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 Program 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 counseling 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, counseling 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 sub regional 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, sub regional 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 programs 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 Program 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 sub regional 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 Program 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 programs 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 programs 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 programs 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 behavior and encouraging responsible sexual behavior,
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 percent, and by 2010 at least 95 percent 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 percent, and by 50 percent by
2010, by: ensuring that 80 percent of pregnant women accessing antenatal care
have information, counseling 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 counseling 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 programs that address activities which place individuals
at risk of HIV infection, such as risky and unsafe sexual behavior and injecting
drug use, have in place in all countries strategies, policies and programs 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 programs 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 programs, 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 counseling service; strengthening reproductive and sexual health
programs; and involving families and young people in planning, implementing and
evaluating HIV/AIDS prevention and care programs, to the extent possible.
64. By 2003, develop and/or
strengthen national strategies, policies and programs, 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 behavior, 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 counseling 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 programs to support programs 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, labor 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 behavioral
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 behaviors.
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 programs 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 programs.
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 programs 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 defense 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 programs 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 programs 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 programs, 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 sub regional commissions and organizations to enable them
to assist Governments at the national, sub regional 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 programs 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.
