World Health Organization
2006-12-01 17:18 977

GENEVA, Dec. 1 /Xinhua-PRNewswire/ -- The HIV/AIDS epidemic continues to

grow. Some 40 million people, their families, and their communities, are now

living with HIV. Effectively tackling this epidemic remains one of the

world’s most pressing public health challenges.

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In August this year, at the XVI International AIDS Conference, 30,000 of

us came together in Toronto in reply to the Conference’s call to action.

That action, we agreed, must reflect a balanced mix of prevention, treatment

and care. This year’s World AIDS Day theme "Accountability" reminds us

again of our responsibility for making the right choices.

In Toronto, I spoke on the three areas in which we had to take action:

the three "Ms" of Money, Medicines and a Motivated workforce.

Money: We have made some important progress and continue to do so. For

example, just over half of the latest round of grants from the Global Fund -

which totalled US$846 million -- will go to fight HIV/AIDS. Continued

commitment is needed and resources must be used effectively. Accountability

is an important theme for those who want to see the best possible results in

terms of human lives.

Medicines: Our goal remains to scale up international efforts to provide

universal access to prevention, treatment, care and support services. The

ten-fold increase in people on treatment in sub-Saharan Africa in recent

years shows that we can do it. Sub-Saharan Africa also illustrates what still

has to be done: it represents 70% of the global unmet need for treatment.

We have a very long way to go still in the provision of medicines to

those who need them. To be able to do that, we must also know who needs

treatment and care.

The latest AIDS epidemic update from WHO and the UNAIDS Secretariat,

released on 21 November, gives us the most accurate picture of the epidemic

to date. HIV surveillance remains weak in almost all regions, particularly

among marginalized groups. Those at highest risk -- men who have sex with

men, sex workers, and injecting drug users -- are not reliably reached

through HIV prevention and treatment strategies.

At the Toronto Conference there was a powerful drive to address the needs

of those who bear the greatest burden of the AIDS epidemic -- women and

girls. Some 40% of new HIV infections now occur among young people aged

between 15 to 24 years. The most striking increases in the number of people

living with HIV have occurred in East Asia, Eastern Europe and Central Asia.

Those most at risk of exposure to HIV do not always know how to protect

themselves and often do not have access to the means to do so, such as

condoms, clean needles and syringes, and treatment for sexually transmitted

infections. Levels of knowledge of safer sex and HIV remain low in many

countries, as well as perceptions of personal risk. Even in countries where

the epidemic has a very high impact, such as Swaziland and South Africa, a

large proportion of the population do not believe they are at risk. Where

prevention efforts decline, HIV infects more people.

Counselling and testing are essential so that people who are infected can

know their status, seek care, and using their increased knowledge, change

their behaviours to prevent transmission of the virus to others. Those who

are tested can also use knowledge of their status to protect themselves.

A Motivated health workforce: Motivated and skilled health workers who

can provide essential services are the crucial missing link in many

countries. WHO’s "Treat, Train Retain" plan for a healthy and well supported

healthcare workforce is being developed now in 15 countries.

Prevention works but has to be focused on the needs of those most likely

to be exposed to HIV, and it must be sustained. There are success stories.

In 8 out of 11 of some of the world’s most affected countries, HIV

prevalence in the age group 15 to 24 years has declined in the past five

years. We must seize on these successes and see that they are repeated.

We know that comprehensive harm reduction programmes reduce risky drug

injecting practice and result in declines in HIV infection rates. Effective

responses are being implemented in many countries, ranging from Brazil and

China to the Islamic Republic of Iran and Indonesia. These experiences

provide good models for other countries.

Another key element in the epidemic -- Tuberculosis -- has recently drawn

increased attention with the development of an extremely drug resistant form

that signals the urgent need for TB control. TB causes up to half of all

deaths in people living with HIV.

The AIDS epidemic provides us with clear evidence that even some of the

most complex health and development problems can be successfully addressed.

To see this positive pattern repeated everywhere will take greater political

will and more resources.

Our ability to be responsive to changes in the epidemic is a central

factor if we are to succeed. We have to be constantly alert to shifts in the

epidemic dynamic and country contexts, aware of which approaches are

successful, and flexible enough to adapt our responses accordingly. We do

not just need "more". We need to commit to clear sightedness about what is

working and what is not -- and quickly apply that knowledge.

For example, recognizing the critical role that vulnerable and

marginalized populations play in the epidemic, we need to invest in models of

service delivery that reach these groups, ensure equitable and quality

services, and are able to provide sustainable support to the most affected


We are now more than 25 years into this epidemic. People living with HIV

and their communities urgently need to see tangible results. We are at a

critical juncture. Just last week, Secretary-General Kofi Annan inaugurated

the new joint UNAIDS/WHO building in Geneva. It is a building which now

houses the HIV, TB and Malaria staff of WHO, side by side with the UNAIDS

team. Nothing more clearly symbolises our determination to work as a team.

It is a commitment to collaboration, and with that comes our commitment also

to accountability: to all those currently living with HIV, and to all those

whose lives must be protected from it.

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Source: World Health Organization