New hope for people living with AIDS
While the AIDS crisis continued to escalate throughout the year 2001, the countries of the world met in two different forums, for the first time coming to agreements that provide hope for those living with the disease and for those governments and organisations fighting the epidemic. In the first universal approach to combating HIV/AIDS, the General Assembly of the United Nations met in a Special Session in June this year to unanimously adopt a Declaration of Commitment on HIV/AIDS. The Declaration of Commitment is not legally binding on the 189 signatory countries, but rather is a "blueprint" setting rigorous timetables for countries to pass legislation and implement strategies to address medical, political, economic and human rights issues surrounding HIV/AIDS. In particular, the Declaration focuses on the need to protect the rights of people living with HIV/AIDS, educate youth and address the inequities suffered by women. For example, the Declaration sets a deadline of the year 2005 by which time countries must: * develop strategies to reduce HIV prevalence among young men and women aged 15-24 by 25 per cent, with the number of infants infected reduced by 20 per cent; * introduce legislation to protect and respect the rights of people living with HIV/AIDS to information, quality care, confidentiality and privacy; * provide education and reproductive health services to increase capacities of women and young girls to protect themselves from risk of infection; principally through gender-sensitive prevention; * and develop national strategies to ensure that orphans and children in families affected by HIV/AIDS are enrolled in school and have access to health and social services on an equal basis with other children. Poverty a major barrier The Declaration also clearly recognises: "that poverty, underdevelopment and illiteracy are among the principal contributing factors to the spread of HIV/AIDS". It notes: "with grave concern that HIV/AIDS is compounding poverty and is now reversing or impeding development in many countries and should therefore be addressed in an integrated manner." In support of the Developing nations in their struggle against the pharmaceutical companies, the Declaration recognises that the availability and affordability of drugs, and access to related technology are "significant factors to be reviewed and addressed", and that "the impact of international trade agreements on access to or local manufacturing of essential drugs and on the development of new drugs needs to be evaluated further". It recognised that the lack of affordable drugs was hindering the fight against AIDS in the poorest countries and, with a clear nod to countries like Brazil, South Africa and India, the Declaration stated it welcomed: "the efforts of countries to promote innovation and the development of domestic industries consistent with international law in order to increase access to medicines to protect the health of their populations". Stating the position that many Developing countries find themselves in, Guyanan Minster for Health, Dr Leslie Ramsammy said, "The hesitancy and slowness in granting debt relief is an ally to the scourge of HIV/AIDS in the world. "For countries such as Guyana, the real possibility that HIV/AIDS can destroy our already fragile economic base necessitates that debt relief is not merely the reduction of the debt burden, but forgiveness of our debts. "HIV/AIDS has begun to erode the significant social progress that Guyana has made in the last decade. Unless Guyana can urgently access additional funds, our capacity to introduce and sustain programs for surveillance, voluntary counselling, testing, capacity building for trained professionals, building of the health infrastructure and treatment, especially obtaining anti-retrovirals will continue to be severely limited. "If my country is to continue to survive as a viable nation, these new and additional resources must be found urgently." Gender equality vital Addressing the urgent need to elevate the status of women in society around the world, Geeta Rao Gupta, President of the International Centre For Research On Women said, "There can be no debate after this session about the role that gender inequality plays in HIV/AIDS... Gender inequality is now fatal. "Gender norms that restrict women's access to productive resources such as education, land, income, and credit, create an unequal balance of power in society... and greatly compromise women's ability to protect themselves against infection, cope with illness once infected, or care for those who are infected. "In the coming decade let us resolve that we will work harder to protect women's basic right to safety and bodily integrity; that we will reduce the gender gap in education; that we will improve women's access to economic resources, assets, and opportunities; "Let us resolve that we will invest in girls and women because it is the right thing to do and the smart thing to do for women, households, communities and entire nations — and because without that investment we will never contain this disease." Victory at Doha Hard on the heals of the Brazilian and South African legal victories, and armed with the backing of the United Nations, many governments and NGOs descended on the WTO Ministerial Conference in Doha, intent on overturning the severe restriction placed on them by the Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Taking the position of the UN Special Session to the WTO Conference, UNAIDS (Joint United Nations Program on HIV/AIDS) issued a statement saying: "The extraordinary scale of the AIDS epidemic and the glaring global inequity in access to HIV treatments calls for a radically new way of doing business based on the ethical imperative of ensuring that the fruits of science benefit all, including the poorest. "This new way of doing business must ensure that much needed innovation in HIV-related pharmaceuticals and technologies continues, while making new HIV medicines — including those under patent — truly affordable... "Global intellectual property rules must support, not undermine, the public health and development of poor nations, including the fight against AIDS." Although the TRIPS agreement itself was not actually amended in any way during the Doha session, a Declaration on Public Health adopted by the Conference was a clear victory. Mark Ritchie, President of the Institute for Agriculture and Trade Policy, described the win, "Over a decade of organizing by NGOs combined with strong efforts by several Developing country governments lead to the adoption of the special section, over the objection of the US, Switzerland, Germany and the United Kingdom. "Use of the current WTO rules of trade covering intellectual property rights, including patents, to impede public health objectives were specifically repudiated." The stated purpose of the Declaration was to provide "guidance for interpreting TRIPS and for Developing countries to use its public health safeguards to the fullest extent". The most significant outcome of the WTO Declaration was that Least Developed Countries were now allowed a blanket extension to the year 2016 before they had to offer patent protection to pharmaceutical companies. The original TRIPS agreement had obliged those countries to offer protection by the year 2006, with extensions only allowed on approval on a case by case basis. Also, while the WTO Declaration blithely insisted that the TRIPS agreement had always contained clauses that allowed governments to protect public health without fear of retribution, it now offered further "clarifications" on the issue, that included: * where TRIPS stated that countries could "adopt measures necessary to protect public health ..." the Declaration reinforced the primacy of public health interests. It stated that the TRIPS agreement "can and should be interpreted and implemented in a manner supportive of WTO Members' right to protect public health and, in particular, to promote access to medicines for all." * where the TRIPS agreement had always permitted governments to grant compulsory licences to manufacture essential drugs in the case of a national emergency, the Declaration "states this in more clear and plain terms so that WTO Members can issue compulsory licences with greater confidence and certainty". * where the TRIPS agreement used the term "national emergency", or "circumstances of extreme urgency", this was explicitly defined in the Declaration as meaning "public health crises, including those relating to HIV/AIDS, tuberculosis, malaria and other epidemics". "The huge profile given to the issue changes the political climate, building on the victories in the South Africa and Brazil cases," said Michael Bailey of Oxfam. "We would have liked to see stronger wording, but the declaration does have a clear political statement that public health concerns must override commercial interests." "Countries can ensure access to medicines without fear of being dragged into a legal battle", said Ellen 't Hoen of Medecins Sans Frontieres. "Now it is up to governments to use these powers to bring down the cost of medicines and increase access to life-saving treatments." Australia has been fortunate in the AIDS crisis, being one of the very few countries in the world where number of people infected with the HIV virus represents less than 0.2 per cent of the population. Progressive social policies implemented by State and Federal Labour Governments in the early 1980s — safe-sex campaigns, sex education in schools, needle exchange programs, and active outreach to workers in the sex industry — helped contain the virus. But Australia must not become complacent in the fight against HIV/AIDS, either domestically or internationally. We have a vital and urgent role to play in assisting other countries to replicate our success. Peter Piot, UNAIDS Executive Director says, "Humanity's future depends on how smart we are in working together, in pooling knowledge and in overcoming difference. So far, the evidence from AIDS is that we are not smart enough. "But I am confident that we are getting there."