The world has fallen far short of its promises five years ago to fight HIV/AIDS, U.N. Secretary-General Kofi Annan warned leaders meeting Wednesday to find new ways to tackle the virus.
A day after a major U.N. report found the disease had slowed in its spread, Annan told delegates that efforts to fight AIDS among women and children had failed and that young people still have little understanding of AIDS.
The virus "has spread further, faster and with more catastrophic long-term effects than any other disease," Annan said. "Its impact has become a devastating obstacle to the progress of humankind."
Annan's words were meant to impart a sense of urgency to the first day of the three-day General Assembly High-Level Meeting on AIDS, which comes a week before the 25th anniversary of the first documented AIDS cases — June 5, 1981.
Several heads of state and dozens of government officials will seek to craft a document that charts a course to provide universal access for AIDS prevention and treatment by 2010.
"Your big task now is making sure that this declaration is not a document of empty promises, not a mere restatement of principle but a platform for target-based action," said Khensani Mavasa, a representative of the Treatment Action Campaign.
The United Nations said Mavasa was the first HIV-positive person to ever address the U.N. General Assembly.
The meeting also will review promises made in a similar conference in 2001 that is largely credited with putting forth the first comprehensive plan for combatting the disease.
Most of those targets have not been met. Among the biggest failures was the so-called "3 by 5" target — of getting treatment to 3 million poor people infected with AIDS by the end of last year.
Peter Piot, head of the U.N. AIDS agency, said he hoped the meeting will generate new funding to fight the disease, which needs between $18 billion and $22 billion each year to be fought effectively. It gets about $10 billion a year now.
"We need to commit to a strategic approach that recognizes AIDS both as a long-term priority as well as an emergency that requires an immediate response," Piot said. "In other words, we need to run a marathon at the pace of a sprint."
According to the report released Tuesday, nearly 40 million people worldwide are living with HIV/AIDS. India now has the largest number of AIDS infections, but the epidemic still remains at its worst in sub-Saharan Africa, where per capita rates continue to climb in several countries.
A third of adults were infected in Swaziland in 2005. By comparison, India's per capita rate is low, at 0.9 percent of its 1. billion people.
Women's vulnerability to the disease continues to increase, with more than 17 million women infected worldwide — nearly half the global total — and more than three-quarters of them living in sub-Saharan Africa, the report found.
HIV/AIDS activists and civil society groups arriving at the United Nations for the three-day event warned that countries appear reluctant to set new targets to fight the disease and will shy away from making any major promises.
"The main problem that we're facing is that governments recognize that they haven't delivered on the 2001 commitments and don't want to make any new commitments," said Kieran Daly, a spokesman for the Toronto-based International Council of AIDS Service Organizations.
Civil society groups also warned that some conservative nations, backed by the Roman Catholic Church, could try to strip out language from the 2001 promises that said effective prevention requires greater availability of condoms, microbicides and vaccines.
Those nations, which include the United States, also want to avoid language emphasizing the need to make treatment available to prostitutes and drug users. They blocked similar language in 2001.
The United States provides the most aid of any nation — $15 billion over five years. Its program, the U.S. President's Emergency Plan for AIDS Relief, has drawn criticism for stressing abstinence programs, though Washington also says it is the largest distributor of condoms worldwide.
Annan said nations must not dilute the 2001 text and should add language on bringing treatment to those who need it most.
"We will not succeed by putting our head in the sand by pretending that these people do not exist or that they do not need help," he told reporters.