UN special envoy calls for international agency specially for women

By henry neondo

No one has captured and understood exactly what needs to be done in the fight against HIV and AIDS scourge than Stephen Lewis, the special UN envoy for HIV and AIDS in Africa.

At the ongoing 3rd International AIDS Society conference taking place in Rio de Janeiro, Brazil, Lewis questioned results of the recently held G8 Summit, called for independent, international women’s agency and challenged scientists to engage in campaign of advocacy.

He said that what is desperately needed in the response to HIV and AIDS today are voices of advocacy: “tough, unrelenting, and informed”.

He said that the issues are so intense, the situation is so precarious for millions of people, the virus cuts such a swath of pain and desolation, that your voices, as well as your science, must be summoned and heard.

Acknowledging that the scientific arts absorb a lifetime, he challenged scientists present at the conference to start mounting the barricades.

He noted that it’s a quarter century into the life of the HIV and AIDS pandemic, and answers still eludes global communities. “Questions still haunt us, and incredibly enough, the responses of the international community continue to be inadequate, sometimes even abysmal”, he said.

At this moment in time, precisely ten years before the target date for the Millennium Development Goals set by all UN member states to tackle poverty and disease, the virus puts every goal at risk for countless nations, and particularly for the continent of Africa.

Yet voices within the scientific and expert communities are as divided now as when the pandemic first broke out.

Some experts say we’re ahead of the pandemic while others say we’re behind the pandemic.

Still there are others who say the pandemic is in its infancy and while others, particularly in Kenya now say the pandemic is its maturing stage.

But whatever the experts, the pandemic continues to engulf the global community; in combination with eviscerating poverty, it puts the survival of entire countries, particularly those in sub-Saharan Africa at risk.

Lewis told a plenary session audience that there is no choice but that “every one of us, however we’re involved --- but especially, I would argue those who have voices that command influence and respect --- every one of us has to speak out on the issues with clarity and courage.”

And the issues abound.

First, he had no nice words for the recently concluded G8 Summit. He said that it was not a breakthrough; it was, in fact, a disappointment.

Citing debt, Lewis said that the cancellation of multilateral debt for eighteen countries, fourteen in Africa, was a start, but hastily added that Africa still carries the insurmountable burden of over $200 billion of debt, debt that cripples the battle against poverty and the pandemic.

Take trade, which everyone agrees is the centerpiece of economic revival. The G8 offered only sonorous words about agricultural subsidies, and could of course offer nothing, because everything rests on the negotiations at the World Trade Organization in its meeting in Hong Kong this December. So far the negotiations are not going well.

Or above all, take foreign aid. In principle, official development assistance to Africa was

doubled by the world’s wealthiest nations. But between principle and delivery, there lies an unblemished record of failure. In this instance, both Germany and Italy have already said that their commitments on future aid will be contingent on the state of their economies at the time.

He said that despite the tremendous energy and commitment of Tony Blair as current chair of the G8, the developed world requires vigilant voices to keep everyone else honest.

Second, the single most dramatic --- indeed brilliant --- design of the last year and a half has been WHO’s 3 by 5 initiative.

It has made all the difference in the world. While it is true that the target will not be reached by the end of this year and desperately painful though that is, there are now more than a million people on treatment who would otherwise be dead.

By setting the target, and breaking the miasma of inertia that seemed to paralyze the world, WHO unleashed an irreversible momentum for treatment.

Further, the entire language of treatment has changed: we now talk of ‘universal treatment’ or ‘universal access’ …gone are intermediate goals. The 3 by 5 initiative launched us on such a trajectory that nothing short of treatment for everyone who needs it is seen as acceptable. For People Living with Aids, who have fought the good fight for so long, it is a potential salvation.

Third, the Global Fund to fight AIDS, Tuberculosis and Malaria is facing a moment of truth. It requires an additional several hundred million dollars this year, an additional several billion dollars over the next two years. UNAIDS and WHO have estimated a shortfall in world-wide AIDS funding of $18 billion dollars between 2005 and 2007; a good chunk of the missing money should go to the Global Fund.

Moreover, UNAIDS estimates that by 2008, we will require, annually, $22 billion for AIDS alone. The Global Fund has a replenishment conference in September, and there the tale will be told.

Fourth, Lewis made a plea that lobbies be ferociously made to engender inequality history. If the carnage of this pandemic has taught us anything, it’s the terrifying vulnerability of women.

He said that the world is losing the women of Africa, and increasingly, the women of the Caribbean and the women of Asia. One of the vexing problems, believe it or not, is that we have no major multilateral organization to represent the needs and rights of the world’s women. Saying that while there is UNICEF for children, we have specialized agencies like WHO, UNESCO, the Food and Agricultural Organization and the International Labour Organization for specific themes … health, education, employment, agriculture, science.

And then the World Food Programme for distribution of food, we have UNDP for governance, we have the UN Fund for Population Activities for sexual and reproductive health; all of these agencies funded in the hundreds of millions, often billions of dollars. And God knows, we have the World Bank and the IMF, Lewis wondered why there is no major international agency devoted to more than half the population of the world.

Agreeing that while every organization pretends to address the needs of women, but no one gets around to it.

Fifth, called for a vaccine that would offer the ultimate prevention, and microbicides that can save millions of lives on the way to a vaccine.

Sixth, is the question of human capacity. Following the progress of former President Clinton’s whirlwind trip through Africa, Lewis noted how often Clinton raised capacity.

It has become the pivotal issue in every country. It compromises everything. It’s a matter of substantial irony that right at the moment when we have generic fixed dose antiretroviral combinations available, at a cost so low as to be able to treat everyone, preferably free, we lack the doctors and nurses and clinicians and pharmacists … we lack the whole gamut of health professionals to do the job.

This requires tremendous ingenuity, training and technical assistance in the response. It requires, of all of you, the leadership, the voices to maintain the focus on capacity, so that when your inspired interventions are discovered or fashioned, there is someone on the ground to make them real in the lives of the potential recipients.

Seventh, is the issue of the orphans. The proliferation of orphans has become a deluge; it’s absolutely overwhelming in country after country. Governments are beside

themselves: no one has any firm grip on how to handle these millions of frantic children.

Extended families and communities struggle to absorb them; grandmothers bury their own children and then try somehow to cope with hordes of grandchildren; child-headed households are an ever-growing phenomenon on the landscape of Africa: it is a nightmare.

Earlier this month, Lewis was in Huruma, one of Nairobi’s slum areas visiting a group of women living with AIDS, tending to large numbers of orphan children.

As is always the case with a visitor, there was a little performance. In this instance, a handful of children came forward to sing a song of their own composition. It began with the words “see us, the children carrying our parents in their coffins to the grave”, and it ended with the words “Help, Help Help”.

And then from the crowd, there emerged a young girl of ten who, with the help of a translator, related the story of the death of her mother.

Many probably feel very distant from the orphans. But they are not. Nothing in this pandemic works in a vacuum, or works in compartments. Everything is linked inextricably to everything else.

That young girl is at the end of a continuum which starts with your scientific inquiry, and moves, inexorably, to her intense human anguish.

It’s a Herculean task. But in this battle, no one is exempt: no government, no sector, no agency, no NGO, no part of civil society, no multilateral organization, no individual – no expert, no scientist, no public health professional. The world can subdue this pandemic, but it will take the collective and uncompromising voices of principle and outrage to make it happen. It will, in other words, take your voices.


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