Wall Street Journal - June 28, 2001
Rachel Zimmerman, Staff Reporter

NEW YORK -- In a strongly worded, 15-page statement, the United Nations General Assembly passed its first targets for member states to follow in fighting the HIV/AIDS pandemic.

The statement, called a Declaration of Commitment on HIV/AIDS, was formally approved late Wednesday at the end of a special three-day General Assembly meeting attended by 3,000 delegates, many of them heads of state, health ministers and activists. The declaration carries no enforcement or funding to meet its ambitious targets, and some activists complained that by itself the statement was a disappointing outcome.

But several U.N. and public-health officials said the statement will provide an important tool in goading poor nations to address the pandemic that has infected 36.1 million people world-wide, 90% of them in developing nations. Government officials and citizens are expected to use the document as a blueprint for demanding action in their countries, officials said.

"When you come to a gathering like this, it is sometimes difficult to quantify" what has been accomplished, U.N. Secretary-General Kofi Annan told reporters Wednesday. "But we have focused attention on this issue in a way not seen before," he said. "We are setting a yardstick, a standard ... People can now challenge their governments on what they are doing and not doing."

One of the declaration's most ambitious targets calls for a 25% reduction in HIV infection rates by 2005 among people aged 15 to 24 in countries hardest hit. The declaration also calls on member nations to agree by 2003 to create national strategies to "address the epidemic in forthright terms," to confront stigma, denial, discrimination, and create specific treatment and prevention programs that meet the U.N.'s new goals.

"This will become a major instrument for accountability," said Peter Piot, executive director of Unaids, which administers AIDS programs for the U.N. and the World Health Organization. "I will use it with governments to say to them forcefully that this is what you committed to doing and we expect you to do it."

Others were less sanguine. "I hope people from the most heavily impacted countries can take this document home and use it to help," said Paul Davis of the AIDS-activist group ACT UP in Philadelphia. "But it's hard to imagine how."

Mr. Annan said the document provided significant progress in several controversial areas. In particular, he pointed to national goals designed to empower women and girls, among whom infection rates are particularly high and who are especially vulnerable because of cultural traditions and national policies. The battle against AIDS "can be won only if women are fully educated and enjoy their full rights, including a full say in devising society's collective response," Mr. Annan said.

Among other goals, by 2005 nations are to ensure that 90% of people aged 15 to 24 have access to AIDS education and prevention services; reduce the proportion of infants infected by 20% from current levels, and by 50% five years later; and develop and "make significant progress in implementing" treatment strategies, including use of drugs.

Also by 2005, the statement states that "through a series of incremental steps," world-wide spending against AIDS in low- and middle-income countries will grow roughly fivefold from current levels to between $7 billion and $10 billion a year. Indeed, by Wednesday the U.N.'s staff had received $961 million in pledges for a new global fund to fight AIDS, one from Mr. Annan himself for $100,000.

Mr. Annan said details of the fund's operations will be decided by year's end, but he said he expects it to be run by an independent, nonprofit board including donors, recipients and U.N. and WHO representatives. He also expects it to be managed by a small staff and to provide funds for treatment and prevention to countries with such programs that make specific requests for money.

While the Bush administration still wants to contribute $200 million to the fund for fiscal 2002, the House International Relations Committee approved a bipartisan bill Wednesday authorizing a $750 million U.S. contribution, on top of $560 million in other AIDS foreign assistance and $50 million to purchase drugs to treat AIDS and related diseases. But House appropriators, who actually allocate the money, appear on track to provide about half of the $1.36 billion in total AIDS foreign assistance that the committee approved.

-- Michael M. Phillips in Washington contributed to this article. Write to Rachel Zimmerman at rachel.zimmerman@wsj.com

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