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UN AIDS goals ignore gay men, sex workers

Critics say US has watered down prevention initiatives

A special United Nations assembly on AIDS in the developing world has refused to specifically acknowledge that men who have sex with men, drug users and sex workers are especially at risk for the disease.

The final declaration agreed to by the assembly, which concluded Jun 2, referred only to “members of vulnerable groups.” The original 2001 UN declaration on AIDS mentioned specific vulnerable groups.

“This is a step backward. It’s a very bad sign in that it’s a form of denial, and denial is what’s killing us,” says Joanne Csete, the executive director of the Canadian HIV/AIDS Legal Network and a member of the Canadian delegation. “It doesn’t bode well for the flow of aid to these groups. It also bodes ill for the meaningful participation of those groups.”

Csete and other members of Canadian and international AIDS service organizations say the declaration also falls short in protecting the rights of women and girls and in addressing sexual and reproductive rights. Those delegates also say the declaration sets financial targets that are far too low, calling for an annual investment of $20US to $23US billion per year by 2010. Delegates from AIDS organizations and the UN’s own agencies on AIDS say that annual investment needs to be as high as $38US billion a year by that date.

The declaration also fails to call for an increase in development aid or to set specific treatment targets and commitments.

Csete says the world political environment has become less open to progressive policies on AIDS.

“I think that the political environment is more difficult now because of the presence of conservative governments. I’m thinking mostly of the Americans, of course.”

However, delegates say the new declaration does make progress in several areas.

“There is language this time that talks about food and nutritional support,” says Michelle Munro, the program director for HIV/AIDS for Care Canada and an assembly delegate. “Where we work, it’s poverty and hunger that’s both a cause and a consequence of HIV/AIDS. I’ve seen people die over the course of three to six months.

“And they did get some reasonable language about violence against women in there.”

Munro says the declaration also talks about comprehensive protection for youth, including allowing — though not promoting — the use of condoms.

Conference delegate Michael O’Connor, the executive director of the Ottawa-based Interagency Coalition On AIDS And Development, says he is pleased about the support of some prevention initiatives.

“There are two references to vaccines and microbicides, references to financial support. It’s an important investment.”

O’Connor also lauds the declaration’s support for some new financial initiatives, particularly a proposal by the European Union to add a tax to airline tickets to fund programs to fight HIV/AIDS, tuberculosis and malaria.

But Munro says she is particularly disappointed about the lack of language guaranteeing the rights of women and girls, a failure she says is attributable in part to some Islamic countries.

The new declaration calls on countries to “promote gender equality and empowerment of women; promote and protect the rights of the girl child in order to reduce their vulnerability to HIV/AIDS.”

Munro says such language doesn’t give women power over their own lives.

“It’s giving someone else the responsibility to take care of them, according to their own views and customs. We feel that certain rights are inalienable and everyone should have them.

“There also isn’t anything about choice and family planning. That isn’t there.”

But Munro says her biggest concern is that the declaration does very little to set specific targets for governments to follow, even allowing governments in developing countries to set their own benchmarks for access to treatment and number of people on medication.

“It’s shirking from setting targets again. It’s harder to hold someone accountable when they haven’t said what they’re going to do.”

O’Connor says the biggest lack of a commitment is in terms of international development aid. The UN has called for countries to contribute 0.7 percent of their gross national product (GNP) to international aid.

“It doesn’t come across as being a global emergency. The statement’s pretty watery. It doesn’t say that countries commit to international development. There’s no reason that the whole world is not at 0.7. It’s member states that are not delivering, including Canada that is not at 0.7.”

But O’Connor praised the work of Canada’s government-controlled negotiators at the assembly.

“They were really pushing in the negotiating forum as best they can.”

Munro agrees.

“I’ve actually felt quite positive at Canada’s interventions. They’ve really gone to bat and fought for vulnerable groups.”