with
HIV/AIDS and vulnerable groups; and the active promotion and protection of human rights;
and recognizing the importance of sharing and building on our collective and diverse
experiences, through regional and international cooperation including North/South,
South/South cooperation and triangular cooperation;

28. Acknowledging that resources devoted to combating the epidemic both at the national
and international levels are not commensurate with the magnitude of the problem;

29. Recognizing the fundamental importance of strengthening national, regional and
subregional capacities to address and effectively combat HIV/AIDS and that this will
require increased and sustained human, financial and technical resources through
strengthened national action and cooperation and increased regional, subregional and
international cooperation;

30. Recognizing that external debt and debt-servicing problems have substantially
constrained the capacity of many developing countries, as well as countries with economies
in transition, to finance the fight against HIV/AIDS;

31. Affirming the key role played by the family in prevention, care, support and treatment
of persons affected and infected by HIV/AIDS, bearing in mind that in different cultural,
social and political systems various forms of the family exist;

32. Affirming that beyond the key role played by communities, strong partnerships among
Governments, the United Nations system, intergovernmental organizations, people living
with HIV/AIDS and vulnerable groups, medical, scientific and educational institutions,
non-governmental organizations, the business sector including generic and research-based
pharmaceutical companies, trade unions, media, parliamentarians, foundations, community
organizations, faith-based organizations and traditional leaders are important;

33. Acknowledging the particular role and significant contribution of people living with
HIV/AIDS, young people and civil society actors in addressing the problem of HIV/AIDS in
all its aspects and recognizing that their full involvement and participation in design,
planning, implementation and evaluation of programmes is crucial to the development of
effective responses to the HIV/AIDS epidemic;

34. Further acknowledging the efforts of international humanitarian organizations
combating the epidemic, including among others the volunteers of the International
Federation of Red Cross and Red Crescent Societies in the most affected areas all over the
world;

35. Commending the leadership role on HIV/AIDS policy and coordination in the United
Nations system of the UNAIDS Programme Coordinating Board; noting its endorsement in
December 2000 of the Global Strategy Framework for HIV/AIDS, which could assist, as
appropriate, Member States and relevant civil society actors in the development of
HIV/AIDS strategies, taking into account the particular context of the epidemic in
different parts of the world;

36. Solemnly declare our commitment to address the HIV/AIDS crisis by taking action as
follows, taking into account the diverse situations and circumstances in different regions
and countries throughout the world;

Leadership
Strong leadership at all levels of society is essential for an effective response to the
epidemic
Leadership by Governments in combating HIV/AIDS is essential and their efforts should be
complemented by the full and active participation of civil society, the business community
and the private sector
Leadership involves personal commitment and concrete actions

At the national level

37. 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;
 - address gender and age-based dimensions of the epidemic;
 - eliminate discrimination and marginalization;
 - involve partnerships with civil society and the business sector and the full
participation of people living with HIV/AIDS, those in vulnerable groups and people mostly
at risk, particularly women and young people;
 - are resourced to the extent possible from national budgets without excluding other
sources, inter alia international cooperation;
 - fully promote and protect all human rights and fundamental freedoms, including the
right to the highest attainable standard of physical and mental health;
 - integrate a gender perspective; and address risk, vulnerability, prevention, care,
treatment and support and reduction of the impact of the epidemic; and
 - strengthen health, education and legal system capacity;

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

At the regional and subregional level

39. Urge and support regional organizations and partners to: be actively involved in
addressing the crisis; intensify regional, subregional and interregional cooperation and
coordination; and develop regional strategies and responses in support of expanded country
level efforts;

40. Support all regional and subregional initiatives on HIV/AIDS
including: the International Partnership against AIDS in Africa (IPAA) and the ECA-African
Development Forum Consensus and Plan of Action: Leadership to Overcome HIV/ AIDS; the
Abuja Declaration and Framework for Action for the Fight Against HIV/AIDS, Tuberculosis
and Other Diseases; the CARICOM 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; the Horizontal Technical Cooperation Group on HIV/AIDS in
Latin America and the Caribbean; the European Union Programme for Action: Accelerated
Action on HIV/AIDS, Malaria and Tuberculosis in the context of poverty reduction;

41. Encourage the development of regional approaches and plans to address HIV/AIDS;

42. Encourage and support local and national organizations to expand and strengthen
regional partnerships, coalitions and networks;

43. Encourage the United Nations Economic and Social Council to request the regional
commissions within their respective mandates and resources to support national efforts in
their respective regions in combating HIV/AIDS;

At the global level

44. Support greater action and coordination by all relevant United Nations system
organizations, including their full participation in the development and implementation of
a regularly updated United Nations strategic plan for HIV/AIDS, guided by the principles
contained in this Declaration;

45. Support greater cooperation between relevant United Nations system organizations and
international organizations combating HIV/AIDS;

46. Foster stronger collaboration and the development of innovative partnerships between
the public and private sectors and by 2003, establish and strengthen mechanisms that
involve the private sector and civil society partners and people living with HIV/AIDS and
vulnerable groups in the fight against HIV/AIDS;

Prevention
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 HIV prevalence among young men and women aged 15
to 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;

48. By 2003, establish national prevention targets, recognizing and addressing factors
leading to the spread of the epidemic and increasing people's vulnerability, to reduce HIV
incidence for those identifiable groups, within particular local contexts, which currently
have high or increasing rates of HIV infection, or which available public health
information indicates are at the highest risk for new infection;

49. By 2005, strengthen the response to HIV/AIDS in the world of work by establishing and
implementing prevention and care programmes in public, private and informal work sectors
and take measures to provide a supportive workplace environment for people living with
HIV/AIDS;

50. By 2005, develop and begin to implement national, regional and international
strategies that facilitate access to HIV/AIDS prevention programmes for migrants and
mobile workers, including the provision of information on health and social services;

51. By 2003, implement universal precautions in health-care settings to prevent
transmission of HIV infection;

52. By 2005, ensure: that a wide range of prevention programmes 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 sterile injecting equipment; 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 transmittable infections;

53. By 2005, ensure that at least 90 per cent, and by 2010 at least 95 per cent of young
men and women aged 15 to 24 have access to the information, education, including peer
education and youth-specific HIV education, and services necessary to develop the life
skills required to reduce their vulnerability to HIV infection; in full partnership with
youth, parents, families, educators and health-care providers;

54. By 2005, reduce the proportion of infants infected with HIV by 20 per cent, and by 50
per cent by 2010, by: ensuring that 80 per cent of pregnant women accessing antenatal care
have information, counselling and other HIV prevention services available to them,
increasing the availability of and by providing access for HIV-infected women and babies
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 treatment, especially anti-retroviral therapy and,
where appropriate, breast milk substitutes and the provision of a continuum of care;

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

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 HIV-related drugs, including anti-retroviral 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;

56. By 2005, develop and make significant progress in implementing comprehensive care
strategies to: strengthen family and community-based care including that provided by the
informal sector, and health care systems to provide and monitor treatment to people living
with HIV/AIDS, including infected children, and to support individuals, households,
families and communities affected by HIV/ AIDS; improve the capacity and working
conditions of health care personnel, and the effectiveness of supply systems, financing
plans and referral mechanisms required to provide access to affordable medicines,
including anti-retroviral drugs, diagnostics and related technologies, as well as quality
medical, palliative and psycho-social care;

57. By 2003, ensure that national strategies are developed in order to provide
psycho-social care for individuals, families, and communities affected by HIV/AIDS;

HIV/AIDS and human rights
Realization of human rights and fundamental freedoms for all is essential to reduce
vulnerability to HIV/AIDS
Respect for the rights of people living with HIV/AIDS drives an effective response

58. By 2003, enact, strengthen or enforce as appropriate legislation, regulations and
other measures to eliminate all forms of discrimination against, and to ensure the full
enjoyment of all human rights and fundamental freedoms by people living with HIV/AIDS and
members of vulnerable groups; in particular to ensure their access to, inter alia
education, inheritance, employment, health care, social and health services, prevention,
support, treatment, information and legal protection, while respecting their privacy and
confidentiality; and develop strategies to combat stigma and social exclusion connected
with the epidemic;

59. By 2005, bearing in mind the context and character of the epidemic and that globally
women and girls are disproportionately affected by HIV/AIDS, develop and accelerate the
implementation of national strategies that: promote the advancement of women and women's
full enjoyment of all human rights; promote shared responsibility of men and women to
ensure safe sex; empower women to have control over and decide freely and responsibly on
matters related to their sexuality to increase their ability to protect themselves from
HIV infection;

60. By 2005, implement measures to increase capacities of women and adolescent girls to
protect themselves from the risk of HIV infection, principally through the provision of
health care and health services, including sexual and reproductive health, and through
prevention education that promotes gender equality within a culturally and gender
sensitive framework;

61. By 2005, ensure development and accelerated implementation of national strategies for
women's empowerment, promotion and protection of women's full enjoyment of all human
rights and reduction of their vulnerability to HIV/AIDS through the elimination of all
forms of discrimination, as well as all forms of violence against women and girls,
including harmful traditional and customary practices, abuse, rape and other forms of
sexual violence, battering and trafficking in women and girls;

Reducing vulnerability
The vulnerable must be given priority in the response
Empowering women is essential for reducing vulnerability

62. By 2003, in order to complement prevention programmes that address activities which
place individuals at risk of HIV infection, such as risky and unsafe sexual behaviour and
injecting drug use, have in place in all countries strategies, policies and programmes
that identify and begin to address those actors that make individuals particularly
vulnerable to HIV infection, including underdevelopment, economic insecurity, poverty,
lack of empowerment of women, lack of education, social exclusion, illiteracy,
discrimination, lack of information and/or commodities for self-protection, all types of
sexual exploitation of women, girls and bys, including for commercial reasons; such
strategies, policies and programmes should address the gender dimension of the epidemic,
specify the action that will be taken to address vulnerability and set targets for
achievement;

63. By 2003, develop and/or strengthen strategies, policies and programmes, which
recognize the importance of the family in reducing vulnerability, inter alia, in educating
and guiding children and take account of cultural, religious and ethical factors, to
reduce the vulnerability of children and young people by:
 - ensuring access of both girls and boys to primary and secondary education, including on
HIV/AIDS in curricula for adolescents; ensuring safe and secure environments, especially
for young girls;
 - expanding good quality youth-friendly information and sexual health education and
counselling service; strengthening reproductive and sexual health programmes; and
 - involving families and young people in planning, implementing and evaluating HIV/AIDS
prevention and care programmes, to the extent possible;

64. By 2003, develop and/or strengthen national strategies, policies and programmes,
supported by regional and international initiatives, as appropriate, through a
participatory approach, to promote and protect the health of those identifiable groups
which currently have high or increasing rates of HIV infection or which public health
information indicates are at greatest risk of and most vulnerable to new infection as
indicated by such factors as the local history of the epidemic, poverty, sexual practices,
drug using behaviour, livelihood, institutional location, disrupted social structures and
population movements forced or otherwise;

Children orphaned and made vulnerable by HIV/AIDS
Children orphaned and affected by HIV/AIDS need special assistance

65. By 2003, develop and by 2005 implement national policies and strategies to: build and
strengthen governmental, family and community capacities to provide a supportive
environment for orphans and girls and boys infected and affected by HIV/AIDS including by
providing appropriate counselling and psycho-social support; ensuring their enrolment in
school and access to shelter, good nutrition, health and social services on an equal basis
with other children; to protect orphans and vulnerable children from all forms of abuse,
violence, exploitation, discrimination, trafficking and loss of inheritance;

66. Ensure non-discrimination and full and equal enjoyment of all human rights through the
promotion of an active and visible policy of de-stigmatization of children orphaned and
made vulnerable by HIV/AIDS;

67. Urge the international community, particularly donor countries, civil society, as well
as the private sector to complement effectively national programmes to support programmes
for children orphaned or made vulnerable by HIV/AIDS in affected regions, in countries at
high risk and to direct special assistance to sub-Saharan Africa;

Alleviating social and economic impact
To address HIV/AIDS is to invest in sustainable development

68. By 2003, evaluate the economic and social impact of the HIV/AIDS epidemic and develop
multisectoral strategies to: address the impact at the individual, family, community and
national levels; develop and accelerate the implementation of national poverty eradication
strategies to address the impact of HIV/AIDS on household income, livelihoods, and access
to basic social services, with special focus on individuals, families and communities
severely affected by the epidemic; review the social and economic impact of HIV/AIDS at
all levels of society especially 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 economic and social development policies, including social protection 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;

69. By 2003, develop a national legal and policy framework that protects in the workplace
the rights and dignity of persons living with and affected by HIV/AIDS and those at the
greatest risk of HIV/AIDS in consultation with representatives of employers and workers,
taking account of 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

70. Increase investment and accelerate research on the development of HIV vaccines, while
building national research capacity especially in developing countries, and especially for
viral strains prevalent in highly affected regions; in addition, support and encourage
increased national and international investment in HIV/AIDS-related research and
development including biomedical, operations, social, cultural and behavioural research
and in traditional medicine to: improve prevention and therapeutic approaches; accelerate
access to prevention, care and treatment and care technologies for HIV/AIDS (and its
associated opportunistic infections and malignancies and sexually transmitted diseases),
including female controlled methods and microbicides, and in particular, appropriate, safe
and affordable HIV vaccines and their delivery, and to diagnostics, tests, methods to
prevent mother-to-child transmission; and improve our understanding of factors which
influence the epidemic and actions which address it, inter alia, through increased funding
and public/private partnerships; create a conducive environment for research and ensure
that it is based on highest ethical standards;

71. Support and encourage the development of national and international research
infrastructure, laboratory capacity, improved surveillance systems, data collection,
processing and dissemination, and training of basic and clinical researchers, social
scientists, health-care providers and technicians, with a focus on the countries most
affected by HIV/AIDS, particularly developing countries and those countries experiencing
or at risk of rapid expansion of the epidemic;

72. Develop and evaluate suitable approaches for monitoring treatment efficacy, toxicity,
side effects, drug interactions, and drug resistance, develop methodologies to monitor the
impact of treatment on HIV transmission and risk behaviours;

73. Strengthen international and regional cooperation in particular North/South,
South/South and triangular cooperation, related to transfer of relevant technologies,
suitable to the environment in prevention and care of HIV/AIDS, the exchange of
experiences and best practices, researchers and research findings and strengthen the role
of UNAIDS in this process. In this context, encourage that the end results of these
cooperative research findings and technologies be owned by all parties to the research,
reflecting their relevant contribution and dependent upon their providing legal protection
to such findings; and affirm that all such research should be free from bias;

74. By 2003, ensure that all research protocols for the investigation of HIV-related
treatment including anti-retroviral therapies and vaccines based on international
guidelines and best practices are evaluated by independent committees of ethics, in which
persons living with HIV/AIDS and caregivers for anti-retroviral therapy participate;

HIV/AIDS in conflict and disaster affected regions
Conflicts and disasters contribute to the spread of HIV/AIDS

75. By 2003, develop and begin to implement national strategies that incorporate HIV/AIDS
awareness, prevention, care and treatment elements into programmes or actions that respond
to emergency situations, recognizing that populations destabilized by armed conflict,
humanitarian emergencies and natural disasters, including refugees, internally displaced
persons and in particular, women and children, are at increased risk of exposure to HIV
infection; and, where appropriate, factor HIV/AIDS components into international
assistance programmes;

76. Call on all United Nations agencies, regional and international organizations, as well
as non-governmental organizations involved with the provision and delivery of
international assistance to countries and regions affected by conflicts, humanitarian
crises or natural disasters, to incorporate as a matter of urgency HIV/AIDS prevention,
care and awareness elements into their plans and programmes and provide HIV/AIDS awareness
and training to their personnel;

77. By 2003, have in place national strategies to address the spread of HIV among national
uniformed services, where this is required, including armed forces and civil defence force
and consider ways of using personnel from these services who are educated and trained in
HIV/AIDS awareness and prevention to assist with HIV/ AIDS awareness and prevention
activities including participation in emergency, humanitarian, disaster relief and
rehabilitation assistance;

78. By 2003, ensure the inclusion of HIV/AIDS awareness and training, including a gender
component, into guidelines designed for use by defence personnel and other personnel
involved in international peacekeeping  operations while also continuing with ongoing
education and prevention efforts, including pre-deployment orientation, for these
personnel;

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

79. Ensure that the resources provided for the global response to address HIV/AIDS are
substantial, sustained and geared towards achieving results;

80. By 2005, through a series of incremental steps, reach an overall target of annual
expenditure on the epidemic of between US$ 7 billion and US$ 10 billion in low and
middle-income countries and those countries experiencing or at risk of experiencing rapid
expansion for prevention, care, treatment, support and mitigation of the impact of
HIV/AIDS, and take measures to ensure that needed resources are made available,
particularly from donor countries and also from national budgets, bearing in mind that
resources of the most affected countries are seriously limited;

81. Call on the international community, where possible, to provide assistance for
HIV/AIDS prevention, care and treatment in developing countries on a grant basis;

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

83. Urge the developed countries that have not done so to strive to meet the targets of
0.7 per cent of their gross national product for overall official development assistance
and the targets of earmarking of 0.15 per cent to 0.20 per cent of gross national product
as official development assistance for least developed countries a agreed, as soon as
possible, taking into account the urgency and gravity of the HIV/ AIDS epidemic;

84. Urge the international community to complement and supplement efforts of developing
countries that commit increased national funds to fight the HIV/AIDS epidemic through
increased international development assistance, particularly those countries most affected
by HIV/AIDS, particularly in Africa, especially in sub-Saharan Africa, the Caribbean,
countries at high risk of expansion of the HIV/AIDS epidemic and other affected regions
whose resources to deal with the epidemic are seriously limited;

85. Integrate HIV/AIDS actions in development assistance programmes and poverty
eradication strategies as appropriate and encourage the most effective and transparent use
of all resources allocated;

86. Call on the international community and invite civil society and the private sector to
take appropriate measures to help alleviate the social and economic impact of HIV/AIDS in
the most affected developing countries;

87. Without further delay implement the enhanced Heavily Indebted Poor Country (HIPC)
Initiative and agree to cancel all bilateral official debts of HIPC countries as soon as
possible, especially those most affected by HIV/AIDS, in return for their making
demonstrable commitments to poverty eradication and urge the use of debt service savings
to finance poverty eradication programmes, particularly for HIV/AIDS prevention,
treatment, care and support and other infections;

88. Call for speedy and concerted action to address effectively the debt problems of least
developed countries, low-income developing countries, and middle-income developing
countries, particularly those affected by HIV/AIDS, in a comprehensive, equitable,
development-oriented and durable way through various national and international measures
designed to make their debt sustainable in the long term and thereby to improve their
capacity to deal with the HIV/AIDS epidemic, including, as appropriate, existing orderly
mechanisms for debt reduction, such as debt swaps for projects aimed at the prevention,
care and treatment of HIV/AIDS;

89. Encourage increased investment in HIV/AIDS-related research, nationally, regionally
and internationally, in particular for the development of sustainable and affordable
prevention technologies, such as vaccines and microbicides, and encourage the proactive
preparation of financial and logistic plans to facilitate rapid access to vaccines when
they become available;

90. Support the establishment, on an urgent basis, of a global HIV/AIDS and health fund to
finance an urgent and expanded response to the epidemic based on an integrated approach to
prevention, care, support and treatment and to assist Governments inter alia in their
efforts to combat HIV/AIDS with due priority to the most affected countries, notably in
sub-Saharan Africa and the Caribbean and to those countries at high risk, mobilize
contributions to the fund from public and private sources with a special appeal to donor
countries, foundations, the business community including pharmaceutical companies, the
private sector, philanthropists and wealthy individuals;

91. By 2002, launch a worldwide fund-raising campaign aimed at the general public as well
as the private sector, conducted by UNAIDS with the support and collaboration of
interested partners at all levels, to contribute to the global HIV/ AIDS and health fund;

92. Direct increased funding to national, regional and subregional commissions and
organizations to enable them to assist Governments at the national, subregional and
regional level in their efforts to respond to
the crisis;

93. Provide the UNAIDS co-sponsoring agencies and the UNAIDS secretariat with the
resources needed to work with countries in support of the goals of this Declaration;

Follow-up
Maintaining the momentum and monitoring progress are essential

At the national level

94. Conduct national periodic reviews involving the participation of civil society,
particularly people living with HIV/AIDS, vulnerable groups and caregivers, of progress
achieved in realizing these commitments and identify problems and obstacles to achieving
progress and ensure wide dissemination of the results of these reviews;

95. Develop appropriate monitoring and evaluation mechanisms to assist with follow-up in
measuring and assessing progress, develop appropriate monitoring and evaluation
instruments, with adequate epidemiological data;

96. By 2003, establish or strengthen effective monitoring systems, where appropriate, for
the promotion and protection of human rights of people living with HIV/AIDS;

At the regional level

97. Include HIV/AIDS and related public health concerns as appropriate on the agenda of
regional meetings at the ministerial and Head of State and Government level;

98. Support data collection and processing to facilitate periodic reviews by regional
commissions and/or regional organizations of progress in implementing regional strategies
and addressing regional priorities and ensure wide dissemination of the results of these
reviews;

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

At the global level

100. Devote sufficient time and at least 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, with a view to identifying problems
and constraints and making recommendations on action needed to make further progress;

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

102. Support initiatives to convene conferences, seminars, workshops, training programmes
and 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 Conference on AIDS, Barcelona; the Xth
International Conference on People Living with HIV/AIDS, Port of Spain; the II Forum and
III Conference of the Latin American and the Caribbean Horizontal Technical Cooperation on
HIV/AIDS and Sexually Transmitted Infections, La Habana; the Vth International Conference
on Home and Community Care for Persons Living with HIV/AIDS, Chang Mai, Thailand;

103. Explore, with a view to improving equity in access to essential drugs, the
feasibility of developing and implementing, in collaboration with non-governmental
organizations and other concerned partners, systems for voluntary monitoring and reporting
of global drug prices;

We recognize 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, and concerted efforts with full and
active participation of the United Nations, the entire multilateral system, civil society,
the business community and private sector;

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

B R E A K   T H E    S I L E N C E
UN General Assembly - Special Session on HIV/AIDS
New York - 25 to 27 June, 2001
Coordinated by Health & Development Networks (HDN)

BTS discussion archives are available at:
http://www.hdnet.org

NB: To obtain a copy of the revised draft UNGASS Declaration of Commitment, or a summary
of civil society feedback so far, write to: ungass@hdnet.org or go to the HDN web site.

--
Send mail for the `ProCAARE' conference to `procaare@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to:  `owner-procaare@usa.healthnet.org'.

The views presented in ProCAARE do not necessarily reflect the opinions of
SATELLIFE  (http://www.healthnet.org), the Harvard AIDS Institute
(http://aids.harvard.edu), or Health & Development Networks
(http://www.hdnet.org), unless otherwise stated. The reader assumes all
responsibilities in using information posted or archived by ProCAARE.
Reproduction is welcomed, provided ProCAARE and procaare@usa.healthnet.org
are quoted, and SATELLIFE is informed of usage.