The special United Nations conference on HIV/Aids has concluded by agreeing to tackle the worldwide pandemic more effectively but with a disappointingly vague commitment of financial resources. The document adopted makes some progress towards specifying the groups spreading the disease and identifying concrete measures such as the use of condoms to help prevent this.
Yet it still came up against a deep hesitation to be frank about the sexual and ethical issues involved among many of the political leaders attending. This is important, because those dealing directly with the disease need a clear text with which to hold government to account.
The three day meeting of government leaders, activists and diplomats was a classic United Nations gathering dedicated to tackling one of the world's greatest health hazards. Organised by the General Assembly, it brought together most of those working on the pandemic. It was given a 629-page report on the Aids epidemic to guide its deliberations, showing the extent of the disease and the progress made since the first such gathering in 2001.
There is a lot that is positive to report. UNAids says $8.3 billion was spent in treatment, prevention and care of orphans in poorer countries last year, meeting the target set out five years ago. Much of this sum comes from foreign aid, special government programmes, international organisations and private sources.
But a major gap between funding and expected expenditure looms in coming years, partly because these programmes have been relatively effective. It is estimated that $18 billion will be needed next year and up to $23 billion by 2010. Less than half this sum will be available and the meeting conspicuously failed to agree new streams of funding. It is crucial that this question be addressed, since there is real evidence that figures of those infected in six out of 11 heavily affected African countries have come down as a result of international intervention.
These limited successes still leave a picture of widespread, growing need and unequal provision. The commitment made in 2003 to put three million low income Aids patients on treatment by the end of last year fell well short of being achieved. Some 38.6 million people are infected, 17.3 million of them women. Three million people died of the disease in 2005. The Taoiseach, in his address, pointed out how many children have been orphaned and how disastrous their position will be if help is not forthcoming. Ireland is to give special attention to this issue, a really worthwhile objective and a vital part of the €100 million per annum this State will donate.
While 700,000 people are being treated with retroviral and antiviral drugs in the developed world, including most of those who need it, the 1.3 million receiving similar treatment in developing countries represent only one in five of those in need. Much more needs to be done to produce low-cost treatments. Development of an effective vaccine has been far slower because of inherent scientific difficulties and quite inadequate funding.