Minister of International Development Ms. Hilde F. Johnson

Speech at Seminar on AIDS and Global Security

Paris, 25 January 2002

Vos Excellences,

Mesdames et Messieurs,

C'est un grand privilège et plaisir pour moi d'être avec vous à ce séminaire, organisé a l’occasion du centenaire du Prix Nobel, et de parler de ce très important sujet.

Si vous voulez bien m’excuser, je continuerai mon discours en anglais.

According to some estimates, we are projected to have a hundred million HIV cases by 2005. If that happens, it will be the biggest epidemic since the Black Death spread along the Silk Road caravan routes and killed as much as half the population of East Asia, South Asia, Arabia, North Africa, and finally Europe in the fourteenth century.

In Zimbabwe life expectancy is now likely to be 22 years shorter than it would have been without AIDS. HIV/AIDS is not only an African problem. The fastest growing rates of AIDS are in the former Soviet Union, in the Caribbean, and in India. Clearly, HIV/AIDS is an issue affecting global security.

UNAIDS reports that 14 000 people are being infected by HIV every day! Ninety-five per cent of them live in developing countries. It is the young, those who should be able to work and take care of their children, who are dying of AIDS.

The implications are hard to grasp. In sub-Saharan Africa, where most of Norway’s development partners are, the epidemic undermines educational programmes, health systems, public administration, agriculture – the entire fabric of society. It is reversing decades of gains made in development. Those countries that are hardest hit may have their GDP reduced by more than 20 per cent by 2020 because of AIDS.

It is all about poverty. Young people die, households loose their breadwinner, families break apart, and children loose their parents. Orphans and children with sick parents are less likely to attend school. Lack of education and necessary life skills puts them at risk of contracting HIV. AIDS is a poor peoples’ disease that creates more poverty. It is undoubtedly the biggest threat to the achievement of the Millennium Development Goals on maternal and child health, and on poverty reduction.

The good news is that the growth of the epidemic is not inevitable. We know how to reduce the spread of HIV. That is our main challenge.

Education and information is the only vaccine we have. In China, only 4 per cent of the adults know how HIV is contracted and spread. That is not a good starting point for containing the epidemic. We find the same pattern in many of our partner countries where primary education is insufficient. Millions of children never go to school. The disease has been around for 20 years, and we may know the causes and implications, but they don’t. If the epidemic is to be curbed, we have to make sure that people get the information and the life skills needed to protect themselves.

The bottom line is that preventing HIV is about changing people’s attitudes to sexual behaviour. Knowledge may not be enough. It is also about empowerment. Women and young girls must be empowered so that they can truly protect themselves. The poor must be empowered to live a life with less exposure to the virus.

In our dialogues with partner countries we emphasise the importance of handling the epidemic as a development problem and not simply as just another health problem.

By that I mean: We need to mobilise all good forces in the fight against AIDS. National policies should enable districts and communities to cope with the impact of the epidemic. Trade unions must be mobilised to protect their members, employers to protect their workers.

Effective health systems and improved services can help reduce some of the hopelessness surrounding the epidemic.

While prevention must continue to be the mainstay of our response if we are to halt the spread of HIV, we must do more for the 40 million plus who are living with HIV/AIDS today. We have to strengthen health systems so that they can meet the growing demands for adequate care and life-prolonging and alleviating medicines.

In that regard, we welcome the declaration from the WTO Ministerial Meeting in Doha on the TRIPS Agreement and Public Health as it points out the flexibility in the agreement and declares that governments have a right to protect their countries’ public health and promote access to medicines for their population. In our view it is important that WTO member states themselves can determine what is a national emergency. In my opinion, the HIV/AIDS epidemic has in many countries already reached a level that calls for emergency efforts.

Making the drugs more affordable and more accessible for developing countries is one of the most pressing issues. This effort must go hand in hand with the broader strategy to contain and fight AIDS. The importance of the drugs that are available today is limited. There is no cure for AIDS. Even if the life-prolonging medicines were offered for free, many HIV-infected people would not have access to them. The medicines would still have to be delivered and administered. Patients would still need counselling and care.

We cannot talk about drugs without stressing the need for further resources for health systems. The burden of AIDS is challenging an already overstretched health sector in many countries. Large additional resources are needed, particularly in the least developed countries. There is an on-going effort to improve co-ordination among the donor countries and the institutions involved.

Any development process, to be sustainable, must be country-owned and country-driven. It is, in development co-operation, the privilege of our partner countries themselves to decide on how best to fight AIDS in their community. Uganda cut the AIDS death rate in half in five years with no medicine, an achievement that demonstrates fully the importance of the government showing leadership. In frankophone Africa, Senegal has managed to prevent HIV/AIDS from developing into a large-scale epidemic. This has been achieved by information campaigns and access to free condoms. In other words, it is possible to turn the trend.

Incorporating the HIV/AIDS challenge into national development strategies is essential to all development goals. There is nothing more deadly than political leaders, church leaders and others in positions of power and influence showing ignorance and indifference instead of providing positive leadership when confronted with a disaster such as the AIDS epidemic.

The Security Council’s recognition of the impact of HIV/AIDS on peace and security was crucial for the general awareness of HIV/AIDS as a global crisis. Security is more than the absence of armed conflict. The impact of AIDS threatens security in the broad sense, as the epidemic endangers the fundamental conditions that people need in order to live safe, healthy and productive lives. It can destroy the very fabric of a nation: individuals, families and communities; economic, social and political institutions; military and police forces.

We must work with the uniformed services, including peacekeeping personnel. Soldiers are themselves exposed to HIV/AIDS. And it cannot be denied that military and peacekeeping personnel, and even aid workers, sometimes put women and girls in local communities at risk. We base our own preventive efforts among peacekeepers on mandatory training. Peacekeepers and aid workers should become "soldiers" in the fight for awareness and prevention of HIV transmission.

Major General Lars Sølvberg will say more about this issue later. The Major General is a member of my Aids Forum, an alliance that brings together representatives from the church, trade unions, business, culture, sports, NGOs, the media, the armed forces, and organisations representing people living with HIV/AIDS. No government can deal with the epidemic on its own. Broad and untraditional alliances are called for in all countries. In many parts of the world NGOs are actually in a stronger position to reach people than the public sector is. This is particularly evident in war-affected areas, where there is often an absence of state authority.

Ladies and gentlemen,

Whether measured by the numbers killed or nations wounded, the AIDS epidemic is a greater global threat than any war. It calls for worldwide, national and individual action. We need political leadership on all levels. We need presidents who are committed to making HIV/AIDS a public issue. We need forceful messages from those who shape opinion. We need political leaders who speak out against harmful myths about HIV/AIDS. Military and peacekeeping personnel are potential allies in HIV/AIDS prevention.

We need the international leadership and will to raise the resources needed. The Secretary General of the United Nations, Mr. Kofi Annan, has said that we need 10 billion US dollars every year to combat the epidemic. At the moment, we are far from reaching this target, but it is a goal that is vitally important to strive for.

But it is also imperative that other actors take their responsibility. The message should go out from churches and mosques that unprotected sex is killing people, millions of people. I would encourage the Pope and other church leaders not only to be vocal on ethical values and moral behaviour in their areas, but also to include the use of condoms in a comprehensive strategy to save sacred human lives. Here, too, the message needs to be loud and clear.

Only by the joint effort by us all can we succeed.

Merci,

Vos Excellences, Mesdames et Messieurs,

de votre attention.