USIS Washington File - May 22, 2007
Judy Aita, USINFO United Nations Correspondent

PEPFAR, now in its fourth year, is beginning to turn the tide against the HIV/AIDS pandemic in some countries, Mally told the U.N. General Assembly May 21.

Mally said that through September 30, 2006, the United States supported life-saving anti-retroviral treatment for 822,000 people in 15 countries and cared for 4.5 million people, including 2 million orphans and vulnerable children.

The $15 billion PEPFAR program supports HIV/AIDS prevention efforts as well as treatment and care for people infected and affected by the virus. U.S. funds for the initiative have grown from $840 million in 2002 to $2.4 billion in 2004 and $3.2 billion in 2006.

Speaking during a U.N. General Assembly session reviewing the world's progress toward universal access to HIV/AIDS care, Mally said PEPFAR has supported behavior change messages for millions of people of all ages and social strata and the development of safe blood systems. PEPFAR also has supported services to prevent transmission of HIV from pregnant women to their children during more than 6 million pregnancies, averting an estimated 101,000 infant infections, he said.

According to Mally, two areas that can have a huge impact on universal access to HIV/AIDS programs are: (1) increasing the number of health care workers by including training programs as part of HIV/AIDS programs, and (2) developing programs that focus on ending discrimination and stigma so that more people will get tested and seek counseling.

The General Assembly review comes one year after it held a high-level meeting on AIDS in May 2006 setting new goals to combat the pandemic by 2010.

"What the developing world needs now is for us to fulfill the commitments we have made," Mally said. "The United States looks forward to working with nations and other partners to transform the declarations into a better life for tens of millions of people living with or affected by AIDS."

A report by U.N. Secretary-General Ban Ki-moon says that efforts to expand treatment have gathered momentum with an estimated 2 million people receiving anti-retroviral therapy in low- and middle-income countries -- an increase of 700,000 since December 2005. The proportion of pregnant women receiving services to prevent mother-to-child transmission has increased from 9 percent in 2005 to 11 percent in 2006. However, if the current increases in care and treatment continue at the same rate, the number of people receiving anti-retroviral drugs in 2010 will be only 4.5 million, less than half those needing treatment.

Ban reported that for every person who starts anti-retroviral treatment, six more become infected. Over the past two years, the number of people living with HIV has increased in every region in the world.

The report warned that many low- and middle-income countries cannot achieve the 2010 goals without international funding for public health and development, especially for health system infrastructure.

The United Nations estimates that $18 billion is needed by low- and middle-income countries in 2007; nevertheless, only $10 billion will be available in 2007, slightly more than half of what is needed. The joint U.N. Program for AIDS (UNAIDS) says that $22 billion a year will be needed by 2008 for AIDS programs, with half going for prevention, another one-fourth for care and treatment of those infected, and the remaining for the care of orphans and children at risk. It is believed that increased financing and services coupled with sustained political leadership can achieve the goal of universal access to treatment by 2010.

All four elements of the response -- treatment, prevention, care and support -- are essential and interconnected, the secretary-general said.

"Make no mistake: In some way or another, we all live with HIV. We are all affected by it. We all need to take responsibility for the response," Ban told the General Assembly.

Mally said one of the most useful suggestions in the secretary-general's report is to "know your epidemic."

"We must be aware of what is driving the epidemic in communities, countries and regions and plan prevention strategies accordingly," he said.

The full text of Mally's remarks is available on the U.S. Mission to the United Nations Web site.

The full text of Ban's remarks is available on the U.N. Web site.

070522
US070501