UNITED NATIONS — Twenty-five years after AIDS was first detected, in Los Angeles, and five years after the UN General Assembly adopted the “Declaration on Commitment on HIV/AIDS,” heads of state, ambassadors, representatives of nongovernmental organizations and people infected with HIV met here to review what progress has been made in the battle against a scourge that has killed millions.

AIDS has become a global pandemic. Over the past few decades it has become the fourth greatest cause of death in the world, and has devastated and destabilized huge swaths of the globe, especially in Africa. It has left millions of children orphaned and millions of people struggling to survive.

The three-day UN meeting, which opened on May 31, produced a new declaration that called for more effort to combat the spread of the disease, including the need to raise $20-23 billion by 2010.

“HIV/AIDS has unfolded along a pattern we tend to see only in nightmares,” UN General Secretary Kofi Annan told the opening session. He said AIDS has had “more catastrophic long-term effects” than any other disease.

“Denial dogged the response to AIDS,” he said. “Millions paid with their lives.”

Annan said that significant progress has been made since the declaration of five years ago, noting that 70 countries have quadrupled access to AIDS testing and services, and that more than 20 countries had succeeded in providing treatment to more than half of those in need.

But most countries have fallen significantly short of the targets set in 2001, he said.

“These shortcomings are deadly,” Annan said. “For example, most countries have still not ensured that young people have an accurate understanding of HIV and how it can infect them.” Another failure is that most countries have made little or no progress in slowing the spread of the disease in women and girls.

Many speakers noted the alarming spread of AIDS among women and youth. “During this high-level plenary, 43,000 more people globally will be infected,” said William Harvey Roedy, president of the MTV cable television network. “More than half of these new infections will be among young people 15-24 and more than half will be among women. If they had been chickens with bird flu, they would dominate the media.”

The first openly HIV-positive person to ever address the General Assembly, South Africa’s Khensani Mavasa, 28, said, “The reality is that hundreds of thousands of people are on treatment, but millions are dying.”

She also emphasized the situation facing women: “I am a person who survived rapes and other forms of abuse. I still live under the power of men and the institutions they run to perpetuate the oppression of women. But women constitute nearly 60 percent of the world’s 40.5 million HIV-positive people. Violence against women has been directly linked to HIV infection in women.”

The negative role of the big, for-profit pharmaceutical companies was made clear at the conference, as was the pronounced division between rich and poor nations. In richer nations, people have greater access to therapy and longer life spans. This is not the case in poorer nations, such as South Africa. “The 900 people who will die in my country today,” said Mavasa, “do not deserve it.”

“Inequality is particularly serious in this pandemic,” said Dr. José Mendoza Graces, Venezuela’s vice-minister of health and social development. Referring to the U.S., he added, “If there are countries which simply defend the rights of multinational manufacturers of medicines and cannot even guarantee these medicines for their own peoples, what cooperation can the peoples of other countries hope to have with this nation?”

He called for “cooperation based on humanism and not on profit.”



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