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UN Contentious Issues: condoms, IDUs, women
  "Keep up AIDS fight, UN urged
Threat remains despite advances, global study finds'

NEW YORK -- The world has made significant advances in grappling with the global HIV/AIDS epidemic, but millions of people in developing countries remain untreated or at risk of infection due to an uneven effort, a UN study says.
The report, released yesterday for this week's special UN General Assembly session on HIV/AIDS, painted a grim picture of a pandemic that remains a major killer in a range of countries from Asia to Eastern Europe to Latin American to sub-Saharan Africa.
While there have been some successes amid a more robust effort, many countries fall woefully short of the goals of prevention and treatment that the world community adopted five years ago.
Activists fear that world leaders and ministers gathered for this year's summit will water down those objectives and fail to make the long-term funding commitments that are needed to control, and eventually roll back, the disease.
"There remains a concern that there really will be a step backward from the 2001 commitments," said Joanne Csete, executive director of the HIV/AIDS Legal network in Toronto and a member of the Canadian delegation.
The UN meeting is drawing a dozen heads of government -- mainly from Africa -- and celebrities such as Whoopi Goldberg and Naomi Watts. Laura Bush, wife of the U.S. President, will lead the U.S. delegation and is scheduled to address the General Assembly on Friday. The Canadian delegation will be headed by Minister of International Co-operation Josee Verner.
Michael O'Connor, executive director of the Toronto-based Interagency Coalition on AIDS and Development, said he's concerned the Conservative government will not assume the leadership role internationally that previous Liberal governments have taken.
Among the contentious issues in New York this week is whether the UN declaration will support the provision of AIDS treatment for intravenous drug users; whether the United States and countries of the Muslim world will continue their staunch opposition to the funding of condom programs; and whether programs will address gender issues in countries where women are vulnerable to infection because they are powerless to dictate sexual behaviour.
The UNAIDS report released yesterday estimated that there are about 38.6-million people living with HIV in lower- and middle-income countries, including 4.1 million who were newly infected last year.
It estimated that about 2.8 million people died from AIDS across the less-developed world last year. In some southern African countries, infection rates have reached a quarter to a third of the adult population.
Despite the appalling conditions in some countries, the report's lead author, Paul De Lay, said yesterday that there are some notable successes.
"The epidemic seems to be slowing down, the rate is still increasing but not at the level it has been in the last 10, 15 years," Mr. De Lay said in a teleconference yesterday.
"We're also seeing a massive scale-up of both prevention and treatment."
Sub-Saharan African countries like Kenya, Uganda and Zimbabwe have reduced the infection rate and improved access to treatment, as have Thailand and Cambodia in Asia.
They have done so by providing sexual education and condoms, as well as funding programs that stress abstinence and fidelity in marriage. Mr. De Lay said several countries have shown a delay in sexual activity among children -- which contributes to a slowdown in infection rates.
"This reconfirms the evidence that one needs a comprehensive response," he said.
In hardest-hit southern Africa, the rate of infection has stabilized -- although at "exceptionally high levels" -- but the number of cases continues to increase with a growing population. Asia, China, Indonesia and Brazil have failed to come to grips with their growing problem.
Global funding for HIV/AIDS programs soared to $8.3-billion (U.S.) last year, meeting the target laid out in 2001, while the number of people receiving treatment in developing countries grew to 1.3-million from 240,000 five years ago.
The United States provides half of all bilateral aid and a third of the money that goes into the UN Global Fund to Fight AIDS, Tuberculosis and Malaria. That U.S. overseas AIDS program, launched by President George W. Bush in 2003, expires in five years.
"We have the elements in place, we have the foundation in countries but we need to move forward. And we need to move from a crisis, urgent response to a much more predictable, sustained chronic response."
HIV/AIDS worldwide
In sub-Saharan Africa, where the epidemic is most prevalent, 12-million people - 6 per cent of the adult population - are living with HIV. Despite the grim statistics, a UN report yesterday said some progress was being made in slowing the rate of infection.
AIDS statistics
2,800,000 people: Died from AIDS in 2005
4,100,000 people: Newly infected in 2005
38,600,000 people: Living with AIDS in 2005
240,000 people: 2001 Third-World access to treatment
1,300,000 people: 2005 Third-World access to treatment
$8,300,000,000 (U.S.): Available funding for treatment
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