Breaking the barriers - partnership to fight HIV/AIDS in Europe and Central Asia

Dublin, Ireland
23 February 2004

Excellencies, colleagues, ladies and gentlemen,

I would like to invite Anastasia of Belarus to the World Health Assembly in May, to deliver the same message.

In Eastern Europe and Central Asia there has been a fifty-fold increase in infections in the space of eight years - from 30 000 people in 1995 to 1.5 million now. Each of these 1.5 million has a face and a story. They are not just nameless numbers. This is the fastest rate of infection in the world at present - first seen in Ukraine and Russia, more recently in the Central Asian Republics of Kazakhstan, Kyrgyzstan and Uzbekistan.

The rapid spread of a lethal disease requires the most effective control measures that exist. Until recently, for HIV/AIDS, this meant prevention, especially through health information and education, and care. Now, the full set of control measures is available: prevention, treatment and care. Effective AIDS medicines that restore patients to normal life now exist and are affordable. This is common knowledge. They have to be made available to the people who need them, or they will die during the next five to ten years.

Where treatment is not available there is little incentive to come forward for testing and counselling. Where people do not know that they are HIV-positive, and are uninformed about risk avoidance and unequipped for it, the rate of transmission continues to accelerate.

Lack of access to treatment means that parents are dying, leaving behind them orphans exposed to the diseases of poverty, which include HIV/AIDS. In sub-Saharan Africa, schoolteachers, doctors, health workers and other workers on whom communities depend for their well-being are also dying. These deaths accelerate the vicious cycle of poverty increased by disease and disease increased by poverty.

When communities are destroyed, the survivors are forced to migrate to where there are more resources and better chances of survival. Those who are sick move, when they can, to where treatment is available. In short, universal access to antiretroviral treatment is not an idea or an option but a necessity. The question of how quickly it can be achieved is important, but it will only be answered by doing everything possible now to make the delay as short as possible.

We strongly endorse the European goal of getting antiretroviral therapy to 100 000 people by 2005, as the first step towards universal access in Europe and Central Asia by 2010. We applaud the strong commitment by the EU and Ireland to HIV/AIDS and we also applaud actions by the US on HIV/AIDS. WHO, UNAIDS, the Global Fund and our other partners are fully supporting this effort in the context of getting three million people worldwide onto antiretroviral therapy by the end of 2005. Perhaps more people can be reached in that time, perhaps fewer, the numbers matter only as an indicator of what to aim for. What absolutely matters is that everything possible must be done now to start and accelerate the trend towards universal access to treatment.

We have done the groundwork of developing simplified and standardized tools for HIV testing and treatment. We are deploying emergency teams for six-eight weeks in over twenty countries around the world, among them Russia and Ukraine, to scale up national AIDS treatment plans. They will also be helping to prepare Round 4 applications for funding from the Global Fund to Fight AIDS, TB and Malaria

I urge all countries, regions and organizations represented here today to give their full support to this effort. The Global Fund needs more contributions so that it can get the financial resources to where they are needed. More funding for countries is needed, but so is funding for the technical assistance that can turn the available money into effective AIDS programmes. I urge Ministers from donor countries to increase their funding for HIV/AIDS.

The people of Europe have the means at their disposal to stop the spread of this disease and restore the health of those suffering from it. Prevention, care and treatment can and must be made available to all who need them. This is still achievable in Europe and central Asia at comparatively low cost. We cannot afford to miss this opportunity.