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AIDS battle hits thicket of cultural differences

The three-day United Nations conference on AIDS offered a fascinating view of the cultural differences that nations bring to the AIDS crisis and a heartening demonstration that these differences can be overcome when nations understand the importance of doing so. While not legally enforceable, the statement that resulted from the conference, the Declaration of Commitment, is a step forward, both in the specific measures it calls on nations to enact and in its approach to AIDS, which it defines not only as a medical problem but as an economic threat and a human rights issue as well.

In stating that “empowering women is essential for reducing vulnerability,” and noting the role that sexual exploitation and female illiteracy play in contributing to HIV infection, the document tackles head-on some of the underlying conditions of the crisis in developing countries. “If there is one idea that stands out clearly, it is that women are in the forefront of this battle,” observed United Nations Secretary-General Kofi Annan, who joined with Peter Piot, executive director of UNAIDS, the United Nations agency coordinating efforts against AIDS, to urge countries to put aside longstanding cultural mores to save lives.

From the beginning of the conference, those cultural mores were evident, as was a clash of cultures. Official discussions focused on the cost of AIDS drugs, but poorer countries wanted more attention to fundamental health problems such as the absence of food and clean water to take drugs with and the scarcity of simple antibiotics. Islamic groups objected to a representative of a gay group joining a roundtable discussion, and language about high-risk populations such as homosexuals, intravenous drug users and prostitutes was eventually deleted from the document because it proved too contentious. As regrettable as these omissions are, the document that was drafted represents a triumph of international cooperation in addressing a worldwide epidemic that often requires different strategies for its containment from one country to another.

The declaration calls on the countries most affected by AIDS to reduce their HIV infection rate among young people by 25 percent by 2005. By 2003, every country should identify the factors responsible for the spread of AIDS within its borders and devise specific goals for AIDS prevention. By 2005, countries are asked to expand AIDS testing and counseling, increase access to male and female condoms, and devise and implement national strategies for the prevention, care and support of AIDS patients. The document asks governments and private donors to create a $7-10 billion Global AIDS and Health Fund to assist in the task.

The conference, the first in the United Nations’ history to focus on a single health care issue, lays important groundwork for action in the future. In approving the measures called for in the Declaration of Commitment, the General Assembly has overcome the often-polarizing differences that divide North and South to focus on a common scourge affecting all.

National Catholic Reporter, July 13, 2001