U.N. Group Sets Compromise on AIDS Policy

By David Brown
Washington Post Staff Writer
Saturday, June 3, 2006

UNITED NATIONS, June 2 -- Delegates to a United Nations conference on AIDS reached agreement Friday after difficult negotiations on a policy declaration that sets no targets for the number of people who should be treated and makes only indirect reference to high-risk groups such as homosexuals, prostitutes and intravenous drug users.

The statement, however, contains language acknowledging the "feminization" of the global AIDS epidemic, as well as the importance of teaching young people about the disease and the need for drugs specifically formulated for children.

The eight-page statement, completed early Friday morning, is a compromise that provided victories to the United States, which opposed numerical treatment targets; Islamic countries, which did not want "vulnerable populations" spelled out in detail; and many activist groups that sought statements that empowering women is a tool against AIDS.

The new "Declaration of Commitment" updates one adopted five years ago that proved crucial in turning resources and attention to AIDS in the developing world.

Response to the document varied among the 800 civil society groups attending the three-day meeting. It was the largest participation of outsiders in U.N. history.

"The final outcome document is pathetically weak," said Sisonke Msimang, a South African activist from the African Civil Society Coalition. "It is remarkable at this stage in the global epidemic that governments cannot set the much-needed targets, nor can they name in the document the very people that are most vulnerable."

But others praised the acknowledgment of the links between AIDS and gender inequality, an assertion that women should have control over their own reproductive health, and language condemning "harmful traditional and customary practices, abuse, rape and other forms of sexual violence."

"From that perspective we feel that we have gained ground," said Zonny Woods, a Canadian with the International Women's Health Coalition, in New York. "In that regard I would say it is a success."

Peter Piot, the Belgian physician who directs UNAIDS, called it "a strong declaration that will move response to AIDS forward," although he said of the reluctance "to name the unnamable groups, here I agree with the activists."

Piot was among many who had called for the declaration to lay out targets for dollar amounts to be spent on AIDS and for the fraction of people who should be getting drug treatment and testing, or prevention interventions during pregnancy. The previous policy document in 2001 contained all of those.

The new one mentions $20 billion to $23 billion as an "estimate" for annual needs starting as of 2010, but it does not commit donors or recipient countries to come up with that amount. There are no clinical targets set out.

An American official not involved in the negotiations said one reason the U.S. delegation opposed numerical targets is that they might be construed as committing money for global AIDS in advance of actual appropriations requested by the executive branch and voted on by Congress.

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