UNITED NATIONS – One after another, African leaders at the United Nations' first global gathering on HIV/AIDS made emotional pleas for help Monday in ending the devastation wrought by the epidemic. Nigeria's president warned that entire populations face extinction.
Secretary-General Kofi Annan, seeking $7-10 billion for a global AIDS fund, said AIDS spending "in the developing world needs to rise to roughly five times its present level." The Americans pledged to provide more aid, but did not say how much.
Annan, a native of Ghana who has made the fight against AIDS his personal priority, opened the three-day special session by urging world leaders to set aside moral judgments and face the unpleasant facts of a disease that has killed 22 million people and ravaged many of the world's poorest nations.
Kenya and Nigeria are each home to more than 2 million HIV patients. In Botswana, more than 20 percent of the adult population is infected, and in South Africa, AIDS will knock off 17 years of life expectancy by 2005.
"The future of our continent is bleak, to say the least," Nigerian President Olusegun Obasanjo said. "The prospect of extinction of the entire population of a continent looms larger and larger."
Obasanjo and others called for "total cancellation of Africa's debt," which takes badly needed money away from health and social programs including the fight against AIDS.
"The undeniable fact is that with the fragility of our economies, we simply lack the capacity to adequately respond to the magnitude of the HIV/AIDS epidemic," the Nigerian leader said.
Secretary of State Colin Powell, leading the U.S. delegation, said more money would come from the United States – which has already pledged $200 million in seed money – "as we learn where our support will be most effective."
"Our response to AIDS must be no less comprehensive, no less relentless, no less swift than the pandemic itself," Powell told the General Assembly.
Several speakers, including Powell, acknowledged that the global response to AIDS has been woefully late. Britain's Clare Short, secretary for international development, went a step further by criticizing the very gathering she addressed.
"We waste too much time and energy in U.N. conferences and special sessions. We use up enormous energy in arguing at great length over texts that provide few if any follow-up mechanisms or assurances that governments and U.N. agencies will carry forward the declarations that are agreed," she said.
Indeed, the Monday morning session ended in more than two hours of arguments over whether to exclude the U.S.-based International Gay and Lesbian Human Rights Commission from the conference. Eleven unidentified countries wanted to keep the group out, but Canada led a successful vote in the assembly to include it.
Elsewhere in the building, diplomats squabbled over a final conference document that will map out a global strategy to halt the disease and reverse its effects. Muslim countries and the United States object to language that specifically names vulnerable groups in need of protection, including men who have sex with men.
Noting the weeks of infighting among delegates leading up the gathering, Annan told the 189-nation General Assembly: "We cannot deal with AIDS by making moral judgments or refusing to face unpleasant facts, and still less by stigmatizing those who are infected. We can only do it by speaking clearly and plainly, both about the ways that people become infected, and about what they can to avoid infection."
But expectations for a successful gathering remained high and varied for many of the 3,000 participants, including health experts, politicians, scientists, AIDS activists and patients working to find an end to the scourge.
Three days of conferences and meetings touch on everything from drug prices to homosexuality, AIDS orphans and funding. Events on Monday included a round-table discussion on prevention and care, a look at how New York City has responded to the epidemic, gender issues relating to AIDS, challenges in rural Africa and the psychological impact of the disease.
To allow some delegates to participate, the United States waived visa restrictions that prevent those with HIV or AIDS from visiting the country.
U.N. radio and an online Webcast will broadcast many of the events around the world in the six official languages of the United Nations – Arabic, Chinese, English, French, Russian and Spanish.
Two dozen heads of state, mostly from Africa, are attending the General Assembly Special Session on HIV/AIDS, though no wealthy nation sent a president or prime minister. Many used their time on the assembly floor to discuss the fund, which Annan expects will be operational by the end of the year.
"It is important for the fund to have criteria that will ensure that resources are used to meet the needs of countries most affected by HIV/AIDS such as my own," President Festus Mogae of Botswana said.
Uganda, a rare success story among African nations battling the disease, became the first developing nation to give to a global AIDS fund Monday with a $2 million donation. Rates of infection in Uganda have declined by two-thirds since 1993.
Canada added its contribution to those made earlier by the United States, Britain and France, for a total of some $600 million so far.
A study published Friday in the journal Science said the world's poorest countries will need $9.2 billion a year to deal with AIDS – $4.4 billion to treat people with the illness and $4.8 billion to prevent new infections.