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Annan calls for reallocation of budgets to tackle AIDS

by Mithre J Sandrasagra

New York, 20 Feb (IPS) -- UN secretary-general Kofi Annan Tuesday appealed to the world body’s 189 member states to reallocate their national budgets in order to reverse the spread of HIV/AIDS.

“The primary challenge for governments is to mobilise resources to meet the scale and devastating impact of the HIV/AIDS epidemic,” Annan said.

Governments must “make sure that HIV/AIDS priorities are properly integrated into the mainstream of development planning”, Annan continued.

Alarmed by the accelerating epidemic and its global impact, the Secretary- General stressed the importance of HIV/AIDS planning in poverty reduction strategies, public investment plans and annual budget processes.

A well-funded response for prevention and basic care in programmes in Africa alone would require upwards of $3 billion per year, according to the Joint UN Programme on HIV/AIDS (UNAIDS) - a coalition of seven UN agencies and the private sector.

“Only a fraction of this amount is available,” Annan says.

“Less than one-fifth of the required resources are available in Africa alone,” Kathleen Cravero, deputy executive director of UNAIDS, told reporters Tuesday.

“The HIV/AIDS epidemic is the most formidable development challenge of our time,” Annan stressed in his call to governments to secure a global commitment of intensified and coordinated action.

In a 29-page report released Tuesday, Annan declared that, “intensified and broadened political and financial commitments are required by nations in their response to the AIDS crisis”.

The report has been issued in preparation for the high-level General Assembly Special Session on HIV/AIDS, which will take place in New York from Jun. 25-27. The report will also form the basis of the first of two rounds of substantive negotiations for the Special Session, set to take place during the week of Feb. 26.

Despite a demonstrated growth in global political will and commitment, financial resources allocated to HIV/AIDS, particularly in the most affected regions, is only a fraction of what is necessary given the magnitude of the epidemic, the report says.

“More than 95% of infected people live in developing countries,” Cravero emphasised.

An enormous resource gap continues to exist, even though resources are being mobilised by African governments and international donors such as Doctors Without Borders and Oxfam.

In South Africa, where 20% of the 15- to 49-year olds is living with AIDS, the nation’s regular budget includes substantial allocations for AIDS prevention and care programmes.

In Zimbabwe, the government mobilised additional funds for AIDS by instituting an AIDS levy against the general population.

Funds are also forthcoming through debt relief, and AIDS now figures prominently in funding activities for Africa through the heavily indebted poor countries initiative; some $30 billion in debt reduction had been achieved by 2000, with $20 million set aside for AIDS programmes in 2001.

Funds are also being made available through round-table mechanisms that bring together all interested parties at the country-level to mobilize financial resources for the implementation of a coordinated strategic plan. $121 million has been made available in Malawi this way, and $113 million in Zambia.

Africa accounts for  70% of adults and 80% of children living with HIV, and to nearly three-quarters of the 22 million people worldwide who have died due to AIDS, according to the new report.

Of the many challenges facing governments, especially those in the developing world, will be the creation of expensive, yet essential infrastructure and training programmes necessary to mitigate the social and economic impacts of the disease.

“Leadership is fundamental to an effective response,” said Annan, referring to one of the other challenges highlighted in the report.  “One of the key issues facing the global community is developing and sustaining such dedicated leadership, vital if the nature of the epidemic is to be clearly understood throughout society and a national response mobilised,” Annan continued.

The report also states that an expanded prevention effort is essential to containing the spread of the epidemic and spending on prevention helps avert the future cost of and impact of infection. A particular effective intervention is the prevention of mother-to-child transmission - a short course of anti-retroviral treatment can cut the rate of transmission to children by 20 to 50%.

As well as the need to strengthen health care systems, the affordability of medicines for opportunistic infections and anti-retroviral therapy - one of the greatest barriers to improving access to care - must be dealt with, the report emphasises.

Some progress in reducing the price of medicines has resulted from the dialogue between the UN system and several research and development-based pharmaceutical companies, initiated in May 2000, as well as through the increasing availability of generic versions of anti-retroviral drugs.

“Despite these efforts, much more needs to be done if access to care and treatment is not to remain out of reach for the majority of people living with HIV and AIDS,” according to the report.

High-income countries witnessed a major decline in AIDS-related deaths in the late 1990s because anti-retroviral therapy is keeping people alive longer.

“Pharmaceutical companies should take the lead in finding a way to make affordable drugs available to poor countries,” Annan told reporters.

Continuing inequalities in access to effective health care and treatment will be specifically addressed at the Special Session through all possible means - including tiered pricing, competition between suppliers, regional procurement, licensing agreements and the effective use of the health safeguards in trade agreements.

“The question of low-cost generic drug production as a method of reducing the cost of anti-retroviral drugs in the developing world will be taken up by a round-table during the Special Session,” Cravero assured IPS. Yet it is too early to guess where these discussions may lead, she said.

“Collective experience with HIV/AIDS has evolved to the point where it is now possible to state with confidence that it is technically, politically and financially possible to contain HIV/AIDS and dramatically reduce its spread and impact,” Annan concluded.

The second set of substantive negotiations leading up to the Special Session will be held from May 21-26.

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