News: U.N. AIDS Special Session

U.N. UPDATE: DIM DECLARATION

2006-06-02T18:37:00.000-04:00

For version with photos, visit www.hwadvocacy.com/update.

As AIDS summit concludes, advocates fume over final document with no concrete treatment targets and vague prevention language

Afternoon showers thundered down today on the United Nations, where a three-day General Assembly Special Session on HIV/AIDS was drawing to a close—and where hundreds of people with HIV/AIDS and their advocates from all over the world were enraged over a final version of the summit's 5-year "political declaration" on global AIDS.

The final draft included absolutely no concrete targets for treatment or prevention through 2011—and referred vaguely to "vulnerable groups" (including injection-drug users and men who have sex with men) and proven prevention methods (such as needle exchange) without explicitly naming them.

A broad global coalition of advocates representing the summit's civil-society (NGO) contingent released this vitriolic press release denouncing African negotiators for breaking away from a continent-wide consensus position and siding with Egypt and South Africa in their opposition to concrete treatment and funding targets.

The evening before, during a formal ceremony called "Evening of Remembrance and Hope," about 50 civil society participants walked out during a musical performance to protest the declaration, chanting: "The Declaration must include treatment, targets, women and girls, harm reduction, vulnerable groups."

As guards herded them out, they chanted, "Silence equals death!" U.N. secretary-general Kofi Annan intevened before guards could strip them of their badges to the summit.

During plenary sessions today, health ministers from an array of nations—including Brazil, Argentina and the Netherlands—flouted the final declaration by boldly calling for concrete targets, and by naming the very vulnerable groups the declaration declined to.

U.S. MUSCLE

The civil-society bloc also denounced the U.S. for the powerful role it was observed playing to ensure as weak and non-commital a document as possible.
Civil-society participants Mike Kink of Housing Works, Kim Nichols of African Services, Eric Sawyer of ACT UP/NY and Paul Davis of Health GAP sat quietly in the chamber last night where delegates were hammering out the final version of the declaration.

According to them, U.S. negotiators successfully managed to water down language identifying trade agreements as a frequent barrier to affordable treatment for PWAS in poor nations—and to distance the document as much as possible from committing to UNAIDS' estimate of the $23 billion to fight AIDS worldwide between now and 2011.

"It's death by diplomacy," said Sawyer, veteran activist and 25-year survivor of HIV?AIDS. "Hour after hour, my government fought for its own selfish interests rather than for the lives of millions dying needlessly around the globe."

Delegates from Canada, the European Union and Latin America had called for the specific target of 80-percent roll-out of HIV treatment, prevention and mother-to-child-transmission-prevention by 2010. The final document merely endorsed the fuzzy concept of "universal" access to such services by that year.

When U.S. civil-society participants met this afternoon with chief U.S. negotiators including Ambassador Jimmy Kolker and Jason Lawrence, the negotiators said they stood by the final draft as a hard-won reflection of compromise among nations with very different priorities, including a forceful bloc of conservative Islamic countries.

Yet, according to HW's Kink, Lawrence later told him privately that the U.S. government had charged him and other negotiators with making sure that the declaration did not commit to the UNAIDS estimate of $23 billion needed globally to stop AIDS through 2011.

BRIGHT SIDE?

Amid laments from advocates over a document that would provide little concrete guidance in directing AIDS funding and policy over the next five years, there was scattered recognition of the declaration's bright spots.

Language endorsing condoms, sterile injection equipment and "harm reduction" (without going so far as to say needle exchange, a policy the U.S. government opposes and will not fund) remains intact from the original (and far more concrete) 2001 declaration.

In addition, there is strong and progressive language around most issues relating to women and girls, the way that the epidemic feeds on gender-related violence and discrimination, and the need to empower women, girls, and young people generally with sexual-health information and education.

Advocates agreed that language around empowering girls specifically might have been stronger if it weren't for robust opposition from Islamic nations including Syria, Egypt, Iraq, Yemen and Pakistan.

And U.S. advocates responded eagerly to a suggestion from Kolker that they meet on a quarterly basis with the government's Office of the Global AIDS Coordinator, represented at the summit by Dr. Mark Dybul.

The U.S. civil society team—which benefited from round-the-clock hard work from not only the groups named above but also from groups including Advocates for Youth, Student Global AIDS Campaign, Global AIDS Alliance, and International Women's Health Coalition—today joined the global civil society bloc for a debriefing and wrap-up.

Everyone agreed that the final declaration might have been even weaker if it hadn't been for their relentless pressure on negotiators. They also noted that the final declaration was vague enough for civil society to continue to lobby aggressively for specific targets in the years ahead.

Yet it was hard to escape the overall feeling of disappointment today among the civil-society bloc regarding a document that many had hoped would be a step up from the 2001 declaration that had started it all.

"I'm not happy with it," said Lindiwe Chaza-Jangira, national director of Zimbabwe AIDS Network, an umbrella advocacy group for hundreds of AIDS service groups in Zimbabwe. According to Chaza-Jangira, Zimbabwe reported recently that its AIDS rate, among the highest in the world, had recently dropped from about 25 percent of the population to 20 percent.

Then, getting to the source of her dismay with the declaration, she summarized a week's worth of dashed hopes in six words: "It doesn't tie anybody down."

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U.N. UPDATE: THE FINAL HOURS

2006-06-01T20:00:00.000-04:00

After delegates release improved declaration, summit-goers hunker down to the final details

Well, the revolt didn't happen. But don't exhale yet.

Last night, we reported that civil-society delegates (a fancy word for representatives of the worldwide AIDS community) were so disgusted with the "political declaration" on AIDS being drafted by national delegates at a big U.N. summit this week that they were threatening to walk out on the process. Many of their concerns were eloquently echoed in this New York Times op-ed they managed to get printed this morning.

Those so-called "CS" folks were slamming yesterday's draft of the declaration—which is supposed to set a course for fighting the pandemic through 2011—because it completely lacked concrete targets for treatment and prevention as well as explicit language on the importance of reaching out to "vulnerable populations"—a euphemistic catch-all for groups that conservatives worldwide would rather not acknowledge: men who have sex with men (sometimes called gays), injection-drug users, and sex workers.

The draft was so bad it actually was a step backward from the original 2001 declaration of commitment on AIDS, they were saying.

They were calling emergency meetings among themselves and with summit brass to demand substantive changes to the document...or they'd take the nuclear option and walk away altogether (even while summit poobahs were politely warning them not to...or they'd never be invited back and consequently have no role in the next process).

That's the note things started on at the U.N. this morning, with the international civil-society crowd huddled in a meeting room braced for battle. "We've only got 24 hours at the most to change things," Gregg Gonsalves of the International Treatment Preparedness Coalition told the crowd.

Everyone focused like a laser-beam on areas where language in the current draft was weakest, including on human rights (those vulnerable pops again) and gender; concrete targets for treatment access; and drug patenting vs. affordable generics.

Meanwhile, word leaked in that U.N. delegates would release a new draft in a matter of hours. That didn't stop the CS gang from plastering the U.N. with this press release and holding an 11:30am press conference to voice their ire.

Left to right, activists Olayide Akanni of Nigeria, Nkhensani Mavasa of South Africa, Nimit Tienudom of Thailand and Laura Villa Torres of Mexico held court at the conference, later joined briefly by Poland's Artur Lutarewicz, who spoke up for injection-drug use in Eastern Europe, which was fueling the epidemic there. The room was packed with journos and CS supporters.

Akanni said that the CS bloc was "worried we might come out of here with a very weak document." An AP journalist asked which countries were the biggest obstructors of concrete and progressive language. Islamic Egypt and Morocco had influenced Gabon to break from a previously brokered African consensus on things like the inclusion of vulnerable pops, answered Akanni—a break that even Nigeria's intervention couldn't fix. Syria was also an obstructor.

Other countries fingered included South Africa and Japan for opposing concrete funding and treatment roll-out goals.

After the press conference, Mavasa, who hails from SA's Limpopo province and is openly HIV-positive, told the Update that she felt that the belief among South African leaders, including the health minister, that HIV may not cause AIDS could be behind the country's opposition to clear targets. Why set treatment benchmarks if you doubt that the treatment works? was their reasoning, Mavasa mused, noting how depressed she felt over the lack of progress at the summit.

But then, only a few hours later, a new draft of the declaration began circulating. Back in their conference room, the CSers seized it and set to their analysis. In less than an hour, the room was packed—and a new inventory was taken.

Everybody agreed that much, if not all, of what they had asked for had finally made it into the draft. As in the 2001 document, vulnerable pops were at least mentioned, if not named. There was stronger language around the need to empower women, if not young girls (or, as the document put it, "the girl child").

The value of condoms (both male and female!), "evidence-based" prevention methods and "sterile injecting equipment" all made it in, even if methadone and buprenorphine "substition therapy" for heroin users did not, to the dismay of the Harm Reduction Coalition's Allan Clear.

The importance of allowing informed consent when testing for HIV made it in. So did the pledge to aim to stop gender inequalities and gender-based violence. So did a call for helping poor nations hold onto and increase their pool of healthcare workers.

An existing trade agreement (called TRIPS) that allows for public health to trump patent laws if necessary was also strongly "reaffirmed," although CSers wanted it to be "ensured" to make sure that low-cost generic AIDS and other key drugs are available in poor and middle-income nations. However, the word "generics" made it in as well.

By most people's estimates, that left the lack of specific targets around treatment and funding as the biggest problem. CSers wanted the declaration to basically commit to an 80 percent roll-out of treatment, prevention, and mother-to-child-prevention efforts by 2010—as well as to the sum of $23 billion by 2010 for all HIV/AIDS programs. Thus far, the document has vaguely called for "universal" treatment by that year.

But an hour after the new draft was released, in a briefing between CSers and reps from the U.S. delegation (including U.N. ambassador Jimmy Kolker, longtime advocate Jairo Pedraza and D.C. AIDS czar Marsha Martin), Kolker told the room flatly that "we cannot commit to funding"—the reason why the latest draft "recognized" the $23B mark but wouldn't promise it.

These were the issues that were still up in the air when the Update cut out of the U.N. around 4pm to get you this report. According to Kolker, all U.N. delegations were going to meet at 5pm to enumerate "the things they absolutely can't live with." This gave some relief to CSers, who were angry that U.N. leadership had been having "bilateral" meetings in semi-secret with different national delegations instead of convening them and putting the whole process out in the open.

And after the Kolker meeting? Suffice to say that everyone was hunkering down for a long and potentially arduous evening at the U.N., in order to have a final declaration ready to present tomorrow morning when the real poobahs arrive, including U.S. First Lady Laura Bush.

We'll be there to let you know the final result of this declaration, which is at once so unimportant (it's not international law, for God's sake) and so crucial in order to have at least some framework by which to plan and assess the world's work against the pandemic in the next five years.

No wonder that, everywhere you looked this afternoon after the new draft was released, all you saw were people with the document, parsing, marking up and strategizing. The final scrum happens tonight.

UNGASS UPDATE WED MAY 31: REVOLT?

2006-05-31T20:48:00.000-04:00

To read this story with photos, click www.hwadvocacy.com/update.

U.N. REPORT: THE BREWING REVOLT

As U.N. leaders ready final version of key AIDS document, advocates hint at walk-out if top demands aren't included

More than 1,000 protesters filled the streets around the U.N. today
The first official day of the United Nations General Assembly Special Session (UNGASS) was filled with anger, drama...and suspense. It started with a protest in the lobby of the office of U.S. ambassador to the U.N. John Bolton during which 21 people were arrested—most of them Housing Works staffers (no surprise there). It crested with a massive rally and midtown march of about 1,000 activists under the sweltering midday sun.

And as afternoon sank into evening, it erupted in barely polite fury, as a sizable bloc of people with HIV/AIDS and their advocates representing the so-called civil society (NGO) contingent of the summit demanded that summit leaders put key provisions in global-AIDS declaration they are working on—or face the embarrassment of a public walk-out of the summit's civil-society sector.

Advocates convened in the UNICEF garden to hatch a last-ditch plan
That anger coalesced this afternoon at an impromptu meeting of that civil-society bloc in the garden at UNICEF. There, it was decided that advocates had to dramatically pump up their own volume if they were going to make any difference in the declaration.

Tonight, the bloc is briefing an even larger contingent of the civil-society sector, drafting a press release of their demands—and planning to stage a press conference tomorrow morning at 10am.

As the Update went to press in the early evening, key civil-society reps were preparing for an emergency meeting with General Assembly (GA) leaders to express their outrage that the near-to-finished draft makes no mention of top demands from most advocates worldwide.

Those demands include: concrete targets for treatment and prevention by 2010 (specifically, 80 percent roll-out of a comprehensive treatment/prevention agenda); explicit mention of the need to target and protect so-called vulnerable populations at very high risk for HIV/AIDS (including men who have sex with men (MSM), injection-drug users (IDUs) and sex workers); stronger language linking an HIV/AIDS response to promoting sexual and reproductive health and fighting violence against women and girls; and a specific call for needle-exchange and condom distribution programs.

The finished draft, while not carrying force of law, will be used, like the original 2001 declaration, as a statement of commitment from world leaders on global AIDS for the next five years. Advocates describe it as something to hold world leaders accountable to. That is why they want it to include targets and language that is as specific as possible.

This morning, opening the summit, U.N. secretary-general Kofi Annan referred specifically to the so-called vulnerable groups, urging that nations reach out to them.

The boldest resistance to the above-mentioned provisions is coming from Islamic nations including Egypt, Yemen and Iran, yet—while leaders from several western nations including Canada have spoken robustly in defense of the provisions, members of the official U.S. delegation have been silent.

Today, rumors swirled that U.S. leaders were actually egging on Islamic leadership to hold its ground against any mention of such provisions.

Civil-society reps told the Update that the document nearing release was looking not only like no advancment over the original 2001 document, but actually a move backwards from it, as the original document at least included specific targets (such as treating 3 million people by 2005), even if they weren't met.

In a briefing with U.S. civil-society representatives today, Housing Works legislative counsel Mike Kink made a passionate call for the document to include specific benchmarks and targets as well as language on vulnerable groups. According to Kink, U.S. delegate Ambassador Jimmy Kolker in the office of the U.S. global AIDS coordinator bluntly responded that the U.S. didn't want to raise "false hope" by including targets that would not be kept, courting the rage of advocates worldwide.

Perhaps not knowing that most of those arrested in Bolton's building that morning were from HW, Kolker cited the protest and arrests as an example of how the U.S. is held solely accountable when internationally drafted promises are not kept.

DOWN TO THE WIRE

Early Wednesday evening, civil-society reps were wondering if U.N. leaders would yield to their last-minute outrage and hold up the document—or on Thursday would release an all-but-final draft with none of the desired provisions.

That second scenario seemed most likely to a civil-society rep from Africa who declined to give his name or country to the Update for fear that speaking out of turn would upset the (increasingly impolite) discussions between official delegates and civil-society types.

"It's been made clear that's there no new language going to be proposed," he said. "It's not going to happen. The ambassador from Thailand in particular"—one of the two GA co-chairs (the other is from Barbados)—"appears to be more interested in getting consensus than in actually facing the very real issues that people face."

"As I understand it, they're producing the final documents tonight," he told us, adding that, if the document went through without the called-for provisions, the civil-society sector would "if not boycott the declaration, then certainly we are going to express our dissatisfaction with not only the contents but the process. Civil society here appears to have been invited as window dressing, because none of our concerns are reflected in the draft that's currently being finalized."

Mathurot Chuladul of Thailand (but representing Irish civil society...don't ask, it's complicated!) said she felt somewhat more optimistic after an emergency civil-society meeting this afternoon with the Swedish ambassador, who is the GA president. "It went really well," she said of the meeting, adding that the Swedish ambassador had said it was "not possible" that official delegates would offer up "a take-it-or-leave-it situation."

She continued: "He told us, 'It's not going to stop there.'" He told us to keep fighting and talk to our [individual country] delegations to make sure that we don't settle for less. He seemed on our side. This could go two ways."

For that reason, everyone is holding their breath to see what kind of a draft GA leaders will release tomorrow. Will it be some last-minute reflection of what advocates want to see? We'll see...and keep you posted.

LOTS OF YELLING

While delegation leaders and some insider-y civil-society types conferred behind closed doors at the U.N., anger and demands raged outside in the streets all day long. It started at 9am, when 21 activists—most of them from Housing Works, but some also from ACT UP/NY and the Student Global AIDS Campaign—raised a ruckus in the lobby of the building on E. 45th Street where U.S. ambassador John Bolton keeps his offices.

No one was quite sure whether Bolton was in the building at the time, but that didn't keep the protesters—including HW president Charles King—from chaining themselves to one another in the lobby, demanding to deliver a letter to Bolton, unfurling a giant replica of the letter and singing and chanting riffs like "End AIDS Now!" for a good hour before police cut their chains and hauled them off to NYPD precinct #7 on the Lower East Side of Manhattan. By evening, the 21 were still being held—and may be held until noon tomorrow.

The civil disobedience action garnered ample media attention from wire services as well as from the local dailies and TV and radio stations.

The letter to Bolton took the U.S. to task for not holding to promises it made as part of the original 2001 declaration.

Douglas Sanders, HW executive administrative coordinator, was among those on the HW staff getting arrested for the first time. Asked why he was participating, the openly HIV-positive Sanders, who celebrated his 32nd birthday this weekend, said, "AIDS is killing people and the U.S. is not living up to the promises it made five years ago."

Only hours after the Bolton Bunch was carried away, actress Rosie Perez kicked off a 1,500-strong rally in Dag Hammarskjold Plaza across the street from the U.N. Organized by groups including African Services, Health GAP and Global AIDS Alliance, the rally—made up of both several hundred local and Philly/Baltimore-area people with HIV/AIDS and their supporters as well as a fair contingent of civil-society reps who left the U.N. proceedings to be part of the action—was meant to put pressure on the U.N. delegations to include the above-mentioned provisions as the draft deadline came down to the wire.

Speakers from five continents roused the crowd, a vast sea of white Tshirts with purple-lettered HIV-POSITIVE signs emblazoned across the chest—a tribute to the South African treatment activists who pioneered the Tshirts.

After the rally, the massive, jubilant crowd snaked its way to a noisy visit outside Uganda's mission to the U.N. There, the crowd loudly derided Ugandan leadership for backpedaling (under U.S. pressure, many say) on its once renowed condom campaign. "Uganda, we need condoms!" the crowd chanted and danced, with the help of an infectious drumbeat.

The Indian mission to the U.N. was next. There, South Asian activists rocked the mic as they jeered India's leaders for being poised to approve patents that will make much-needed second-chance AIDS drugs like tenofovir and lopinavir (Kaletra) highly unaffordable for countless PWAs in poor nations who need such treatments. "Jago!" cried the crowd...Hindi for "Wake up!"

The final stop brought activists once more outside Bolton's office to jeer the U.S.'s role in setting global AIDS policy.

By this point, rumors were already rocketing through the crowd that the civil-society sector back at the U.N. was pondering revolt.

"Maybe no declaration at all is better than a horrifying one," mused Jelle Houtsma, an openly HIV-positive rep from the Dutch civil-society delegation. He then elaborated on his frustration with the seemingly backwards-sliding document that seemed to be moving inexorably toward passage tomorrow in the majestic midcentury building on the East River just a few blocks away.

"That's why I'm here," he said, gesturing at the crowd around him, "instead of inside the building. This makes more sense. This is us."

48 HOURS TO SEND A MESSAGE

2006-05-30T19:30:00.000-04:00

As U.N. AIDS summit kicks off, activists from nations worldwide convene to focus priorities for multinational pledge

FROM BOTSWANA: Bagaisi Phaphe (left) and Grace Sedio

Today at the United Nations, delegates from U.N. member nations kicked off a weeklong summit with a high-stakes finale to take place Friday: the adoption of a political declaration aimed at mapping out a plan to reverse the HIV/AIDS epidemic in the next five years. The declaration is meant to be the follow-up to a declaration produced at the first such U.N. AIDS summit (or General Assembly Special Session) in 2001.

Few of the original declaration's goals were met. Three million people were not on HIV/AIDS treatment by the end of 2005, as the document pledged. The big question for this year's declaration: Will the final version include specific targets and timelines for an array of priorities, from treatment (the global demand is to treat 10 million people by 2010) to prevention to human rights?

Activists are calling the draft version circulating now too vague—and too silent when it comes to culturally controversial populations that are especially vulnerable to HIV, including men who have sex with men (MSMs), commercial sex workers (CSWs) and injection-drug users (IDUs).

FROM LATIN AMERICA: NGO members from the region work out priorities

Yes, it's all just words on paper, far from a binding law—but it's something to hold world leaders to in terms of responding to the global pandemic in the next five years, and for that reasons, people with HIV/AIDS and their advocates worldwide have a special stake in making the declaration as progressive and concrete as possible.

For that reason, hundreds of people with HIV/AIDS and advocates from non-governmental organizations (NGOs) and civil-society groups worldwide convened this morning at Cooper Union in downtown Manhattan to clump into regional contingents (pe continent, basically) and nail down the main messages they want to get to delegates from their countries as those countries, in turn, hammer out the final version of the declaration, to be released Friday.

Folks like this from NGOs have varying levels of access at various times to U.N. delegates from their countries. At times, they'll be able to sit down with them face to face to get across their demands, at other times, they'll have to nab them as they go in and out of closed-door meetings over the next 48 hours.

At Cooper Union today, people with HIV/AIDS and their supporters spoke to the Update about what they hope to see in the final proclamation.

FROM CAMBODIA: Moni Pen (left) and Dy Many

"We want to see greater involvement of civil societies in the final decision-making," said Bagaise Phaphe of the BONASO netowrk of AIDS organizations from Botswana. She and Grace Sedio of the International Community of Women Living with HIV said they also hoped that the proclamation would make sure that prevention and treatment were addressed comprehensively and not prioritize one over the other.

Dy Many and Moni Pen from Cambodia, who identified as women living with HIV/AIDS, said they wanted their government to enforce laws calling for treatment, care and support for people with HIV/AIDS.

Ramon Espacio, who said he'd been living with HIV for 23 years, said he wanted to see his country, Spain, give more money to the Global Fund to Fight AIDS, TB and Malaria—and to "export" its effective prevention strategies like needle exchange programs to Eastern Europe, where many are getting HIV through injection-drug use. "They have the same situation there we had 20 years ago," he said.

FROM SPAIN AND ZAMBIA: Ramon Espacio and Faith Jere

Sitting with him was Zambia's Faith Jere, a member of the country's Orphans and Vulnerable Children Advocacy Network.

From Albania, Genci Mucollari said he worked for the group Aksion Plus, which offered prevention and harm reduction. He sat with an HIV-positive woman who was the executive director of People Living with HIV/AIDS in Albania but said she couldn't risk having her name and picture on the Internet. "It's difficult in my country to speak openly" about having HIV, she said—a sentiment echoed by many at Cooper Union today who said that stigma and discrimination against people with HIV/AIDS remained one of the greatest obstacles to improving treatment, prevention and human rights for such people.

From Nepal, Surendre Pathak, Ashok Bikram Jairu and Rishi Raj Ojha all said they weren't HIV-positive but that HIV-positive folks were joining them in NYC tomorrow. "HIV infections are rising in Nepal," Jairu said. "People migrate to India to work and come back with HIV from sex workers. Then their wives get it, too."

After groups worked out their top messages to deliver to delegates representing their nations, they shared them with the assembled crowd at Cooper Union. The top messages delivered by the North American delegation were fairly in line with those delivered by other regions.

The demands included: 80 percent (10 million) of people worldwide needing treatment on treatment by 2010; 80 percent roll-out of prevention-of-mother-to-child-transmission treatment by 2010; a total of $23 billion in funding from all sources (public, private, individual) by 2010.

FROM ALBANIA: Genci Mucollari

Demands also included for the declaration to explicitly name vulnerable populations: MSMs, IDUs and sex workers and for the adoption of evidence-based prevention interventions: condoms, needles, and comprehensive sex education.

Demands also called for stronger human rights language to fight AIDS stigma and HIV-related violence and gender violence and to promote and defend sexual and reproductive rights.

The issue of sustainability of resources was also high on regions' list of priorities, from promoting poor nations' supply of health care workers to shoring up their health care infrastructures.

FROM NEPAL: (left to right) Surendre Pathak, Ashok Bikram Jairu and Rishi Raj Ojha

Intellectual property also was a priority issue, with regions calling for the declaration to support low-cost generic drugs through the TRIPS agreement and other mechanisms.

If there was one rallying cry for the day, it was for the declaration to include strong benchmarks and timeframes for all aspects, from treatment to prevention to human rights.

Tomorrow, as you may know, is when the activists really break out, with a huge rally at Dag Hammarskjold Plaza at 12:30pm as delegates enter the U.N. across the street. Housing Works will be there in force and we'll report on it right here in the Update after it happens! Wanna join in? Catch all the details at www.ungassaction.org.