The three-day conference of the United Nations General Assembly held to debate the global AIDS crisis was intended as a face-saving exercise for Western governments.
With public opinion increasingly appalled at the lack of response to the disease—currently affecting 36 million people of whom 90 percent are in developing countries and 75 percent in sub-Saharan Africa—UN Secretary General Kofi Annan called for the setting up of a $10 billion a year fund. The derisory response from both Western governments and corporations has clearly been an embarrassment. Less than one billion has been pledged, with $200 million from the United States, $127 from France, $110 million from Norway, $60 million from Sweden and $73 from Canada. The Bill and Melinda Gates Foundation donated $100 million. After protests from charities, the British government doubled its donation to $200 million but this is to be spread over five years.
At the beginning of the conference, it was announced that the US government would drop its case on behalf of the drug companies against Brazil at the World Trade Organisation. Brazil’s production of “generic” AIDS drugs at far lower prices than demanded by the global pharmaceutical manufacturers had been deemed to be a breach of patent rights. With widespread protest against the drug companies, the US has now decided to pursue bilateral negotiations with Brazil over the issue.
The UN conference proceedings descended into a shambles, as bitter arguments took place behind the scenes. Islamic countries objected to gay and lesbian organisations participating in the meeting. The declaration at the end did not mention drug users, homosexuals or prostitutes—groups particularly at risk—because of pressure from Muslim countries, the Vatican and the American right.
Even the apparent US climb down over drug prices failed to boost the standing of the UN initiative amongst charities and AIDS campaigners. An article on the Aidsmap website pointed out: “Firstly, for many countries, cancellation of unsustainable international debts is likely to do more to enable their governments to respond to HIV and AIDS than any amount which is likely to be received from the Fund. Secondly, the Fund will only help if it represents money given in addition... If money is diverted from other international development budgets; it could do more harm than good.”
Jubilee USA said, “the $200 million which Bush has pledged is the same amount as sub-Saharan Africa spends on debt payments in less than a week.”
Moustapha Gueye of the African Council of AIDS Services Organisations pointed out that although the declaration agreed at the end of the UN assembly had a range of goals—such as reducing HIV prevalence among 15 to 24 year olds by 25 percent over the next four years, halving infant infection by the year 2010, and drawing up plans for comprehensive health services by 2003—none of them were binding on signatory countries. “Nobody will be held accountable,” he said.
Mark Curtis, head of policy for UK-based charity Christian Aid, said, “The global fund is likely to be a distraction from addressing the poverty upon which HIV/AIDS thrives...national health services are at breaking point in many countries - not helped by structural adjustment programmes imposed by the World Bank that demanded cutbacks in public spending.” Regarding the $1 billion likely to be raised this year, he pointed out that 23 of the world’s poorest countries have to repay twice that each year on debt repayment.
Christian Aid point out that the Western donor countries had failed to maintain even the 0.7 percent of national wealth they had pledged in aid 30 years ago, and that the UN initiative was really designed to increase the public perception that “there is something being done about HIV/AIDS.” Over the last 10 years, overseas aid to the world’s 49 least developed countries has been reduced by 45 percent in real terms.
Something of the arrogant and dismissive attitude of Western politicians towards the AIDS crisis was displayed in the speech given to the UN assembly by Britain’s Clare Short, Secretary of State at the Department for International Development (DFID), who said, “It is my strongly held view that we waste too much time and energy in UN conferences and special sessions.” Implying that the British were not responsible, she bemoaned the lack of “follow up mechanisms or assurances that governments and UN agencies will carry forward the declarations that are agreed.” Speaking in an interview after her assembly speech, she described Anan’s proposed fund as being an over-hyped “piece of nonsense.” Attacking the target figure of $7-$10bn she said, “Nobody could administer such a fund.” She thought $1bn was a realistic figure, and added that Britain’s $200m contribution was dependent on the money being managed rigorously.
Whilst the UN resolution accepted that the provision of anti-retroviral drugs would now be included in its AIDS strategy—previously it was committed only to prevention, i.e. the provision of condoms and sex education—this is clearly not regarded by Western governments as a policy they are prepared to fund. Even with the reductions in drug prices, the annual cost of such treatment is at least $500 a year, well beyond the income of most AIDS sufferers. Given also the virtual absence of health services in many developing countries, without which the drugs cannot be administered, it is clear that even the $10 billion figure put forward by Annan is woefully inadequate.
Clair Short again put forward the position of the West. Whilst anti-retroviral drugs would now be part of the global fund initiative, “they will have to be responsibly made available”—meaning presumably that they will only be available for the few that can afford them. Short said that the real problem was with the developing countries: “the most important achievement of the global fund would be to encourage developing country governments to spend more than the £3 a person they spend on health on average each year.”
Andrew Natsios, the newly appointed head of the US Agency for International Development (USAID), openly opposed the funding of anti-retrovirals. In an interview in the Boston Globe and in testimony before the House International Relations Committee, he argued strongly against the provision of anti-AIDS drugs in developing countries. Taking drugs to a strict timetable was not possible with African AIDS patients who “don’t know what Western time is,” he said. Natsios advocated “abstinence, faithfulness and the use of condoms” as the way to deal with the HIV/AIDS crisis.
His remarks produced an outraged response from AIDS campaigners and the liberal press Yet despite the rhetoric of the UN Assembly, the Western government’s have made clear that they are also opposed to the kind of wide-ranging response—in terms of adequate health care, availability of anti-retroviral drugs, and dealing with the high levels of poverty - that the AIDS crisis warrants.