Red Cross and Red Crescent Speech on HIV/AIDS, Human Dignity, Global Fund How to respond to the challenge of HIV/AIDS
Statement delivered by Juan Manuel Suárez del Toro, President of the International Federation, to the 58th Session of the United Nations General Assembly, New York.
22 September 2003
I speak today on behalf of the International Federation of Red Cross and Red Crescent Societies. The fact that over 100 Heads of State, Heads of Government and Ministers have come to the United Nations to speak on this subject is itself a testimonial of the growing awareness of the gravity of the situation. However, in our view, the debate would have been much more useful if we had also heard the voices of representatives from other civil society organisations. As the International Federation is the only international organisation represented here that has a civil society dimension, I therefore speak today with a great sense of responsibility.
Much has been said already about the social and economic impact of the HIV/AIDS epidemic, and the threat that it represents for security and stability in the world. The projections are truly frightening: HIV/AIDS will kill more people this decade than all the wars and disasters in the past 50 years. There is no doubt that the pandemic is a global disaster of catastrophic proportions.
But this simply must not become a cold debate around numbers and figures. Instead, we must make this an ethical debate, and move away from ethics of mere survival to the ethics of dignity. The fact that the discourse has turned into discussions on how much money is needed or what types of interventions we should or should not do is indecent, and an affront to the dignity of every person who is living with or has been affected by HIV/AIDS. Millions of people continue to suffer and die because of the epidemic.
And yet, even now, even after all we have seen and heard attitudes and policies continue to discriminate against people living with HIV/AIDS, impeding our efforts to halt the advance of the epidemic. We have to refocus the discussion back on to the issue of the impact of HIV/AIDS on human dignity. If we must speak of numbers, fine. But let us talk in terms of making the necessary investment in preventing and alleviating suffering and protecting human dignity.
The moment for debate is long behind us. There are no mysteries. We know what we need to do, and we know how to do it. And we know that we can defeat this terrible epidemic.
The Declaration of commitment on HIV/AIDS made at the special session of the UN General Assembly in 2001 was a call to the world to take urgent measures in the face of the HIV/AIDS crisis. The International Federation has taken that call very seriously, and has made the task of working against HIV/AIDS our top priority.
I believe governments, civil society and people all over the world know very well about the actions of the Red Cross Red Crescent have undertaken to combat the stigma and discrimination associated with HIV/AIDS, as well as our work in prevention, care and treatment. Our network, with over 180 National Red Cross and Red Crescent Societies, almost 100 million members and volunteers, and a presence virtually everywhere, makes the International Federation one of the world’s strongest allies in this struggle.
Allow me to share some reflections on the lessons learned, and the challenges ahead, not as a means to praise ourselves, but to demonstrate that so long as there is political will, any organisation large or small can transform itself and make a contribution to the struggle we have ahead of us.
There are four main lessons from our experience:
First, acknowledging that we in the Red Cross and Red Crescent also have AIDS.
Breaking the barriers of silence, stigma and discrimination within our own organisation is an ongoing task, but we have succeeded in making the Red Cross Red Crescent a more welcome home for persons living with HIV/AIDS. Today, we recognise that many of the most valuable resources we have in this struggle are themselves people living with HIV/AIDS. Our new workplace policies and access to treatment for our people have not just protected them as resources, but have created awareness and sensitivity, which is itself, a priceless asset and an example to the wider community.
Second, we cannot face the crisis alone.
We need to join forces and work together with other if we are to be successful. We have forged new partnerships with international organisations governments, and private sector companies. But our most important partnership is with the Global Network of People Living with HIV/AIDS (GNP+). This partnership is engaged at the local, regional and global levels, working together against stigma and discrimination.
Third, the fight against HIV/AIDS requires new models for action.
HIV/AIDS is a cross-cutting problem: its impact is even more devastating because of the complex interaction between HIV/AIDS and situations of conflict and disaster, poverty, food shortages, the lack of access to treatment and health services, and discrimination and stigmatization. We cannot propose to utilise the same methods as the past. We need to address the problem with innovative and integrated approaches to prevention, care and treatment that are grounded in preserving the dignity of every person affected by the epidemic. We call this approach ‘Not business as usual’, and have spoken of it many times, including at the recent sessions of ECOSOC and ESCAP. We urge all governments, and all donors, to match this effort, and to recognise that HIV/AIDS will not be defeated by a “business as usual” approach.
Fourth, if we hope to halt and reverse the spread of the epidemic, we need to massively scale-up the level of our actions.
In 2002, the International Federation spent ten times more in the fight against HIV/AIDS than we did in 1999, investing over $30 million USD on HIV/AIDS programmes. However, despite our successes, we recognise that there is still much more that we can and must do. It is clear that the full capacity of Red Cross and Red Crescent is far from fully utilised. Our experience with pilot projects in many countries has shown that if the resources were available, our actions could well be multiplied a hundred times over. We need to look into ways of building our capacity and reach, to realise the great potential of our network.
Let me turn now to the challenges ahead.
The Declaration of Commitment speaks of investing a minimum of $10 billion USD by 2005 for the response to HIV/AIDS to have an impact. Using the most conservative figures of the number of persons living with HIV/AIDS, those $10 billion USD represent only $250 per person, over three years. That’s much less than $1 a day per person!
Is this too high a price to pay to protect human dignity? Is this too much to restore hope and dignity to the millions of persons affected and living with HIV/AIDS? I am adamant that it is not. But we are far from reaching even this target!
Mechanisms like the Global Fund for HIV/AIDS, Tuberculosis, and Malaria (GFATM) is in serious danger because of the lack of resources. The Global Fund represents by far the best investment in the struggle to which we are all committed. Yet, despite many fine words it is in serious danger of faltering for lack of support. This must not be allowed to happen.
We join our voices with other organisations which have appealed for more meaningful support for the Global Fund. We call on all governments to honour their commitments to support the Global Fund, and in particular, to adopt funding mechanisms such as an Equitable Contributions Framework based on a county’s GDP in order to assure the long-term stability and sustainability of the Fund. This point is critical, as we know that response to the crisis must be sustained over many years to come.
Just as importantly, we need to understand what science and experience have taught us about HIV/AIDS, and apply it in our interventions. It is a clear and indisputable fact that the harm reduction approach does reduce HIV transmission. This means that governments and international organisations must incorporate proven and effective measures into their strategies - measures which give people the means they need to reduce risks and halt the spread of the disease. Hostility and punishment for people who are ill is not just inhumane, it is also a guarantee of policy and programme failure.
Finally, we know that access to treatment continues to be one of the most effective means to restore hope and dignity to people living with HIV/AIDS, as well as contributing to preventing the further spread of HIV/AIDS. Recently, there has been some promising news about access to antiretroviral medicines for those countries that most need them.
However, access to prevention and treatment programmes for the millions of people affected by HIV/AIDS continues to be one of the biggest challenges we face, especially for populations that are marginalised and discriminated against. The real measure of success for such initiatives will be seen at the community level. If we fail to reach the millions of people who need our assistance, then our efforts will have failed.
In this regard, the Red Cross Red Crescent and other civil society organisations can act as a bridge between governments and national health systems and persons affected by and living with HIV/AIDS. But this requires governments to recognise the value of working in partnership with organisations like the Red Cross Red Crescent, and making the necessary investment to support and build local capacity in order to reach those who need our assistance. As we said before, we cannot face this crisis alone.
We call on governments to build on the positive experiences and lessons learned from the Red Cross Red Crescent. Continue to build partnerships with the Red Cross Red Crescent, civil society. Recognise and support the valuable contribution of persons living with HIV/AIDS, so that their voices and their concerns are heard. Forge the link between policies at the national level and action at the local level. Eliminate stigma and the social attitudes and legal and policy barriers that so often discriminate against persons living with HIV/AIDS and other vulnerable and marginalized groups. Ensure that everyone, regardless of their circumstance or situation, has access to prevention, treatment and care programmes. If these commitments were to come from this United Nations Session, it would be possible to say that something useful had been done.
In December 2003, the International Conference of Red Cross and Red Crescent will bring together governments and the Red Cross and Red Crescent to discuss the theme of “Protecting Human Dignity”.
The International Conference is an excellent opportunity for the governments represented here today, as well as the Red Cross and Red Crescent to reaffirm our firm commitment to support the response to the HIV/AIDS epidemic, and to take concrete actions against the indignity that HIV/AIDS represents.