USIS Washington File - June 1, 2006
Judy Aita, Washington File United Nations Correspondent

Nations must leave U.N. headquarters "with renewed commitment to effective action" at the end of the three-day session, said U.S. Assistant Secretary for International Organization Affairs Kristen Silverberg.

"What the U.N. says it's going to do is less critical than what member states do. What we want to see is some commitment from member states -- not only the U.S. but across the board," Silverberg said at a press briefing May 31.

"We need commitments that are achievable and member states need to have their own individual plans about how they are going to reach them," the assistant secretary said.

"That is what we have in the United States . . . and this is the kind of plan we want to see from member states," she said.

Dr. Mark Dybul, acting U.S. global AIDS coordinator, called the May 31 to June 2 U.N. meeting "an important event." To highlight the commitment of the Bush administration, first lady Laura Bush is heading a large U.S. delegation that includes officials from the Department of Health and Human Services, the Centers for Disease Control and Prevention, the National Institutes of Health as well as members of Congress and business leaders.

The U.S. global AIDS coordinator emphasized the importance of focusing on "what we need to get . . . as close as possible to universal access to treatment, care, and having AIDS-free generation."

Dybul directs President Bush's Emergency Plan for AIDS Relief, also known as PEPFAR. The five-year, $15-billion initiative supports the prevention, treatment and care for people infected and affected by HIV/AIDS. U.S. funding for HIV/AIDS programs has grown from $840 million in 2001 to $3.2 billion in 2006. (see related article)

The joint U.N. Program for AIDS (UNAIDS) estimates that $22 billion a year will be needed by 2008 for AIDS programs with half going for prevention, one-fourth for care and treatment of those infected and the remaining for the care of orphans and children at risk. The increased financing and services coupled with sustained political leadership can achieve the goal of universal access to treatment by 2010, according to the United Nations.

"Unfortunately, the American people have been contributing approximately half of all contributions worldwide," Dybul said. "We can't sustain it. We need to work on getting greater contributions because it is a global epidemic that requires a global response."

The United States is "not in the position to tell governments or the rest of the world what they should be committing," Dybul continued. "Our view is that everyone should look to see what they can and should be committing as a people and government."

UNAIDS reports signs that the epidemic is slowing in a few countries, but most countries have fallen short of the goals they set at the 2001 Special Session on AIDS. More than 20 million people have become infected with the HIV virus since that meeting.

NATIONAL STRATEGIES CRUCIAL

U.S. officials say that treatment now is receiving the attention it requires. In 2001, only 50,000 people were receiving anti-retroviral therapy; by 2005, the United States was supporting national treatment programs in sub-Saharan Africa that reached 400,000 people.

"The American people are committed to stand with the people in these countries to support national strategies," Dybul said. "We need to concentrate on the big-picture issue of what needs to be done" to build on the progress of the past five years.

The United States does not believe in "large-scale international targets," Dybul said. "Countries need to be looking at their plans, their opportunities, and what they can do."

"Countries begin at different capacities, different levels, and are at different stages," he said. "It is impossible to ask countries that have much different capacities to achieve a certain level of access to treatment in the same four-year period."

Commenting on the final declaration scheduled to be adopted June 2, Dybul said "everyone recognizes the importance of overcoming stigma and discrimination against women and young girls, [and] targeting men so they don't behave badly. All of these are critical components of an effective response."

The United States would "welcome the mention of vulnerable groups, generally and specifically," Silverberg said, referring to debates over whether prostitutes, drug users and homosexuals should be mentioned in the final declaration.

The United States also has "absolutely no objection" to the mention of condoms as part of the so-called ABC approach (abstinence, be faithful, correct and consistent use of condoms) in addressing HIV prevention, Dybul said. All the data from sub-Saharan African programs have shown that the ABC approach has been effective in stemming the rate of infection.

For information on U.S. policies and programs see HIV/AIDS.

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