San Francisco Chronicle - Tuesday, June 26, 2001
Sabin Russell, Chronicle Medical Writer

"AIDS can no longer do its deadly work in the dark," said U.N. Secretary- General Kofi Annan of Ghana, pleading for cooperation before an audience of 2,000 delegates and observers. "The world has started to wake up."

He also warned that the world cannot deal with AIDS "by making moral judgments, or refusing to face unpleasant facts -- and still less by stigmatizing those who are infected and making out that it is all their fault."

The three-day meeting was called to build global consensus and a new battle plan against a 20-year-old epidemic. But the language of science and medicine quickly clashed with the language of diplomacy in the storied U.N. hall, where 189 nations of vastly different size, wealth and cultures meet and often disagree.

CONFLICT OVER SPEAKER

Delegates of Islamic countries objected to the inclusion of a gay woman from a San Francisco human rights organization on a list of speakers scheduled to address a panel today.

For more than two hours, the fate of the conference appeared to hang in the balance as delegates from Egypt, Malaysia, Pakistan and other predominantly Muslim nations raised procedural objections requiring a rare casting of votes in a process typically run by consensus. In the end, the panel list including Karyn Kaplan of the International Gay and Lesbian Human Rights Commission was approved 62-0, but with 30 delegates abstaining.

"They had to work two hours to see if I could speak for three minutes," said Kaplan, a New Yorker who was stunned to find herself at the center of a global controversy. "It's horrifying, actually, given what we are here for."

By tomorrow, the delegates hope to forge a document, called a Declaration of Commitment, that will lay out a coordinated attack against a disease that has already killed 22 million people. An additional 36 million people are infected with HIV and face certain death without treatments.

A parade of African heads of state and high-level diplomats from around the globe stepped up to the marble podium to give brief but passionate speeches urging delegates to support an international commitment to battle the disease.

STRONG WORDS FROM POWELL

Secretary of State Colin Powell, who headed the U.S. delegation, delivered the strongest statement yet by the Bush administration on the topic of AIDS and HIV.

"I was a soldier," Powell boomed from the lectern. "But I know of no enemy in war more insidious or vicious than AIDS."

For those who wondered whether the U.S. government would side with those favoring prevention rather than treatment, Powell left little room for doubt: "Unless a strong emphasis is put on prevention, prevention and more prevention, this pandemic will continue to rage out of control," he said.

Powell gave his support to a still-nascent Global AIDS and Health Fund proposed by Annan. The Bush administration has pledged $200 million for the fund, which is expected to become operational by year's end.

Other nations, including Canada, Britain and even impoverished Uganda, have brought total pledges so far to nearly $700 million, far short of the $7 billion to $10 billion sought by Annan.

"It's not just governments who can play leadership roles," Powell said. "Philanthropists, foundations and corporations must step up to the challenge."

AFRICAN LEADERS SPEAK

African leaders, many of them dressed in traditional formal costume, called for emergency steps to rescue the continent. More than 25 million of those infected with HIV live in sub-Saharan Africa, which also accounts for three- quarters of those who have already died.

Senegalese President Abdoulaye Wade told how his tiny nation has kept HIV infection rates down by "talking about it, breaking the conspiracy of silence about it."

Dr. Pascoal Manuel Mocumbi, prime minister of Mozambique, delivered a stirring speech about AIDS in his hard-hit nation, and the need to change sexual behavior and gender inequality, which "drive this epidemic."

In Mozambique, the HIV infection rate among girls and young women is 15 percent, twice the rate of boys their age. "This is not because the girls are promiscuous," he said, "but because nearly 3 out of 5 are married by age 18 -- 40 percent of them to much older, sexually experienced men who may expose their wives to

HIV/AIDS."

"Abstinence," he said, "is not an option for these child brides." The soaring speeches of the morning session were quickly overshadowed by the dispute over the inclusion of the International Gay and Lesbian Human Rights Commission in a panel that will discuss the human rights aspects of the AIDS epidemic this afternoon.

For weeks leading up to today's meeting, delegates and their staffs had been planning the session in a series of closed-door meetings where the dispute over frank discussion of homosexuality, prostitution and injection drug use blocked the production of a draft agreement.

Behind the dispute is a question whether so-called "vulnerable" groups will be itemized in the final U.N. declaration, or will be discussed in very general terms. Advocates for private agencies said it is vital that the groups be named so that organizations most familiar with people suffering from the disease can help direct the flow of AIDS dollars.

Dr. Nils Daulaire, president of Global Health Council, an organization representing a range of health care organizations, said the strange parliamentary moves are part of the United Nations' unique vocabulary of diplomacy.

"Parliamentary maneuvers are a way of addressing their worries without saying the words they stand for. . . . The function the U.N. serves is as a hot crucible for mixing together a volatile combination of cultures. . . . We're seeing polite warfare."

E-mail Sabin Russell at srussell@sfchronicle.com.

010626
SC010628

Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2001. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .