[e-drug] UN Declaration on HIV/AIDS

["Andy Gray" <andy@healthlink.org.za>]

E-DRUG: UN Declaration on HIV/AIDS
---------------------------------------
[crossposted from DRUGINFO with thanks to Andy for
identifying the parts relevant to essential drugs. NN]

Hi all

The UN Declaration of Commitment on HIV/AIDS can be accessed at:
http://www.un.org/ga/aids/coverage/FinalDeclarationHIVAIDS.html

Several clauses have a direct bearing on drug policy: in the
preambular section, the careful wording of clause 15, then the
specific mention of drug issues in clauses 23-26. Then, in the
operative section, look at clause 54 (on MTCT), 55-56 (on ARVs)
and 70-74 (on research). Obviously, the whole section on funding is
also relevant (79-93). Many of the operative clauses have tight
timelines and specific targets: e.g. "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". These services are then
spelled out quite clearly.

regards
Andy

Andy Gray
Discipline Chair: Pharmacy Practice
School of Pharmacy and Pharmacology
University of Durban-Westville
email: andy@healthlink.org.za
Tel: +27 31 2044358 Fax: +27 31 2044792

~~~~~

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 counselling 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 factors 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 boys, 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 as 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, Changmai, 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.



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