From Norway we would like to thank the Secretary General for a very good and comprehensive report, underlining both the achievements and the important challenges ahead, if we are to reach the targets for 2015.
Last year here in New York, we marked the victories and successes of 30 years of effort. The scientific achievements have been remarkable. Trends point in the right direction. Unique partnerships have been created
While there is room for celebration, there is no room for complacency! We would like to highlight the following elements that need to have our attention:
• We need to work SMARTER to ensure that funds available are spent in the best possible way. This means in particular that we must invest where the needs are greatest. The investment framework developed by UNAIDS and others, is an important tool in doing so. Particular emphasis must be put on reaching those groups that are at higher risk of becoming infected and infecting others, be it migrant workers, persons who sell sex, men who have sex with men, injecting drug users, prisoners, or others.
• Working SMARTER also means ensuring that HIV is not addressed in isolation, but that one need to create synergies with other services, such as TB detection and treatment. Linkages with other reproductive health services are of particular importance. Prevention of infection from mother to child is an important intervention that needs to be well connected to other health services aiming at women, pregnant women and babies. It is discouraging to learn from the report that many women are given suboptimal treatment to prevent such transmission, and we encourage countries to provide dual prophylaxis, and to link services closely to antenatal health services.
• Facts and figures tell us that proper sexuality and HIV education in schools and other venues is important, and also to provide youth-friendly access to sexual and reproductive health services.
• While condoms will never be THE solution to HIV prevention, they are an indispensable part of prevention, and it is therefore discouraging that they are still hard to find in many places. Female condoms are needed to supplement the male condoms, and more efforts need to be done to develop new generations of such condoms.
• In HIV prevention, and in order to protect public health interests, one must try to reduce the harm of negative behaviour and practice. Needle and syringe programmes, medically assisted therapy and other such interventions aimed at injecting drug users can be seen as low hanging fruits that can be implemented regardless of the legal framework for drug use. We have very good experiences from this in Norway, where we unfortunately have a high number of injecting drug users, but luckily very low HIV infection rates in that group.
• 60 per cent of people with HIV infection are girls and women. We also know that gender based violence correlates with HIV infection, and is important to counteract. Gendered work is not only towards women, it is very important to work with men and boys to change negative notions of masculinity and promote gender equality.
Over the last decade, and incredible increase in resources has been seen, through global mechanisms and large donor-driven programmes. Norway contributes around 75 million USD annuaklly to the Global Fund alone. And that is only a part of our HIV policy.
But we are watching carefully, and some so-called recipient countries still spend little of own budget funding for HIV. Now it is time that these countries enter into an active partnership also on the funding side, as a way of developing even more sustainable responses to HIV. If we all work together, smarter and more consolidated, we may in some years be able to find ourselves in a situation where HIV largely belongs to history.