At the end of a three day high level meeting on AIDS from 31 May — 2 June 2006, in United Nations, New York, the UN General Assembly adopted a consensus Declaration on the continuing fight against HIV/AIDS. The Declaration recognizes that that HIV/AIDS constitutes a global emergency that posed formidable challenges to development, progress and stability of societies and the world at large, and reaffirms the intention of the international community to fully implement the 2001 Declaration of Commitment on HIV/AIDS called “Global Crisis – Global Action” and internationally agreed development goals and objectives, including the Millennium Development Goals, in particular the goal to halt and begin to reverse the spread of HIV/AIDS. The Declaration was adopted unanimously after the Assembly had heard from over 150 speakers today, including 11 Heads of State or Government and numerous other high Government officials.

“If we don’t see radical change, we will get nowhere close to universal access to HIV prevention, treatment, care and support by 2010 -- the goal that you committed yourselves to at the World Summit last September. If we don’t step up the fight drastically, we will not reach the Millennium Development Goal of halting, and beginning to reverse, the spread of HIV and AIDS by 2015”, United Nations Secretary-General Kofi Annan said in his remarks to the General Assembly.

The epidemic continued to outpace the response, he said, while noting some progress made since the 2001 special Assembly session. Nevertheless, in some countries, there were fewer young people being infected than five years ago, and seven times more people had access to treatment. Every President and Prime Minister, every parliamentarian and politician, needed to decide and declare that “AIDS stops with me”.

According to the Political Declaration, participants recognized that the means to reverse the global pandemic and to avert millions of needless deaths were available. However, to mount a comprehensive response, any legal, regulatory, trade and other barriers that blocked access to prevention, treatment, care and support must be overcome. Adequate resources must be committed. All human rights and fundamental freedoms must be protected, and gender equality and empowerment of women promoted. The rights of the girl child must also be promoted and protected in order to reduce girls’ vulnerability to HIV/AIDS.

Participants committed to pursue all necessary efforts to scale up nationally driven, sustainable and comprehensive responses to achieve broad multisectoral coverage for prevention, treatment, care and support, with full and active participation of people living with HIV, vulnerable groups, most affected communities, civil society and the private sector, towards the goal of universal access to comprehensive prevention programmes, treatment, care and support by 2010.

The participants also pledged to provide the highest level commitment to ensure that costed, inclusive, sustainable, credible and evidence-based national HIV/AIDS plans werefunded and implemented with transparency, accountability and effectiveness, in line with national priorities. Noting the current level of resources ( around $ 8 billion), they recognized that an estimated $20 billion to $23 billion was needed per annum by 2010 to support rapidly scaled-up AIDS responses in low- and middle-income countries.

The Declaration reaffirmed that prevention of HIV infection must be the mainstay of the national, regional and international responses to the pandemic. Prevention programmes must take account of local circumstances, ethics and cultural values and must be available in all countries. They should include information, education and communication, in languages most understood by communities and respectful of cultures. They should be aimed at reducing risk-taking behaviours and encouraging responsible sexual behaviour, including abstinence and fidelity. There should also be expanded access to such essential commodities as male and female condoms and sterile-injecting equipment.

Participants reaffirmed that prevention, treatment, care and support for those infected and affected by HIV/AIDS were mutually reinforcing elements of an effective response and must be integrated in a comprehensive approach to combat the pandemic. Deeply concerned by the overall feminization of the pandemic, participants pledged to eliminate gender inequalities, gender-based abuse and violence, and to increase capacities of women and adolescent girls to protect themselves from the risk of HIV infection. They also committed to intensify efforts to eliminate all forms of discrimination against people living with HIV and members of vulnerable groups.

The Political Declaration further addressed issues of children and youth, legal and regulatory barriers to effective HIV prevention, HIV/AIDS education, reduction of mother-to-child transmission, human resources and intellectual property rights in relation with pharmaceuticals, among other things.

Finally, participants committed themselves to set, in 2006, ambitious national targets, including interim targets for 2008 in accordance with core indicators recommended by the Joint United Nations Programme on HIV/AIDS (UNAIDS). They decided to undertake comprehensive reviews in 2008 and 2011 in the General Assembly on the progress achieved in realizing the 2001 Declaration of commitment.

The Partners in Population and Development (PPD) was represented at the high level meeting by Mr. Jyoti Shankar Singh, its Permanent Observer to the United Nations.

Draft resolution
submitted by the President of the General Assembly

The General Assembly

Adopts the Political Declaration on HIV/AIDS annexed to the present resolution.

Annex
Political Declaration on HIV/AIDS

1. We, Heads of State and Government and representatives of States and Governments participating in the comprehensive review of the progress achieved in realizing the targets set out in the Declaration of Commitment on HIV/AIDS[1], held on 31 May and 1 June 2006, and the High-Level Meeting, held on 2 June 2006;
   
2. Note with alarm that we are facing an unprecedented human catastrophe; that a quarter of a century into the pandemic, AIDS has inflicted immense suffering on countries and communities throughout the world; and that more than 65 million people have been infected with HIV, more than 25 million people have died of AIDS, 15 million children have been orphaned by AIDS and millions more made vulnerable, and 40 million people are currently living with HIV, more than 95 per cent of whom live in developing countries;
   
3. Recognize that HIV/AIDS constitutes a global emergency and poses one of the most formidable challenges to the development, progress and stability of our respective societies and the world at large, and requires an exceptional and comprehensive global response;
   
4. Acknowledge that national and international efforts have resulted in important progress since 2001 in the areas of funding, expanding access to HIV prevention, treatment, care and support and in mitigating the impact of AIDS, and in reducing HIV prevalence in a small but growing number of countries, and also acknowledge that many targets contained in the Declaration of Commitment on HIV/AIDS have not yet been met;
   
5. Commend the secretariat of the Joint United Nations Programme on HIV/AIDS and its co-sponsors for their leadership role on HIV/AIDS policy and coordination, and for the support they provide to countries through the Programme;
   
6. Recognize the contribution of, and the role played by, various donors in combating HIV/AIDS, as well as the fact that one third of resources spent on HIV/AIDS responses in 2005 came from the domestic sources of low- and middleincome countries, and therefore emphasize the importance of enhanced international cooperation and partnership in our responses to HIV/AIDS worldwide;
   
7. Remain deeply concerned, however, by the overall expansion and feminization of the pandemic and the fact that women now represent 50 per cent of people living with HIV worldwide and 60 per cent of people living with HIV in Africa, and in this regard recognize that gender inequalities and all forms of violence against women and girls increase their vulnerability to HIV/AIDS;
   
8. Express grave concern that half of all new HIV infections occur among children and young people under the age of 25, and that there is a lack of information, skills and knowledge regarding HIV/AIDS among young people;
   
9. Remain gravely concerned that 2.3 million children are living with HIV/AIDS today, and recognize that the lack of paediatric drugs in many countries significantly hinders efforts to protect the health of children;
   
10. Reiterate with profound concern that the pandemic affects every region, that Africa, in particular sub-Saharan Africa, remains the worst affected region, and that urgent and exceptional action is required at all levels to curb the devastating effects of this pandemic, and recognize the renewed commitment by African Governments and regional institutions to scale up their own HIV/AIDS responses;
    
11. Reaffirm that the full realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV/AIDS pandemic, including in the areas of prevention, treatment, care and support, and recognize that addressing stigma and discrimination is also a critical element in combating the global HIV/AIDS pandemic;
    
12. Reaffirm also that access to medication in the context of pandemics, such as HIV/AIDS, is one of the fundamental elements for progressively achieving the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health;
    
13. Recognize that in many parts of the world, the spread of HIV/AIDS is a cause and consequence of poverty, and that effectively combating HIV/AIDS is essential to the achievement of internationally agreed development goals and objectives, including the Millennium Development Goals;
    
14. Recognize also that we now have the means to reverse the global pandemic and to avert millions of needless deaths, and that to be effective, we must deliver an intensified, much more urgent and comprehensive response, in partnership with the United Nations system, intergovernmental organizations, people living with HIV and vulnerable groups, medical, scientific and educational institutions, non-governmental organizations, the business sector, including generic and research-based pharmaceutical companies, trade unions, the media, parliamentarians, foundations, community organizations, faith-based organizations and traditional leaders;
    
15. Recognize further that to mount a comprehensive response, we must overcome any legal, regulatory, trade and other barriers that block access to prevention, treatment, care and support; commit adequate resources; promote and protect all human rights and fundamental freedoms for all; promote gender equality and empowerment of women; promote and protect the rights of the girl child in order to reduce the vulnerability of the girl child to HIV/AIDS; strengthen health systems and support health workers; support greater involvement of people living with HIV; scale up the use of known effective and comprehensive prevention interventions; do everything necessary to ensure access to life-saving drugs and prevention tools; and develop with equal urgency better tools — drugs, diagnostics and prevention technologies, including vaccines and microbicides — for the future;
    
16. Convinced that without renewed political will, strong leadership and sustained commitment and concerted efforts on the part of all stakeholders at all levels, including people living with HIV, civil society and vulnerable groups, and without increased resources, the world will not succeed in bringing about the end of the pandemic;
    
17. Solemnly declare our commitment to address the HIV/AIDS crisis by taking action as follows, taking into account the diverse situations and circumstances in different regions and countries throughout the world;
    
    Therefore, we:
    
18. Reaffirm our commitment to implement fully the Declaration of Commitment on HIV/AIDS, entitled “Global Crisis — Global Action”, adopted by the General Assembly at its twenty-sixth special session, in 2001; and to achieve the internationally agreed development goals and objectives, including the Millennium Development Goals, in particular the goal to halt and begin to reverse the spread of HIV/AIDS, malaria and other major diseases, the agreements dealing with HIV/AIDS reached at all major United Nations conferences and summits, including the 2005 World Summit and its statement on treatment, and the goal of achieving universal access to reproductive health by 2015, as set out at the International Conference on Population and Development;
    
19. Recognize the importance, and encourage the implementation, of the recommendations of the inclusive, country-driven processes and regional consultations facilitated by the Joint United Nations Programme on HIV/AIDS and its co-sponsors for scaling up HIV prevention, treatment, care and support, and strongly recommend that this approach be continued;
    
20. Commit ourselves to pursuing all necessary efforts to scale up nationally driven, sustainable and comprehensive responses to achieve broad multisectoral coverage for prevention, treatment, care and support, with full and active participation of people living with HIV, vulnerable groups, most affected communities, civil society and the private sector, towards achieving the goal of universal access to comprehensive prevention programmes, treatment, care and support by 2010;
    
21. Emphasize the need to strengthen policy and programme linkages and coordination between HIV/AIDS, sexual and reproductive health, national development plans and strategies, including poverty eradication strategies, and to address, where appropriate, the impact of HIV/AIDS on national development plans and strategies;
    
22. Reaffirm that the prevention of HIV infection must be the mainstay of national, regional and international responses to the pandemic, and therefore commit ourselves to intensifying efforts to ensure that a wide range of prevention programmes that take account of local circumstances, ethics and cultural values is available in all countries, particularly the most affected countries, including information, education and communication, in languages most understood by communities and respectful of cultures, aimed at reducing risk-taking behaviours and encouraging responsible sexual behaviour, including abstinence and fidelity; expanded access to essential commodities, including male and female condoms and sterile injecting equipment; harm-reduction efforts related to drug use; expanded access to voluntary and confidential counselling and testing; safe blood supplies; and early and effective treatment of sexually transmitted infections;
    
23. Reaffirm also that prevention, treatment, care and support for those infected and affected by HIV/AIDS are mutually reinforcing elements of an effective response and must be integrated in a comprehensive approach to combat the pandemic;
    
24. Commit ourselves to overcoming legal, regulatory or other barriers that block access to effective HIV prevention, treatment, care and support, medicines, commodities and services;
    
25. Pledge to promote, at the international, regional, national and local levels, access to HIV/AIDS education, information, voluntary counselling and testing and related services, with full protection of confidentiality and informed consent, and to promote a social and legal environment that is supportive of and safe for voluntary disclosure of HIV status;
    
26. Commit ourselves to addressing the rising rates of HIV infection among young people to ensure an HIV-free future generation through the implementation of comprehensive, evidence-based prevention strategies, responsible sexual behaviour, including the use of condoms, evidence- and skills-based, youth-specific HIV education, mass media interventions and the provision of youth-friendly health services;
    
27. Commit ourselves also to ensuring that pregnant women have access to antenatal care, information, counselling and other HIV services and to increasing the availability of and access to effective treatment to women living with HIV and infants in order to reduce mother-to-child transmission of HIV, as well as to ensuring effective interventions for women living with HIV, including voluntary and confidential counselling and testing, with informed consent, access to treatment, especially life-long antiretroviral therapy and, where appropriate, breast-milk substitutes and the provision of a continuum of care;
    
28. Resolve to integrate food and nutritional support, with the goal that all people at all times will have access to sufficient, safe and nutritious food to meet their dietary needs and food preferences, for an active and healthy life, as part of a comprehensive response to HIV/AIDS;
    
29. Commit ourselves to intensifying efforts to enact, strengthen or enforce, as appropriate, legislation, regulations and other measures to eliminate all forms of discrimination against, and to ensure the full enjoyment of, all human rights and fundamental freedoms by people living with HIV and members of vulnerable groups, in particular to ensure their access to, inter alia, education, inheritance, employment, health care, social and health services, prevention, support and treatment, information and legal protection, while respecting their privacy and confidentiality; and to developing strategies to combat stigma and social exclusion connected with the epidemic;
    
30. Pledge to eliminate gender inequalities, gender-based abuse and violence; increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection, principally through the provision of health care and services, including, inter alia, sexual and reproductive health, and the provision of full access to comprehensive information and education; ensure that women can exercise their right to have control over, and decide freely and responsibly on, matters related to their sexuality in order to increase their ability to protect themselves from HIV infection, including their sexual and reproductive health, free of coercion, discrimination and violence; take all necessary measures to create an enabling environment for the empowerment of women and strengthen their economic independence; and in this context, reiterate the importance of the role of men and boys in achieving gender equality;
    
31. Commit ourselves to strengthening legal, policy, administrative and other measures for the promotion and protection of women’s full enjoyment of all human rights and the reduction of their vulnerability to HIV/AIDS through the elimination of all forms of discrimination, as well as all types of sexual exploitation of women, girls and boys, including for commercial reasons, and all forms of violence against women and girls, including harmful traditional and customary practices, abuse, rape and other forms of sexual violence, battering and trafficking in women and girls;
    
32. Commit ourselves also to addressing as a priority the vulnerabilities faced by children affected by and living with HIV; providing support and rehabilitation to these children and their families, women and the elderly, particularly in their role as caregivers; promoting child-oriented HIV/AIDS policies and programmes and increased protection for children orphaned and affected by HIV/AIDS; ensuring access to treatment and intensifying efforts to develop new treatments for children; and building, where needed, and supporting the social security systems that protect them;
    
33. Emphasize the need for accelerated scale-up of collaborative activities on tuberculosis and HIV, in line with the Global Plan to Stop TB 2006-2015, and for investment in new drugs, diagnostics and vaccines that are appropriate for people with TB-HIV co-infection;
    
34. Commit ourselves to expanding to the greatest extent possible, supported by international cooperation and partnership, our capacity to deliver comprehensive HIV/AIDS programmes in ways that strengthen existing national health and social systems, including by integrating HIV/AIDS intervention into programmes for primary health care, mother and child health, sexual and reproductive health, tuberculosis, hepatitis C, sexually transmitted infections, nutrition, children affected, orphaned or made vulnerable by HIV/AIDS, as well as formal and informal education;
    
35. Undertake to reinforce, adopt and implement, where needed, national plans and strategies, supported by international cooperation and partnership, to increase the capacity of human resources for health to meet the urgent need for the training and retention of a broad range of health workers, including community-based health workers; improve training and management and working conditions, including treatment for health workers; and effectively govern the recruitment, retention and deployment of new and existing health workers to mount a more effective HIV/AIDS response;
    
36. Commit ourselves, invite international financial institutions and the Global Fund to Fight AIDS, Tuberculosis and Malaria, according to its policy framework, and encourage other donors, to provide additional resources to low- and middleincome countries for the strengthening of HIV/AIDS programmes and health systems and for addressing human resources gaps, including the development of alternative and simplified service delivery models and the expansion of the community-level provision of HIV/AIDS prevention, treatment, care and support, as well as other health and social services;
    
37. Reiterate the need for Governments, United Nations bodies, regional and international organizations and non-governmental organizations involved with the provision and delivery of assistance to countries and regions affected by conflicts, humanitarian emergencies or natural disasters to incorporate HIV/AIDS prevention, care and treatment elements into their plans and programmes;
    
38. Pledge to provide the highest level of commitment to ensuring that costed, inclusive, sustainable, credible and evidence-based national HIV/AIDS plans are funded and implemented with transparency, accountability and effectiveness, in line with national priorities;
    
39. Commit ourselves to reducing the global HIV/AIDS resource gap through increased domestic and international funding to enable countries to have access to predictable and sustainable financial resources and ensuring that international funding is aligned with national HIV/AIDS plans and strategies; and in this regard welcome the increased resources that are being made available through bilateral and multilateral initiatives, as well as those that will become available as a result of the establishment of timetables by many developed countries to achieve the targets of 0.7 per cent of gross national product for official development assistance by 2015 and to reach at least 0.5 per cent of gross national product for official development assistance by 2010 as well as, pursuant to the Brussels Programme of Action for the Least Developed Countries for the Decade 2001-2010[2], 0.15 per cent to 0.20 per cent for the least developed countries no later than 2010, and urge those developed countries that have not yet done so to make concrete efforts in this regard in accordance with their commitments;
    
40. Recognize that the Joint United Nations Programme on HIV/AIDS has estimated that US$ 20 to 23 billion per annum is needed by 2010 to support rapidly scaled-up AIDS responses in low- and middle-income countries, and therefore commit ourselves to taking measures to ensure that new and additional resources are made available from donor countries and also from national budgets and other national sources;
    
41. Commit ourselves to supporting and strengthening existing financial mechanisms, including the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, as well as relevant United Nations bodies, through the provision of funds in a sustained manner, while continuing to develop innovative sources of financing, as well as pursuing other efforts, to generate additional funds;
    
42. Commit ourselves also to finding appropriate solutions to overcome barriers in pricing, tariffs and trade agreements, and to making improvements to legislation, regulatory policy, procurement and supply chain management in order to accelerate and intensify access to affordable and quality HIV/AIDS prevention products, diagnostics, medicines and treatment commodities;
    
43. Reaffirm that the World Trade Organization Agreement on Trade-related Aspects of Intellectual Property Rights does not and should not prevent members from taking measures now and in the future to protect public health; accordingly, while reiterating our commitment to that Agreement, reaffirm also that the Agreement can and should be interpreted and implemented in a manner supportive of the right to protect public health, in particular to promote access to medicines for all, including the production of generic antiretroviral drugs and other essential drugs for AIDS-related infections; and in this connection, reaffirm further the right to use, to the full, the provisions contained in the Agreement, the Doha Declaration on the Agreement on the Trade-related Aspects of Intellectual Property Rights and Public Health, and the World Trade Organization General Council decision of 2003 and amendments to article 31, which provide flexibilities for this purpose;
    
44. Resolve to assist developing countries to enable them to employ the flexibilities outlined in the World Trade Organization Agreement on Trade-related Aspects of Intellectual Property Rights, and to strengthen their capacities for this purpose;
    
45. Commit ourselves to intensifying investment in and efforts towards the research and development of new, safe and affordable HIV/AIDS-related medicines, products and technologies, such as vaccines, female-controlled methods and microbicides, paediatric antiretroviral formulations, including through such mechanisms as advance market commitments, and to encouraging increased investment in HIV/AIDS-related research and development in traditional medicine;
    
46. Encourage pharmaceutical companies, donors, multilateral organizations and other partners to develop public-private partnerships in support of research and development and technology transfer, and in the comprehensive response to HIV/AIDS;
    
47. Encourage bilateral, regional and international efforts to promote bulk procurement, price negotiations and licensing to lower prices for HIV prevention products, diagnostics, medicines and treatment commodities, while recognizing that intellectual property protection is important for the development of new medicines and recognizing the concerns about its effects on prices;
    
48. Recognize the initiative by a group of countries, such as the International Drug Purchase Facility, based on innovative financing mechanisms that aim to provide further drug access at affordable prices to developing countries on a sustainable and predictable basis;
    
49. Commit ourselves to setting, in 2006, through inclusive, transparent processes, ambitious national targets, including interim targets for 2008 in accordance with the core indicators recommended by the Joint United Nations Programme on HIV/AIDS, that reflect the commitment of the present Declaration and the urgent need to scale up significantly towards the goal of universal access to comprehensive prevention programmes, treatment, care and support by 2010; and to setting up and maintaining sound and rigorous monitoring and evaluation frameworks within their HIV/AIDS strategies;
    
50. Call on the Joint United Nations Programme on HIV/AIDS, including its co-sponsors, to assist national efforts to coordinate the HIV/AIDS response, as elaborated in the “Three Ones” principles and in line with the recommendations of the Global Task Team on Improving AIDS Coordination among Multilateral Institutions and International Donors; assist national and regional efforts to monitor and report on efforts to achieve the targets set out above; and strengthen global coordination on HIV/AIDS, including through the thematic sessions of the Programme Coordinating Board;
    
51. Call on Governments, national parliaments, donors, regional and subregional organizations, organizations of the United Nations system, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, civil society, people living with HIV, vulnerable groups, the private sector, communities most affected by HIV/AIDS and other stakeholders to work closely together to achieve the targets set out above, and to ensure accountability and transparency at all levels through participatory reviews of responses to HIV/AIDS;
    
52. Request the Secretary-General of the United Nations, with the support of the Joint United Nations Programme on HIV/AIDS, to include in his annual report to the General Assembly on the status of implementation of the Declaration of Commitment on HIV/AIDS, in accordance with General Assembly resolution S-26/2 of 27 June 2001, the progress achieved in realizing the commitments set out in the present Declaration;
    
53. Decide to undertake comprehensive reviews in 2008 and 2011, within the annual reviews of the General Assembly, of the progress achieved in realizing the Declaration of Commitment on HIV/AIDS, entitled “Global Crisis — Global Action”, adopted by the General Assembly at its twenty-sixth special session, and the present Declaration.

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