Message from the Director-General

1 December 2005

Today, World AIDS Day, I want to re-introduce two young women whom you may have met once before. Their stories illustrate the pain and the hope of a life lived with HIV.

I met the first, Carolina Pinto, in August 2003 when I travelled to Angola and met with people living with HIV. Carolina was then 20 years old and bravely speaking out to the African media - despite the strong discrimination against people living with HIV. Her aim: to teach people about preventing disease and to challenge us to do more to stop the death toll.

She was one of the fortunate ones - she had access to antiretrovirals. At that point only one centre in the whole of Angola offered some treatment, but even that was not secure. She told me that she was afraid for her future, that she didn't know where the therapy was going to keep coming from. She passionately wanted a life, to become a mother and to study and become a doctor. What I learnt in that visit from Carolina and others shaped my determination to tackle the barriers to access to ARVs.

Two years ago, WHO and UNAIDS launched the "3 by 5" strategy - to provide HIV therapy to 3 million people in low- and middle-income countries by the end of 2005.

There have been remarkable successes. In just 18 months, the number of people on antiretroviral treatment in Africa and Asia has tripled. More than 1 million people in the developing world now have access to antiretroviral therapy.

We talked to Carolina again this week and she again went straight to the point.

She told us that, although there has been some progress, access is still a real problem in her country. Carolina said that most people from the provinces can't afford to come to Luanda for treatment, and their families refuse to house them.

Some of Carolina's hopes have been met in the last two years - she has a young son. She is still on treatment - although it's now bought from Brazil, and paid for by friends, because she became resistant to the first line drugs.

But there is so much still to fight for. She said "All this insecurity prevents me from finding peace. I would like to study, but I don't see how I can with all these worries. Most of these worries aren't even about me." Carolina is desperate to survive - more than that - to live. She wants to bring up her son and be able to share a long life with her husband. But she doesn't plan to stay at home. She has a lot to say - and does, working with others to promote information and education, changing mindsets through working with the media, using television, personal stories, and individual statements to get the messages across.

She wants universal access for everyone who needs treatment. So do I. So do the G8, and all of the countries at the World Summit in New York this year. This is what "3 by 5" started. This is what we have to achieve.

Today in Lesotho a campaign begins to offer HIV testing and counselling to all households by end 2007. This massive scale-up of services is also being seen in other high-burden countries such as Botswana and Swaziland. The growing availability of affordable AIDS treatment in these and other developing countries is transforming the fight against AIDS.

My second story comes from a lady who spoke to us at the World Health Assembly two years ago. Anastasia Kamylk. Here she is, challenging us to act, in May 2004.

" How many more meetings and conferences must be held before people living with HIV in each individual country begin receiving proper treatment and start to live without fear of what the morrow will bring, or of their own future? When will we stop counting the losses? The World Health Organization’s "3 by 5" initiative is one real way of starting to count the number of lives saved and to reduce AIDS mortality…"

Because of "3 by 5", and the tireless work of people like Carolina and Anastasia, I think we are now able to start counting the number of lives saved.

But that doesn't mean that we can feel comfortable about our progress. It's still too little.

And for so many, already too late. That is the pressure on us all - to find the fastest and most effective ways to get rid of the bottlenecks to access, increase people's understanding about AIDS, and get treatment and prevention programmes working hand in hand.

One of those ways is through using grassroots organizations led by HIV-positive people who can teach others about prevention, treatment, and care. This approach promises to be a key way forward. Community involvement is already taking treatment to the most remote, resource-poor settings. The campaign in Lesotho will use extensive community mobilization and education, with "people's committees" established at local, district and national levels.

For the last two years, Anastasia - originally from Belarus - has been working in the Russian Federation, as the regional coordinator in one such collaborative organization. She's still feeling well, and has starting to study at University. She's found a way to live positively despite being infected, and despite knowing, as she said so memorably before, that her life will one day be dependent on the power of drugs to keep death away, from her, and from her young family.

"It is only now I know that with HIV a person can live life to the full. It is only now that having met during the past seven years so many HIV-positive individuals who are taking antiretroviral therapy, that I realize that medical drugs really do pull a person back from the grave. I know that I can love, raise a family and give birth to a healthy baby. But to this very day I am also tormented by the fear that in my hour of need in the future, I may not obtain what will save my life or the life of my child."

That awareness has given her both the drive to fight for the right to treatment, and the urgency of working as a leader with those who can most productively teach and help others. Like all those who are living with HIV, she has a strong sense of her own mortality. Living with death postponed sharpens the urgency to make the most of skills and the time left. Anastasia got in touch again last week.

This was her message:

" It is important to understand what you really want in your life and never stop moving to that goal.
Sometimes make a stop.
Come to your children, friends, family members, lovers and tell how much you love them. Tell them.
Don't assume they know."

Anastasia reminds us how important it is to make the most of what we have. Hers is a very personal message. But it also works in a wider sense, to remind us of the other goals we must strive for in our work to support people like Carolina, people like Anastasia. Her message of two years ago is as fresh and valid now as it was then. It is a challenge to us to fulfill her vision - which we share- of respect for the dignity of each human being, and their right to care.

She said that every human being is worthy to receive medical care when needed, and every individual is entitled to receive it, whether suffering from HIV/AIDS or some other illness.

Thank you.