Statement at the XV International AIDS Conference

Statement by Thoraya Ahmed Obaid, Executive Director, UNFPA

BANGKOK-It is a great honour to address all of you at the 15th International AIDS Conference in this wonderful and amazing city of Bangkok.

I would like to pay tribute to all of you participating in this event—especially those of you who are living with HIV/AIDS. Together and individually you have taken many important steps. You have been courageous in speaking out, and progress has been made.

We are making progress when global spending on HIV/AIDS has risen from $150 million dollars ten years ago to nearly $5 billion today.

We are making progress when a person can receive effective AIDS treatment for less than a dollar a day.

We are making progress when global efforts are underway to get life-saving treatment to 3 million people by the end of 2005.

And we are making progress when countries have one national AIDS action plan, one coordinating authority, and one monitoring and evaluation framework.

Yet, as we all know, this progress is not enough.

Despite local successes, such as here in Thailand, Uganda, Brazil and other countries—and some recent signs of growing commitment—national and international responses to the epidemic remain wholly inadequate.

Our collective efforts have failed the 3 million people who died of AIDS in 2003.

Our efforts have failed the 14 million AIDS orphans who have watched helplessly as their parents died before their very eyes.

And our efforts have failed the 5 million people who were newly infected last year.

As this Conference has made clear, AIDS is taking a terrible and increasing toll on young people, and on women. Among the most vulnerable are those who are poor, young and female.

The women and girls who are more vulnerable to HIV/AIDS are the same women and girls who are coerced into early marriage.

They are the same women and girls who die in labour after too many closely-spaced births.

They are the same women and girls who suffer from sexually transmitted infections and unwanted pregnancies.

They are the same women and girls who have unequal access to education and health care.

They are the same women and girls who are told that if they get married they will be safe from HIV and AIDS.

And they are the same women and girls who suffer in silence from violence and abuse and they are the same who are infected by their unfaithful husbands.

To make prevention work, we must confront the widespread poverty and gender discrimination and violence that help the epidemic to spread. And we must address these issues vigorously and simultaneously, cutting across sectors and through red tape.

Let me first talk about some of the basic areas where we need to expand efforts immediately to reduce the risk of transmission. For one thing, we must ensure that everyone knows how to avoid infection and has the means to do so.

We are living in the global information age, and yet millions of young men and women remain dangerously ignorant about their own bodies and how to protect their health.

Like most of you, I have heard that young people are the future. I have news for you: Young people are the present and we must support their leadership today. And that is why we have established at UNFPA a Youth Advisory Panel to inform senior management and to work with the various experts in the Fund on how to respond effectively and efficiently to the needs of young people in their various contexts and identities. We are also in the process of recruiting young people to work with our staff for programme development.

One of our youth advisers tells adults: “You say we are too young to know; we say we are too young to die.”

We must raise our voices in unison: We agree, you are old enough to know and you are too young to die. You have the right to life-saving information and services. You are the solution.

We know that education is absolutely central to an effective response.

Today I call on world leaders to ensure access for all to education. I also call on leaders to introduce school curricula that includes sexual and reproductive health and life skills education.

Study after study and our field experience show that young people are more likely to delay sexual activity and protect themselves when they have the information and skills to make informed decisions.

And finally, we must provide youth-friendly services that they have participated in designing and implementing. We must ensure access for all to services that include harm reduction for drug users. And we must ensure access for all to services to prevent unwanted pregnancy, and sexually transmitted infections, including HIV/AIDS.

My friends,

It is time for leaders and policymakers to stop arguing about the merits of condoms versus abstinence, because both are options for young people in different settings. They should have choices and be able to make their own informed decisions. And when they become sexually active, they must have access to HIV prevention services, which are not as simple as ABC.

We know that condoms are the single most efficient, available technology to reduce the sexual transmission of HIV. Condoms are the most effective prevention tool at our disposal and we must ensure that they are universally available as part of a comprehensive response.

Resource poor countries need an estimated 12 billion condoms each year and many rely on external assistance. But donors provide only enough funding for about 2.5 billion condoms. As a result, there is a serious shortage of condoms, which is a hazard to public health and a denial of the human right to health, the right to informed and voluntary choice.

Today I call on all leaders to close the condom gap and increase funding for these essential commodities.

At the same time, we must also increase access to female controlled methods of prevention, such as female condoms and the development of microbicides. We should promote them, subsidize them and distribute them more widely. It is matter of expanding choices and saving lives.

And we should increase funding for microbicides to get them through the research and trial phase and into the hands of women as quickly as possible. Making sure that women have life-saving tools such as female condoms and microbicides could change the course of epidemic.

I am proud to co-Chair the Steering Committee of the Global Coalition on Women and AIDS, which was launched officially this past February under the leadership of UNAIDS. The Coalition is a growing movement of people, networks and organizations to raise visibility and scale up action that will lead to concrete results. UNFPA is working with the Coalition to prevent HIV infection among women and adolescent girls. This commitment is directly linked to our work in 150 countries to advance sexual and reproductive health, women’s empowerment and gender equality.

World leaders agreed on these global priorities in 1994 in Cairo, at the International Conference on Population and Development. Today, ten years later, I call on world leaders to keep the promises made in Cairo. To make prevention work, we must ensure universal access to reproductive health and rights by the year 2015 as world leaders agreed.

Today the vast majority of HIV infections worldwide are sexually transmitted or associated with pregnancy, childbirth or breastfeeding. We must integrate HIV AIDS services and reproductive health care in ways that work for women and girls and that increase their access to these vital services.

We have built up an extensive reproductive health network. Let’s expand it to reach more women and men, and let’s use it more fully in the fight against AIDS.

All of the things I have mentioned so far—education, condoms, linking HIV/AIDS and reproductive health are critical for making prevention work. But we must go further. More than any other health crisis, AIDS has exposed the social and economic inequities that surround us and reside within us. To make prevention work, especially for women and girls, we must promote and protect their human rights. We must work within cultures to challenge the social norms that contribute to the lower status of women and girls and that condone violence against them.

Today, violence is a fact of life for too many women in all countries, in peacetime and in war.

Gender based discrimination and violence create an environment that allows and encourages HIV and AIDS to claim more lives.

We know that rape is a violation of human rights. But it is a double violation when rape leads to HIV infection. All rape survivors should have immediate access to counseling and treatment to prevent infection. UNFPA is working with partners to ensure that these services are more widely available, especially in conflict zones, where rape and sexual violence have reached alarming proportions.

To make prevention work, stopping violence against women and girls must be a priority. Laws must be strengthened and enforced. Perpetrators must be brought to justice. From the time they are on their mother’s knee, boys should be taught that this kind of behaviour is unacceptable. Today I call on leaders at all levels—including political leaders, traditional leaders, religious leaders and community leaders—to carry the message of zero tolerance of violence against women and girls forward.

My friends,

Human rights begin in the home and community, but ultimately it is governments that must be held accountable.

It is a sad commentary and an indictment of our inaction that in some places women themselves can be inherited, yet they cannot inherit land and property.

And in many cases, when they are found to be HIV positive, women are blamed for bringing the infection home; they are rejected and left penniless and homeless. And what is even more appalling is that in many cases their only risk factor was being a faithful wife. Today studies show in some places, young married women are at a higher risk than their unmarried peers. This is because they marry older more experienced men who may be infected and who refuse to protect their young wives by using condoms. It is time to dispel the myth that child marriages protect girls from HIV; we need to expose this practice for the dangerous risk that it is.

And let me make an important point:

We must stop blaming women for what goes wrong, when they are denied the power to make sure things go right.

The responsibility lies with men. I was on a panel a few days ago with a wise community leader from South Africa. He spoke passionately about ending male dominance and violence and being a supportive and caring father and husband. This is the environment and the relationships we must work together to expand. There are men who are leading the way and they deserve our full support.

Ladies and gentlemen,

I have outlined some key actions that are needed. But even as I make these sensible recommendations, I know that the real challenge is translating these recommendations into practical action that is guided by the realities of people’s lives and that gives them the leadership with our support to improve and save lives.

As we meet here in Bangkok, AIDS continues to cause horrible suffering and death. It is reducing economies to ruins, and collapsing nations into failed states. And if the devastation in Africa is not enough, we are now on the brink of a second wave of destruction from Asia to Eastern Europe and all the way to the Caribbean. Is not our failing to confront HIV and AIDS a crime against humanity?

Every person who dies from AIDS represents an individual and family tragedy, and it points to our collective failure.

There is no doubt that we have to think and do things in new ways. And we have to think big because the epidemic is growing bigger and bigger every minute.

We must all work together to scale-up our response.

If we don’t, then millions and millions will continue to die.

Ladies and Gentlemen,

Leadership is essential. Today some leaders are wide-awake and we should support their efforts. Some leaders are half asleep and some are in a deep slumber of denial. It is our collective job to wake them up to reality and demand effective action.

Increased resources are vital for resource poor countries. We need at least $10-12 billion a year. We need the Global Fund for AIDS, TB and Malaria to be funded in full. We need the Cairo agreement to be funded in full for universal sexual and reproductive health. All nations can do more.

To make prevention work, we must make the money work. We must build national capacity, institutions, structures and human resources.

We must ensure that resources and services reach the most vulnerable and marginalized people, and to do so we must support and strengthen community-based efforts and that includes local leadership, community groups, civil society and religious and traditional leaders.

In closing, I would like to stress that reducing inequalities is essential to making prevention work. We must reduce inequalities not only with regard to access to prevention, treatment and care, but also between men and women, and between rich and poor. As long as we continue to live in separate worlds—of the haves and the have-nots, of the powerful and the powerless—AIDS will continue to spread.

So let us come together and join forces. We must join forces to fight silence, stigma and discrimination.

Let us build on the resilience and leadership of women. Let us join hands with men and boys.

Let us build on the idealism, energy and full participation of young people.

Let us be guided by the experience and insight of people living with HIV and AIDS.

And when we demand universal access to prevention, treatment and care, we must also demand universal access to human rights and equality.

Thank you.