Gandhi on AIDS at UNGASS

[Guest guest]

Statement by Her Excellency The Honorable Mrs. Gandhi,

Member of Parliament and Leader of the Opposition,

Lok Sabha, Parliament of India

The Twenty-Sixth Special Session of the UN General Assembly on

HIV/AIDS. New York. June 26, 2001

Mr. President,

This is the first time the General Assembly is holding a Special

Session on an epidemic. But HIV/AIDS is now much more than

a serious public health problem, it poses a grave economic and social

challenge to the world. We endorse the Secretary

General's call for global, regional and national level initiatives to

meet the challenge, and we thank him and you, Mr. President,

for the initiative to call this Special Session.

HIV/AIDS was the scourge of the 2Oth century. Sub-Saharan Africa has

borne the brunt so far, but its ravages are beginning

to be felt in Asia and elsewhere. Asian countries still have low rates

of infection, but because our populations are large, even a

small increase in the rate translates into millions of cases. We

cannot have, particularly in Asia, the high prevalence rates now

seen in Africa. The Declaration we adopt must, therefore, address the

needs of all countries with a high burden of disease.

The thrust of our global effort should be on prevention, not

restricted to the high-risk groups, but reaching out to all sections

of the population in affected countries, particularly vulnerable

groups like students, youth, migrant workers, rural women and

children. Large scale prevention programmes can only be put into

operation by involving community representatives and

grass-roots democratic institutions, and with them, leaders from

social, cultural and faith-based groups. The aim should be to

bring about a behaviourial change among people at large.

Addressing the crisis in resource-poor developing countries needs

strategies totally different from those followed in the

developed world. Developing countries need strategies rooted in their

socio-cultural environment, with communication

strategies tailored to the sensitivities of people in traditional

societies. Governments must lead the response to the challenge

posed by HIV/AIDS. Civil society has an important part to play, but

where it is weak or ill-organised, Governments have an

even more crucial role. In India, we have an all-party consensus on

this issue, demonstrated by my speaking to you, as Leader

of the Opposition, on behalf of my country.

In India, we also have a rigorous and scientific methodology to

monitor prevalence levels in the general population. Working

estimates indicate that the Indian programme, which has encouraged

decentralisation and multi-sectoral involvement, has

prevented a runaway spread of infection, produced a quantified

increase in awareness levels by accessing individual households

and led to a substantial reduction in the risk of transmission through

blood transfusions.

While prevention is paramount, care and support for those infected

cannot be secondary in importance, or restricted only to the

provision of medical services. Social and emotional support from the

family and the community at large are vital. Prevention and

care must therefore be made mutually reinforcing strategies in a

control programme. We advocate a strategy, involving NGOs

and civil society, to offer a continuum of care from the provision of

voluntary testing and counselling services to hospital-based

treatment, and drugs for opportunistic infections.

Developing countries with a high incidence of HIV/AIDS also have a

high disease burden, spread through several other

communicable diseases like malaria, tuberculosis and leprosy.

Governments have to ensure that resources, always scarce, are

equitably allocated to all patients. Within these constraints,

countries like India are trying to channel the most resources to

HIV/AIDS, with a strong programme-focus on prevention.

The introduction of antiretrovirals in a national programme, however,

is a special challenge. In India, even at the reduced price

announced by some drug manufacturers, the cost of antiretroviral

treatment would be a hundred and fifty times more than the

per capita expenditure on health care provided by the Government. Such

a large allocation of funds for a programme of

palliative treatment would skew the distribution of resources between

key components of our public health initiatives. Nor can

the limited resources available for HIV/AIDS control programmes be

diverted from prevention to financing antiretroviral

treatment, when global evidence shows that a slackening of prevention

leads to a resurgence of infection levels. Antiretrovirals,

therefore, can only be widely used in the developing world if very

substantial additional resources are assured through

international funding over at least a decade, to start with.

This brings us to the issue of additional resources. Of the three

factors identified in the Secretary General's Report - leadership,

coordination and resources – resources are the most important and

critical. What makes this Special Session so topical is the

recent commitment to create a global mechanism to fund HIV/AIDS

programmes in developing countries. The norms of

eligibility for this global fund must be flexible, its resources

equitably apportioned, and it should be designed to serve the needs

of all regions of the world carrying high burdens of disease.

A definitive solution to the problem of HIV/AIDS will come about only

through the development of potent therapeutic drugs

and vaccines. The time-frame for their development is uncertain. If

the HIV-infected are to benefit, research must be financed

by international funding, so that the product, when available, is in

the public domain, for use by all in need.

In conclusion, Mr. President, I would like to assure you of our deep

commitment in India at the highest political level to do

everything we can to control this epidemic. We have to control it

before it overwhelms us.