World leaders on Friday declared HIV "an unprecedented human catastrophe" and adopted new targets to combat the epidemic, including providing drug treatment to 15 million people by 2015,
A political declaration hammered out after seven weeks of difficult negotiations was adopted by consensus by the U.N. General Assembly at the end of a three-day high-level meeting to spotlight successes in tackling HIV/AIDS and the need to intensify the fight.
It commits the U.N.'s 192 member states to cut in half the transmission of HIV through sexual activity and injecting drugs by 2015 — and to ensure that all babies are born HIV-free by that date.
"The world has watched as we forged a new declaration that will shape the endgame of the AIDS epidemic," General Assembly President Joseph Deiss told the leaders, ministers and diplomats after banging his gavel to signify the declaration's adoption by consensus.
Funding to combat AIDS increased eight-fold, from $1.8 billion in 2001 to $16 billion in 2010, but the U.N. agency to combat AIDS says between $22 billion and $24 billion is needed to address the magnitude of the crisis and respond to global demands for prevention, treatment and fighting discrimination against HIV sufferers.
The declaration commits nations to work to find the additional $6 billion needed annually by 2015 to close the funding gap.
"If we don't pay now, we'll pay forever," Michel Sidibe, the executive director of the U.N. agency, UNAIDS, told a panel Friday morning, repeating his warning from Wednesday's opening session which for many delegates became the slogan for the meeting.
While AIDS was identified as a disease 30 years ago, world leaders first took responsibility for controlling the epidemic at a U.N. meeting in 2001.
A UNAIDS report released last week said the last decade has seen a nearly 25 percent decline in new HIV infections, a reduction in AIDS-related deaths, and "unprecedented advances" in access to treatment, prevention services and care. But it said more than 34 million people were living with HIV at the end of 2010 — including 2.6 million who became newly infected in 2009.
Although an estimated 6.6 million people in low- and middle-income countries were receiving antiretroviral drug treatment at the end of last year, about 9 million eligible people in those countries were not, UNAIDS said.
Sidibe said early treatment is a priority following the striking results of an international study overseen by the U.S. National Institutes of Health.
The nine-nation study offered convincing evidence of what scientists have long believed — that HIV medicines don't just benefit the patient, but may act as a preventive by making those people less infectious. Earlier treatment in the study meant patients were 96 percent less likely to spread the virus to their uninfected partners, according to preliminary results announced last month.
Professor Michel Kazatchkine, executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, said the message from this week's meeting is that it is now possible "to treat millions of people at large scale in the poorest settings of the world with antiretrivoral drugs," and that prevention is effective.
"Science has made such tremendous progress that we do have the tools to actually truly impact, if not end this epidemic," he said in an interview. "I want people to have this renewed sense of emergency" and ensure that everyone can access treatment and prevention worldwide.
Kazatchkine said he was pleased with the agreement to try to provide drugs to 15 million people with HIV by 2015.
"It's basically what we estimate as `experts' to be universal coverage and it will be a driving force for mobilizing resources," he said.
Will it be possible to raise $6 billion in additional funding? "It's challenging, but I'm hopeful. I'm positive," Kazatchkine said.
Sharoann Lynch of Doctors Without Borders said that by approving the declaration, "governments just put themselves on the hook for treating 15 million people by 2015 and paying for it."
"This means both saving lives and taking a substantial step toward stopping the virus — and potentially breaking the back of the epidemic," she said.
After the vote, several Muslim and Roman Catholic nations expressed concern about the declaration's efforts to define the groups most vulnerable to getting infected by the HIV virus, including homosexuals, sex workers and intravenous drug users. These countries had tried to water down such references during negotiations on the declaration.
Iran's representative expressed concern that listing vulnerable groups appeared to promote what he termed "unethical behavior" which his country opposed.
There was applause when ambassadors from Roman Catholic Mexico and Brazil endorsed the declaration and named all vulnerable groups. There were boos in the chamber, which was filled with many AIDS activists, when the Vatican representative repeated the church's opposition to condoms and said the declaration "should focus on risk avoidance," including sexual abstinence before marriage and help for addicts to break free from drugs.