Inter Press Service - September 16, 2008
Ida Karlsson

"Halfway to the target date of 2015, it is clear that we are not on track to meet the goals, especially in Africa," U.N. Secretary-General Ban Ki-moon stressed when a MDG review was launched here last week.

The U.N. Millennium Development Goals are eight targets to be achieved by 2015. The goals adopted by 189 nations have set worldwide objectives for reducing extreme poverty and deprivation, empowering women and ensuring environmental sustainability.

According to the MDG 6 commitment -- to combat HIV/AIDS, malaria and other diseases -- these diseases should be halted by 2015 and the spread of HIV/AIDS should be reversed.

Former U.N. special envoy on HIV/AIDS in Africa and international AIDS activist, Stephen Lewis, has criticised U.N. efforts -- the world community's failure to meet the Millennium Development Goals -- calling the U.N. "paralysed" and "uncritical".

"There is no time for caterwauling about the cost of drug treatment and the inability of wealthy countries to pony up because of economic problems. There is a humanitarian necessity of investing in prevention," he emphasised in his speech at the International AIDS Conference in Mexico City in August.

Joseph Amon, director of the HIV/AIDS programme at the New York-based Human Rights Watch, has a similar approach.

"We will not win the fight against AIDS unless we increase the rate at which people get access to medicines, the antiretroviral therapy, and make sure that prevention truly reaches everyone," he told IPS.

The recent U.N. review is a snapshot of what the global community has achieved thus far. According to the report, HIV/AIDS continues to take a terrible toll especially in sub-Saharan Africa. Every day nearly 7,500 people become infected with HIV and 5,500 die from AIDS. U.N. statistics show that -- in 2007 alone -- 1.6 million people in sub-Saharan Africa died from AIDS. Another 22.5 million people are living with HIV.

Access to medicines to combat HIV/AIDS, malaria and tuberculosis has improved. However, the availability of affordable essential medicines is still far from adequate in both the public and private sectors, and wide variations in pricing mean that essential medicines are often unavailable to the poor.

According to Amon, one obstacle is countries' regulations restricting access to drugs. Another is that people often are not able to get access to treatment if they do not have appropriate residency papers. This is a huge problem in countries where there is internal migration.

Amon gives an example of how the disease affects all generations: "In Zimbabwe, I spoke with a woman whose four children had all died from AIDS. She was caring for her grandchildren. Some of them were infected and she, herself, was also infected. So three generations had been intimately infected by the epidemic."

But he also explains a counter scenario. He says this does not have to be the case if there is a strengthened public health sector and access to treatment. Then people can live long lives and care for their own children. "We can imagine a world where HIV is another chronic disease," Amon stressed.

He also emphasises the importance of the U.N. as an organisation to provide global leadership, both in the context of highlighting the epidemic and to make countries come together and to submit progress report towards the MDGs.

"But I would like to see the U.N. challenging countries that are failing these goals. One of the places right now that is worrying is Gambia, where we have seen the president of Gambia promoting a fake cure for AIDS which includes taking people off of antiretroviral drugs," Amon explained. "The U.N. initially challenged that cure but then was kicked out of the country. The question is how the U.N. could continue to challenge the countries that are going in the wrong direction."

According to the United Nations Programme on HIV/AIDS (UNAIDS), increases in treatment access have been extraordinary in some African countries -- for example, in Namibia, where treatment coverage was only 6 percent in 2003. In 2007, 57 percent of those in need were on antiretrovirals. In Rwanda, antiretroviral coverage increased to more than 60 percent in 2007.

But the trend is not continent-wide. In Mozambique, for example, the epidemic continues to grow. In the central and southern zones of the country, adult HIV prevalence has exceeded 20 percent.

The U.N. secretary-general has called for a special high-level event on Sep. 25 to boost global action to achieve the MDGs. Nearly 100 heads of state and government are expected to participate, as well as leaders from the private sector, foundations and civil society organisations.

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