Dr Peter Piot addresses SA AIDS Conference

Dr Peter Piot, Executive Director, UNAIDS and the UN Under-Secretary General addresses the SA AIDS Conference on 3 August 2003.

I truly regret that I cannot be with you in person today to deliver this statement, which I make on behalf of the 8 UN System organisations that together make up UNAIDS.

This is the most important gathering on AIDS in Southern Africa since the historic International Conference on AIDS here in Durban in 2000.

Allow me to commend the organizers of this conference - Professor Coovadia and Professor Abdool Karim - for their outstanding leadership and to pay tribute to the thousands of South Africans who are working and struggling on the front lines of this epidemic. South Africa's leadership is vital in the global fight against AIDS and this conference clearly demonstrates that there is a vibrant response to AIDS at all levels in South Africa.

However, the epidemic has also added a new dimension to the gap between the "haves" and the "have nots" - the rich who are living with HIV have access to antiretroviral treatment; the poor who are living with HIV do not. The educated have access to prevention services, the illiterate often not. And often it is men, not women, who decide when and how sex happens. This is another reason for firmly locating the response to AIDS in broader developmental imperatives such as tackling poverty and gender inequality.

I strongly believe that, at the end of the day, only a united front, fully committed to achieving a set of common goals will defeat this epidemic.

And these common goals can only be ensuring:

• that the young generations remain free of HIV;
• that those who are living with HIV have access to antiretroviral treatment and are not discriminated against; and
• that the children and grandparents left behind after the loss of a loved one to AIDS are fully supported.


The UN Declaration of Commitment on HIV/AIDS, which was unanimously adopted by all Member States in June 2001, is very clear: prevention and treatment are equally essential components in the response to AIDS. There is no return possible on this paradigm. Throughout the world, the debate is not on whether to offer antiretroviral treatment in the public sector, but how to do it given the numerous real constraints - be it cost and financing, infrastructure, capacity of the health systems, lack of monitoring systems and last, but not least, social and gender inequalities.

But for Heaven's sake, let us not wait to act until we have the perfect solution, because the era of perfect solutions is still far away. As much as we in UNAIDS believe that access to HIV treatment should be urgently expanded, it is critical that we do not make the same mistakes that rich nations made when antiretroviral therapy was introduced. We MUST not grossly neglect HIV prevention. We MUST not limit the response to AIDS to a therapeutic model with the doctor at the centre, thereby neglecting community action, programmes with youth, engagement of all sectors of society. In a sense such a model may make life easier since we would not have to address the really difficult questions around AIDS - those touching on sexuality, gender inequality, and democracy.

Globally, and in many countries, the AIDS response is moving into a new phase. A phase characterized by strong political commitment, a dynamic grass roots movement, more funding, scaling up of prevention, and rolling out of treatment programmes. It will be critical to ensure that international funding supports nationally-owned action, and reaches communities and people.

AIDS is now a core priority throughout the UN system. Last month in Maputo on the sidelines of the African Union Summit, senior officials of all UNAIDS Cosponsoring Agencies committed themselves to a major intensification of UN support to national AIDS responses in southern Africa. They also agreed to firmly and explicitly centre AIDS within our humanitarian and development work. So, you can count on us...

I trust that this conference will be the conference of good news stories on AIDS in South Africa, because I know that there are many. It is this evidence of success and an iron faith that we can do it, that will give us the strength and perseverance to succeed. I wish you an inspiring meeting. Thank you.