U.N. GROUP SETS COMPROMISE ON AIDS POLICY

Document Sets No Targets, Cites Risks to Women

UNITED NATIONS -- Delegates to a United Nations conference on AIDS
reached agreement Friday after difficult negotiations on a policy
declaration that sets no targets for the number of people who should
be treated and makes only indirect reference to high-risk groups such
as homosexuals, prostitutes and intravenous drug users.

The statement, however, contains language acknowledging the
"feminization" of the global AIDS epidemic, as well as the importance
of teaching young people about the disease and the need for drugs
specifically formulated for children.

The eight-page statement, completed early Friday morning, is a
compromise that provided victories to the United States, which
opposed numerical treatment targets; Islamic countries, which did not
want "vulnerable populations" spelled out in detail; and many
activist groups that sought statements that empowering women is a
tool against AIDS.

The new "Declaration of Commitment" updates one adopted five years
ago that proved crucial in turning resources and attention to AIDS in
the developing world.

Response to the document varied among the 800 civil society groups
attending the three-day meeting. It was the largest participation of
outsiders in U.N. history.

"The final outcome document is pathetically weak," said Sisonke
Msimang, a South African activist from the African Civil Society
Coalition. "It is remarkable at this stage in the global epidemic
that governments cannot set the much needed targets, nor can they
name in the document the very people that are most vulnerable."

But others praised the acknowledgment of the links between AIDS and
gender inequality, an assertion that women should have control over
their own reproductive health, and language condemning "harmful
traditional and customary practices, abuse, rape and other forms of
sexual violence."

"From that perspective we feel that we have gained ground," said
Zonny Woods, a Canadian woman with the International Women's Health
Coalition, in New York. "In that regard I would say it is a success."

Peter Piot, the Belgian physician who directs UNAIDS, called it "a
strong declaration that will move response to AIDS forward," although
he said of the reluctance "to name the unnamable groups, here I agree
with the activists."

Piot was among many who had called for the declaration to lay out
targets for dollar amounts to be spent on AIDS and for the fraction
of people who should be getting drug treatment and testing or
prevention interventions during pregnancy. The previous policy
document in 2001 contained all of those.

The new one mentions $20 billion to $23 billion as an "estimate" for
annual needs starting as of 2010, but it does not commit donors or
recipient countries to come up with that amount. There are no
clinical targets set out.

An American official not involved in the negotiations said one reason
the U.S. delegation opposed numerical targets is that they might be
construed as committing money for global AIDS in advance of actual
appropriations requested by the executive branch and voted on by Congress.

The contentious negotiations were led by the U.N. ambassadors from
Thailand and Barbados and featured many countries acting as blocs.

Numerous African nations agreed earlier this year in Abuja, Nigeria,
to push for a common position -- that 80 percent of pregnant women
have access to drugs preventing transmission of the virus to their
infants, that 80 percent of the population have access to testing,
and that 80 percent of infected people needing antiretroviral drugs
get them, among other goals.

The Africa Group, however, fractured with the defection of Egypt and
South Africa from that position and by the alliance of Gabon with
several Islamic countries in opposing language in favor of the
"empowerment of girls." This helped doom the naming of goals.

"The continent that is most ravaged by AIDS has demonstrated a
complete lack of leadership. It is a sad, sad day as an African to be
represented by such poor leadership," Omololu Falobi of the African
Civil Society Coalition said in a statement released at the end of the meeting.

The Organization of the Islamic Council, a bloc of many Islamic
countries, opposed even using the term "vulnerable groups" to
describe sex industry workers, gay men and drug users. The "Rio
Group" of South American countries favored naming them. An American
official familiar with the negotiations, demanded anonymity to
describe confidential discussions, said the U.S. delegation had no
strong position on the matter.

The phrase "vulnerable groups" appears several times in the final
document, and it also contains references to specific materials the
unnamed people at risk need to protect themselves: "male and female
condoms and sterile injecting equipment."

The document asserts the importance of "harm-reduction efforts
related to drug use" -- a reference to needle-exchange programs,
which the United States has opposed as a matter of policy under both
Republican and Democratic administrations. Some activist groups,
however, wanted the declaration to go further, and criticized it for
not mentioning "substitution therapies" for opiate addiction, such as
methadone.

Yesterday's General Assembly began with a speech from Laura Bush, who
praised her husband's $15 billion, five-year global AIDS plan,
including its effort to train health care workers in affected
countries. Many have been leaving for higher-paying jobs abroad.

The first lady also put in a plug for literacy, one of her personal
causes, calling it especially important "for women and girls, so they
can learn to make wise choices that will keep them healthy and safe."

The meeting featured a cavalcade of prime ministers, presidents, and
one king, Mswati III of Swaziland. More than 140 spoke.

For the first time in its history, the General Assembly divided
itself in half and had people speak simultaneously in two rooms in
order to fit their speeches into one day.