Norway welcomes the report of the Secretary-General on the progress made in the implementation of the 2001 Declaration of Commitment on HIV and AIDS and the 2006 Political Declaration on HIV and AIDS. The significant progress that is outlined in the report demonstrates real results - what can be done when the UN, Member States and individuals mobilize action together. We have had strong leadership from the UN. Two UN Secretary-Generals, Kofi Annan and Ban Ki-moon, with visible, specific and powerful political leadership of the HIV/AIDS response. Two Executive Directors of UNAIDS, Peter Piot and Michel Sidibe, with strategic and evidence-based direction for translating challenges into action and generating momentum. This is remarkable. HIV/AIDS demonstrates the UN as a “can do” organization.
Norway, as one among the many Member States that have been inspired by this strong leadership, is proud to have been part of this movement, where words and action have come together, and new ground has been broken. Space has been opened up for new ideas and new multilateral and bilateral instruments and initiatives, such as The Global Fund to Fight AIDS, TB and Malaria (GFATM), the US President's Emergency Plan for AIDS Relief (PEPFAR) and UNITAID. Civil society and non-state partners have been included in new ways for the UN. And most of all, the dignity, voices, knowledge and insights of HIV positive people have been given significance in planning, decision making and action.
As we note the progress, we also note the fragility of what we have achieved
• those that receive treatment today will also need treatment tomorrow
• a large number of people that need treatment do still not have access
• there is not yet a break through to stop HIV transmission, meaning the rate of infection continues to outgrow the global response.
This means the need for doing even better to safeguard achievements and results - and to ensure long term sustainability. The financial crisis calls for efficiency and value for money. The fact that we are still far from Universal Access means that we also need to work differently. Stopping HIV transmission is one key element. Stopping stigma, discrimination and disempowerment is another.
At the centre of the challenges we face, is dealing with structural causes that disempower women and girls, cause vulnerability and deny dignity and rights. This is not just a matter of money. It is a matter of enabling policies, in the hands of member states.
We need the energy and the courage of the AIDS movement to illuminate what these challenges look like, community by community and country by country. And we need the strength of the UN not just to say what is right, but to drive change, report on and speak to results.
Now, at the last stretch before we should have reached Universal Access for HIV/AIDS, we are at a cross roads. The progress report has clear messages about how AIDS is linked to all the other MDGs, as a potential contributor or as a barrier. The message is: We cannot any longer deal with HIV and AIDS in isolation, what counts are synergies.
The obvious synergies are in the health sector – the need for comprehensive systems and bundled services with the best possible use of infrastructure, health personnel, procurement and supply systems – services with quality and continuity which are accessible, credible and build trust. At the same time, the response to HIV and AIDS must also be tailored to different needs of different groups and different epidemic profiles. It must be mainstreamed and targeted at the same time.
The Secretary-General’s report makes a special case for maximising the potential in synergies between MDG 4 and 5. The strong link between HIV and maternal mortality is substantiated by strong evidence. The Joint Action Plan which is being formulated for the MDG Summit, makes a clear case for bringing together action on MDG 4, 5 and 6. Norway strongly believes that the approach outlined in the draft Joint Action Plan is essential, both to keep mothers alive and to prevent HIV transmission between mother and child. It should be embraced and acted upon by the AIDS movement.
The message to bring forward is that vertical HIV transmission and maternal mortality and morbidity due to HIV and AIDS can be stopped. Safe deliveries, care for the newborn and coping with HIV before, during and after birth has the same system requirements. Vertical HIV transmission and maternal mortality caused by AIDS is a system failure which needs to be monitored and acted upon at all levels. If we cannot cope with AIDS in pregnancies, we cannot make deliveries safe.
HIV/AIDS is not just a health sector issue. We knew it from the start, and need to renew our understanding now. The structural causes for gender inequality and disempowerment are strongly and causally interlinked with HIV and AIDS, as with MDG 5. HIV resilience, safe motherhood and gender empowerment need mutually re-enforcing strategies, which must be understood and pursued jointly at local, national and global level.
Critical steps toward stopping HIV transmission has to start with the right of women to their own body and sexuality, and has to address perceptions and expressions of masculinity that undermines this right, as well as sexual and gender-based violence and traditional practices that makes women vulnerable to HIV.
The gender community and the AIDS community cannot any longer just talk together, but need to act together. Norway is committed to joining with UNAIDS and other partners in making gender policies AIDS responsive and AIDS policies gender responsive.
As we go forward we should build on what we have learned and actively use the HIV and AIDS response as an amplifier for tracking and accelerating the MDG response;
• a tracer of equity in access to health services; demonstrates barriers, vulnerability and marginalisation in society which is often not given enough attention in planning and service provision – so critical also for dealing with maternal and neonatal mortality
• a pathfinder to community response, in social dialogue and for improving the interaction between delivery and demand; the services, the clients and their communities
• a driver for enabling policies and rights; such as access to medicines at an affordable price and legislation that safeguards rights and builds resilience rather than maintaining vulnerability
• a monitor for what increases or undermines sustainability of social services, both as domestic investments and as expression of global commitment to equity and solidarity
• a mirror of the status of women and gender, tracking progress in overcoming vulnerability and building resilience through following the profile of HIV transmission and relating it to status for gender indicators and sexual and reproductive health and rights.
In concluding - we have highlighted the leadership that has taken us to achievements and results. We have also noted the need to work differently as we move forward, building on what we know works and dealing with what are the deeper and more resistant and structural challenges we face.
One key challenge as we go forward is the building of a “New Generation Leadership” – recognizing young people as the most important agents for change and innovation that can empower and build resilience. They need to be given space for their leadership. Norway commends the way the Executive Director of UNAIDS has made new generation leadership one of his key themes.
Norway supports the recommendations in the Secretary-General’s report and stands ready to do its part in achieving what we have promised in the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS.
Our task is now to make the synergies between the HIV/AIDS response and the response to all the MDGs visible and actionable in the MDG Summit outcomes and commitments. We believe the report of the Secretary-General and this debate will help build a broad commitment among Member States to uphold and build on the best of the “aids movement”, to demonstrate what can be done through inclusive and broad participation and leadership, and with the UN in front.
Thank you for your attention.