Despite global gains in the fight against the HIV and AIDS epidemic, some 1,800 young people a day were being newly infected with the virus and prevention rates among adults around the world had stalled, the General Assembly’s President said today.
Peter Thomson, in his remarks at the start of a debate that reviewed international progress towards achieving a world free of the virus by 2030, commended notable advancements, as well. He said that antiretroviral medicines had become significantly more available to those who needed them and that there had been a decline in the number of babies born with HIV.
However, he continued, ending the epidemic by 2030, a goal the international community pledged to last year with the signing of the Political Declaration on Ending AIDS, required a comprehensive approach. It would require ensuring access to education, information and services to people living with HIV and to those groups most at risk.
It was also important to combat the stigma attached to those living with HIV and groups at risk including men who have sex with men and transgender persons, and people who inject drugs, he said. Bringing together the power and cooperation of all stakeholders would help build synergies and progress in the fight against the epidemic. To that end, he urged Member States to fund the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other programmes that aimed to meet those objectives. It was particularly crucial to close the $7 billion funding gap for the global AIDS response.
“The AIDS pandemic is far from over,” Amina Mohammed, Deputy-Secretary-General of the United Nations, warned. She stressed that young women and adolescent girls, most notably in sub-Saharan Africa, were particularly vulnerable. The region had a high rate of infection, lagged in testing and remained behind in HIV treatment. Addressing such concerning gaps required the integration of HIV into sexual reproductive programmes. She highlighted the critical role of communities in coming up with solutions and encouraged Governments to listen closely to what they had to say. “If we do that, we will truly be able to end AIDS,” Ms. Mohammed added.
She also urged Member States to heed the call to reach the targets of the 2030 Agenda for Sustainable Development and highlighted the need to establish within the United Nations system, and particularly UNAIDS, a culture of accountability that focused on people rather than bureaucracy. Ending AIDS fit squarely within the 2030 Agenda, whose goals and targets reinforced efforts to eradicate the virus.
Echoing a similar sentiment in the debate that followed, Gambia’s representative, speaking on behalf of the African Group, said that poverty and unemployment aggravated HIV and AIDS. The AIDS epidemic was indeed disproportionately affecting sub-Saharan Africa, with Eastern and Southern Africa home to half of the world’s people living with HIV.
Throughout the morning debate, speakers called for a redoubling of global efforts to ensure access to affordable drugs, address the particular vulnerabilities of women and girls, and to boost the international cooperation to the epidemic through UNAIDS and other United Nations programmes.
Norway’s speaker said that, with the female prison population rising globally, HIV prevalence rate among female inmates was much higher than those outside of jail. Many children were born in prisons, and yet there were no systems in place to prevent HIV transmission, or to even monitor transmission in such cases.
Some speakers noted good news, with the representative of India reporting that new infections in his country had declined by 66 per cent from 2000 to 2015. He credited the achievement to collaboration among Government, communities and people living with HIV, and civil society. Reaching “the last mile” would require laws that addressed discrimination and fight stigma in education and the workplace.
Several other speakers also emphasized the need to fight discrimination and stigma, with the delegate from Kenya, where 1.5 million people lived with HIV, said that the Government had launched a “Kick Out HIV Stigma” campaign that sought to engage youth through county football leagues. Colombia’s delegate called stigma a determining factor, which often compounded vulnerabilities, and expressed concern that “someone living with the virus could be rejected by their family or from their job”.
Speakers from developing countries urged developed countries to keep up with their financing of the HIV and AIDS global response. The representative of France, stressing the need for innovative and ambitious funding solutions, said a tax on airline tickets and financial transactions had enabled her country to cover nearly 60 per cent of the annual budget of the international drug purchase facility UNITAID. She went on to say preparations should be made for middle-income countries that would no longer be a part of international financing mechanisms, given that more than half of those living with HIV were in those countries.
Some Member States, although backing global efforts to end AIDS, also said countries should be able to deal with the epidemic as seen fit for their needs. The representative of the Russian Federation said he did not agree with some provisions of the Secretary-General’s report on reinvigorating the AIDS response, which the Assembly had before it. Emphasizing the need for a balanced response that reflected cultural and religious specificities, he said it was perplexing to consider that the criminalization of drugs and drug use was a barrier to AIDS-related services. Punishment for drug-related crimes was the prerogative of States.
Also today, the General Assembly elected Chairpersons to its six committees as follows: Mouayed Saleh (Iraq) to its First Committee (Disarmament and International Security); Sven Jürgenson (Estonia) to its Second Committee (Economic and Financial); Einar Gunnarsson (Iceland) to its Third Committee (Social, Humanitarian and Cultural); Rafael Darío Ramírez Carreño (Venezuela) to its Fourth Committee (Special Political and Decolonization); Tommo Monthe (Cameroon) to its Fifth Committee (Administrative and Budgetary); and Burhan Gafoor (Singapore) to its Sixth Committee (Legal).
The Assembly also appointed Steve Townley (United Kingdom) as a member of the Committee on Contributions for a term beginning on 1 June and ending on 31 December — as recommended by the Fifth Committee.
Also speaking today were the representatives of Philippines (on behalf of the Association of Southeast Asian Nations), Bulgaria, Switzerland, Botswana, Lichtenstein, Namibia, Argentina, Brazil, Canada, Hungary, Kyrgyzstan, Indonesia, Luxembourg, United States, Mexico, El Salvador and Japan, as well as the European Union.
PETER THOMSON (Fiji), President of the General Assembly, said that, while major advancements had been made, including scaled-up access to antiretroviral treatments, and a decline in the number of children born with HIV, the scale of shortcomings remained deeply concerning. HIV prevention rates among adults around the world had largely stalled, with the number of new infections actually increasing in some regions. Some 1,800 young people a day were being newly infected with the virus, with young women at particular risk. Ending the epidemic of AIDS by 2030 required a comprehensive and inclusive approach, he added, stressing the need to provide education, information and services to people living with HIV and to those at risk.
It was particularly crucial to combat stigma and discrimination against people living with HIV and populations at higher risk of infection including sex workers, men who have sex with men, transgender persons and people who inject drugs, he continued. Harnessing the power of all stakeholders would help meet the global challenges through strengthening already established strategic partnerships, as well as creating new ones. It was important to leverage the integrated nature of the Sustainable Development Goals by building on the synergies between the global AIDS response and efforts to achieve universal health coverage. Adequate funding remained critical to meet the objectives, he added, emphasizing the need to close the $7 billion funding gap for the global AIDS response.
AMINA MOHAMMED, Deputy-Secretary-General of the United Nations, said achieving the aim on AIDS was linked with the greater 2030 Agenda for Sustainable Development. “The AIDS pandemic is far from over,” she warned Member States, expressing concern at the lack of decline in the number of new annual infections. People with HIV and those groups particularly at risk must have access to services at every stage of life, she said, noting that the world had the scientific knowledge to help those infected. Young women and adolescent girls, most notably in sub-Saharan Africa, were particularly vulnerable. “Now we need to do a better job to reach young and adolescent girls,” she stressed.
It was critical to integrate HIV and sexual reproduction programmes, she continued, emphasizing the need for those infected to access services and treatment. Ending AIDS fit squarely within the 2030 Agenda, whose goals and targets reinforced efforts to eradicate the virus. She urged Member States to heed the call to reach the targets and highlighted the need to establish within the United Nations system, and particularly at the Joint United Nations Programme on HIV/AIDS (UNAIDS), a culture of accountability that focused on people rather than bureaucracy. Reiterating the link between achieving the 2030 Agenda and eradicating the AIDS epidemic, she highlighted the role of communities in coming up with solutions. “I encourage you to listen closely to what communities have to say; if we do that we will truly be able to end AIDS,” she said.
MAMADOU TANGARA (Gambia), speaking on behalf of the African Group, said Africa’s commitment to fight HIV and AIDS — which threatened sustainable development — was unwavering, as demonstrated by the African Union Road Map on Shared Responsibility and Global Solidarity for AIDS, Tuberculosis and Malaria in Africa. Poverty and unemployment aggravated HIV and AIDS, he said, stressing also the need for progress in gender equality and the empowerment of women and girls. The AIDS epidemic disproportionately affected sub-Saharan Africa, he said, with eastern and southern Africa being home to half the world’s people living with HIV.
Underscoring the importance of sexual health education related to HIV, he said AIDS-related stigma was undermining an effective AIDS response. People with HIV faced challenges around the world, including the violation of their human rights. In some cases, those with disabilities were at higher risk of infection, as were those displaced by humanitarian emergencies. The African Group strongly appealed for people with HIV to be treated equally and fairly, he said, expressing thanks to those States that had lifted travel restrictions on people living with HIV and AIDS. He went on to call on donor countries to invest more in HIV and AIDS to break the $7 billion gap, and emphasized the need for greater technological transfers and capacity-building.
TEODORO LOPEZ LOCSIN, JR. (Philippines), speaking on behalf of the Association of Southeast Asian Nations (ASEAN), said that, in 2015, an estimated 1.7 million people in the region had been affected by HIV. Affected populations differed in each member State and could include sex workers and their clients, people who injected drugs, men who had sex with men and the transgender population. In September 2016, ASEAN had adopted the Declaration of Commitment on HIV and AIDS, reaffirming its support for the 2016 Political Declaration on HIV and AIDS: On the Fast-Track to Accelerating the Fight against HIV and to Ending the AIDS Epidemic by 2030.
The ASEAN Declaration would focus on several areas and ensure no one was left behind in HIV and AIDS response efforts, he said. Activities included offering programmes for key affected populations, scaling up and strengthening prevention, testing, treatment, care and support services, and pledging to ensure the achievement of the 90-90-90 treatment target by 2020. ASEAN would also sustain the response by further strengthening the capacities of national and local Governments and continue to invest in broad community participation.
ANTONIO PARENTI, European Union, reaffirming its commitment to the 2016 Political Declaration, said the time had come to scale up prevention and testing programmes, as well as to address social inequalities and determinants that affected prevention, access to screening and care. “We need to combine health instruments with social instruments and work together across health and social policies,” he said, adding that, in doing so, it was important to help community organizations come up with more effective approaches to reduce stigma and discrimination.
He said the European Union and its member States were committed to the promotion, protection and fulfilment of the right of every individual to have full control over — and to decide freely and responsibly — on matters related to their sexuality and sexual and reproductive health, free from discrimination, coercion and violence. He also emphasized the need for universal and affordable comprehensive sexual and reproductive health information, education — including sexuality education — and health-care services. The European Union’s investment in AIDS included €60 million for developing a vaccine. He went on to say that it was crucial to ensure that the global AIDS response was adequately funding, including the UNAIDS-Global Fund partnership. With UNAIDS having a critical role to play, its unique model should be refined and reinforced so that it could keep guiding the global agenda, support countries as they adopted fast-track approaches, and remain a pathfinder for United Nations reform.
GEORGI PANAYOTOV (Bulgaria), associating himself with the European Union, expressed concern that delivery gaps of HIV prevention, testing and treatment services were largest among people most in need, especially those facing hate crimes due to their sexual orientation and gender identity. For young people, he advocated universal access to sexuality education and non-judgmental services, stressing that ending AIDS required progress across the entire human rights spectrum, with gender equality and an end to gender-based violence at the centre of the response. For its part, Bulgaria had created a comprehensive HIV prevention programme involving the Government, medical institutions and civil society, and had established 35 preventive health centres. The new national strategy on HIV and sexually transmitted infections for 2017-2020, adopted in March, complied with international standards and political commitments.
MARÍA EMMA MEJÍA VÉLEZ (Colombia) said AIDS was both a public health and development problem. She expressed concern that overall progress on the epidemic had been weak. Colombia had a low prevalence rate throughout the country and above 5 per cent in most affected areas. The Government continued to remain committed to the 2030 Agenda and had followed recommendations of the World Health Organization (WHO). Still, challenges persisted, she continued, urging the United Nations to double its efforts to end the epidemic by paying particular attention to ensuring access to affordable medicines, comprehensive sex education and improved diagnosis. She said stigma was a determining factor, which often compounded vulnerabilities, and expressed concern that “someone living with the virus could be rejected by their family or from their job”. Sexual and reproductive rights were human rights, which must be promoted and protected without discrimination. Resources for public health, however, remained scarce, she added, calling for global strategies to help scale-up the response.
MAYANK JOSHI (India) said that access to effective and affordable medicines remained critical to combating the epidemic. More than 80 per cent of the quality antiretroviral drugs used globally were supplied by the Indian pharmaceutical industry. For its part, new infections in India had declined by 66 per cent from 2000 to 2015, and AIDS-related deaths had fallen by 54 per cent between 2007 and 2015. He credited that success to collaboration between Government, communities and people living with and affected by HIV, civil society and other stakeholders. India was now building on lessons learned to redefine the national approach to reach “the last mile”. It was working to enact an HIV and AIDS law focused on protecting the human rights of people living with or affected by HIV by addressing discrimination in education and the workplace. Moreover, some 21,000 HIV counselling and testing centres continued to help ensure that 90 per cent of people infected by HIV were on treatment.
JÜRG LAUBER (Switzerland), also speaking on behalf of Zambia, said that UNAIDS had been working systematically across the United Nations system with co-sponsoring organizations for more than 20 years. It was important to put the recommendations set out in the report of the Global Review Panel on the Future of the UNAIDS Joint Programme Model in the context of wider United Nations reform. The Political Declaration on HIV and AIDS clearly laid out the strategic direction for the next few years, he continued.
If the AIDS epidemic was to be eliminated as a public health threat by 2030, fast-tracking the response would be the key, he added, underscoring several particularly prevalent points. First, a balanced approach between prevention and treatment was crucial. Second, it would be critical to ensure that human rights and gender equality were at the centre of any action. He also highlighted the need for an evidence-based approach in order to focus on location and population and to “take AIDS out of isolation”. That meant also strategically and efficiently linking funding for HIV and AIDS with broader health systems issues.
CHARLES THEMBANI NTWAAGAE (Botswana), associating himself with the African Group, said the fight against HIV and AIDS remained a key priority for his country’s national development plans, with 95 per cent of people living with HIV having access to antiretroviral drugs. However, HIV and AIDS remained a domestic and global threat, he said, emphasizing that it should remain a top priority. To control the epidemic, Botswana would implement the Most-At-Risk Populations Programme during 2017-2018, he said, urging Member States to continue to review national and global responses with a view to ending the epidemic by 2030.
CHRISTIAN WENAWESER (Liechtenstein) said legal, social and cultural barriers undermined efforts to combat HIV and AIDS at the national and international levels. Only a comprehensive strategy would enable commitments to be delivered. While some countries had contributed to destigmatization, it was alarming that discrimination persisted in others, with homosexuality still a crime in almost 80 countries. Women and girls’ access to sexual and reproductive rights and health services had proven successful in preventing HIV and AIDS, especially mother-to-child transmission, but that was by no means universal. He said his country would continue to support HIV- and AIDS-related projects run by the United Nations Children’s Fund (UNICEF), Global Fund to Fight AIDS, Tuberculosis and Malaria and others, giving priority to prevention and vulnerable groups.
NEVILLE GERTZE (Namibia), associating himself with the African Group, said his country was among those most affected by HIV, with 14 per cent prevalence. While a marked improvement over 18 per cent registered in 2010, young women and adolescent girls were most at risk of contracting the virus, due to a lack of sexual and health education and limited access to resources. Namibia’s aggressive anti-HIV and AIDS campaign included an antiretroviral programme, rolled out in 2002, and a systematic focus on social and behaviour change, HIV counselling and testing, condom distribution, voluntary male circumcision and prevention of mother-to-child transmission. The Government’s contribution to total HIV and AIDS spending had grown from 55 per cent in 2012-2013 to 64 per cent by 2013-2014. It was conducting an 18-month assessment to examine the distribution of HIV and the impact of the prevention, care and treatment response.
MARTÍN GARCÍA MORITÁN (Argentina) said it was time to redouble political commitments and resources to end the HIV and AIDS epidemic. “We cannot allow the achievements made to date to weaken our commitment,” he said. Argentina supported a human-rights- and gender-based approach, he said, adding that the promotion, protection and full enjoyment of all human rights for women and girls — including sexual and reproductive rights — was fundamental. So, too, was universal access to health coverage and access to affordable quality medication. Reiterating support for UNAIDS, he said it should be provided with all necessary resources so that it could fulfil its mandate.
MAURO VIEIRA (Brazil) said that countries and regions must be able to respond to specific patterns of the epidemic. For example, Governments of high‑prevalence epidemic countries must focus on the needs of populations that were at higher risk of infection. In Brazil, there had been high incidences among people who use drugs and young men who have sex with men. During the last 30 years, however, Brazil had made substantial progress. Today, some 500,000 people benefited from antiretroviral therapy, he continued, stressing that the participation of civil society in designing and implementing HIV and AIDS programmes was a pivotal tool for progress. Underscoring the need to reduce therapy prices, he emphasizing that public health must always prevail over commercial interests. He also called on developed countries to keep their commitments to maintain and expand pledges and international cooperation in order to address collective challenges
MARIANNE LOE (Norway) said that HIV disproportionately affected young people. Girls in sub-Saharan Africa were facing a “triple threat”: a high risk of HIV infection, low rates of HIV testing and poor adherence to HIV treatment. Education was one of the most powerful ways of improving people’s health and of making sure that the benefits were passed on to future generations. Taking AIDS out of isolation remained imperative, she continued, underscoring the need to ensure that UNAIDS continued to deliver results within the realm of budgetary constraints and increased funding insecurity. Noting that the female prison population was rising around the world, she said that the HIV prevalence rate among women in prison was much higher than those outside of prison. Many children were unfortunately born in prisons, and there were no systems in place to prevent HIV transmission, or to even monitor transmission in such cases.
SUSAN WANGECI MWANGI (Kenya), associating herself with the African Group, said 1.5 million people in her country lived with HIV, with most new cases being among adolescents and young people. To deal with the scourge, Kenya had adopted a data-driven and multi-sector HIV response, aimed at speeding up access to services for young people and the most vulnerable. To combat HIV-related stigma, the Government had launched a “Kick Out HIV Stigma” campaign that sought to engage youth through county football leagues. Mother-to-child transmission had declined from 16 per cent in 2012 to 8.3 per cent in 2015, but progress remained uneven across counties. Emphasizing that high-burden countries like Kenya could not achieve HIV and AIDS targets without cooperation and support from partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, Centers for Disease Control and Prevention and United States President’s Emergency Plan for AIDS Relief, she called on Member States to commit themselves to closing the $7 billion investment gap required to end AIDS and achieve the Sustainable Development Goals.
MICHAEL GRANT (Canada) expressed concern that, in recent years, there had been no decrease in mortality and new infection rates. He called for scaling up new approaches to reach key vulnerable populations with testing and treatment. Adolescents, in the context of the epidemic, were poorly understood and challenging to reach, and as a consequence at heightened risk of getting infected. He underscored that women and girls were agents of change, in their families and communities, and that their leadership must be fully integrated into the fight against the epidemic. It was also important to bolster efforts fight tuberculosis, the leading cause of death among people infected with HIV and AIDS. He welcomed the call to improve and strengthen UNAIDS methods and functionality in the broader efforts to accelerate reform within the greater United Nations system. The fight against HIV and AIDS required collective efforts.
PETR ILIICHEV (Russian Federation) said that recent progress in fighting HIV instilled hope that the AIDS epidemic would be eliminated by 2030. However, the Russian Federation could not agree with some provisions of the Secretary-General’s report on reinvigorating the AIDS response to catalyse sustainable development and United Nations reform, he said, emphasizing the need for a balanced response that reflected cultural and religious specificities. The Russian Federation believed that the fundamental goal of public health approaches was not drug-related harm reduction, but ending the use of drugs for non-medicinal purposes. He added that it was perplexing to consider that the criminalization of drugs and drug use was a barrier to AIDS-related services. Punishment for drug-related crimes was the prerogative of States. Responsible conduct, particularly among young people, should be encouraged and UNAIDS and UNICEF should coordinate their work in that regard. The Russian Federation was working in a targeted way to prevent the spread of HIV through awareness-raising campaigns that included young people at school and work, he said, adding that a regional conference on HIV and AIDS would be held in Moscow in April 2018.
KATALIN ANNAMÁRIA BOGYAY (Hungary) said policies and programmes to end the AIDS epidemic by 2030 must be ambitious, underpinned by political will, professional support and sufficient human and financial resources. Sustainable financial support for prevention, screening and treatment was critical. So, too, was the fight against stigma and discrimination, particularly in rural areas where transmission was less frequently detected. She said Hungary had been quite successful in containing HIV and AIDS, with 90 per cent of those diagnosed as HIV-positive having access to antiretroviral therapy and almost 90 per cent of patients getting treatment being HIV-virus-free or having very low viral loads. Every HIV patient moreover had access to the latest antiretroviral drugs for a very low fee.
MIRGUL MOLDOISAEVA (Kyrgyzstan) said his country was committed to the Political Declaration in accordance with national laws and priorities and with international human rights principles. Kyrgyzstan’s national sustainable development strategy recognized the importance of addressing HIV and AIDS and a national programme would be adopted soon. The Government was also in the process of identifying the largest number of people living with HIV and rapid testing was being carried out, with mobile clinics serving remote areas. Discussions were also being held on existing challenges and solutions. The economic hardships of developing States restricted their ability to finance HIV and AIDS programmes, he said, emphasizing that, without sufficient funding, many gains would be lost. Achieving the agreed‑upon goals depended on States, civil society and international partners committing to progress.
DIAN TRIANSYAH DJANI (Indonesia), associating himself with ASEAN, said it was alarming that so many people who were HIV positive had no idea about their status. That could lead to more infections and the transmission of the virus from pregnant mothers to their babies. Highlighting steps taken by the Government, he said that it had been providing antiretroviral drugs at treatment centres throughout the country. Moreover, the use of condoms was being promoted and mobile-testing was reaching communities particularly at risk. Underscoring the need for legal and policy frameworks to support action, he cited several laws particularly related to the provision of reproductive health services. The Government was also focusing on preventing mother-to-child transmission by conducting HIV tests and providing counselling services. It was also encouraging responsible sexual behaviour that encompassed abstinence, fidelity and the consistent use of condoms.
HARALD BRAUN (Luxembourg), warning against yielding to self-satisfaction, expressed support for the Secretary-General’s call for a revolution in HIV testing. It was thus important to strengthen testing services and increase access to them, he said, adding that girls’ education and food security also contributed to reducing HIV infection rates. Noting his country’s financial contribution to HIV and AIDS efforts, he stressed the need to ensure the effective provision of resources.
STEFANIE AMADEO (United States) said UNAIDS data-driven evidence was critical in ensuring the greatest possible impact of global investments. “Having the right data is vital to tracking progress,” she continued. Highlighting the work of the President’s Emergency Plan for AIDS Relief, a national programme aimed at combating the epidemic, she underscored her Government’s commitment to HIV prevention, detection and treatment. The work, however, was far from done, she added, emphasizing the need to focus on preventing new cases of HIV infections and noting that young women and adolescent girls were at higher risk of infection. Continued global solidarity and strategic investments put the world on a trajectory to end the HIV and AIDS epidemic. “As a global community, we have made tremendous progress, but this is no time to slow down and rest on our laurels,” she stressed. It would take all partners to work with commitment and focus to end the AIDS epidemic.
JUDITH MARCIA ARRIETA MUNGUIA (Mexico) said Member States and the United Nations system must scale up efforts to combat HIV and AIDS. Mexico had the fourth-lowest rate of people living with HIV in the Americas. There were still major challenges in key groups, however, including men who have sex with men and sex workers. The involvement of young people, women and those living with HIV was critical. Federal resources continued to be made available for civil society projects and projects in the area of prevention, detection and treatment. Prevention policies were cost-effective when compared with other aspects of control. Detection was fundamental, as well, she continued, underscoring the need to correctly identify key groups. It was essential to support UNAIDS so that the Joint Programme could operate effectively as a United Nations agency and set standards at the global level.
RUBEN ZAMORA (El Salvador) said his country remained committed to achieving the health-related goals of the 2030 Agenda through integral reform of its health sector. The purpose was to ensure quality treatment without any discrimination. Primary prevention and early diagnosis was essential to contain the epidemic. Concentrating efforts on populations at greatest risk, El Salvador had made great progress in the national response by investing in health, despite an unfavourable financial climate. He cited a campaign that had reduced mother-to-child transmission of HIV and congenital syphilis to less than 2 per cent in line with the WHO goal to eliminate transmission of both diseases. Moreover, retroviral therapy was provided free of charge and health workers were adequately trained in line with international guidelines. El Salvador was working to strengthen the recording and monitoring of data on HIV and AIDS which enabled better understanding of the epidemic.
MANABU SUMI (Japan) said that the most effective means to ensure universal access to services was through the achievement of universal health coverage. Achieving such coverage would require social restructuring and a firm commitment to the principle of “leaving no one behind”. Health systems would need to mobilize large financial and human resources, he added, underscoring the need to place higher priority on health sector development, increasing domestic resource mobilization and enhancing the international framework to support developing countries. Furthermore, it would be crucial to address the needs of those particularly vulnerable, including women and girls. Japan had long played a major role in global health, supporting efforts of developing countries both bilaterally and multilaterally, through programmes such as UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
FABIENNE BARTOLI (France), associating herself with the European Union, said significant progress in the last 15 years had been made possible by an unprecedented level of mobilization among States, organizations and civil society. Emphasizing an inclusive approach that left no one behind, she said France was committed to promoting sexual and reproductive health and rights in multilateral institutions. At the national level, pre-exposure prophylaxes were available to people most at risk. Expressing concern at the situation in West and Central Africa, she said France would continue to lend technical support to the work of UNAIDS in those regions. Stressing the need for innovative and ambitious financing solutions, she said a tax on airline tickets and financial transactions enabled France to cover nearly 60 per cent of the annual budget of the international drug purchase facility UNITAID. She went on to suggest that preparations be made for middle-income countries that would no longer be a part of international financing mechanisms, given that more than 50 per cent of those living with HIV were in those countries.