U.S. Intervention on the Implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS in consideration of Agenda Item 41, at the 63rd Session of the UN General Assembly

John F. Sammis
United States Deputy Representative to ECOSOC 
U.S. Mission to the United Nations 
New York, NY
June 16, 2009


We welcome this opportunity to focus attention on the continuing fight against HIV/AIDS and thank the Secretary-General and his staff for their great work in putting together an excellent report that underlines the challenge before us.
The United States stands behind our commitments made in 2001 and renewed in 2006 and is proud to be a partner in the global effort to halt and reverse this terrible disease. Our major contribution to the global fight is through the President’s Emergency Plan for AIDS Relief (PEPFAR), the largest international health initiative in history dedicated to a specific disease.

In the first five years of the program, the American people supported antiretroviral treatment for more than 2.1 million men, women, and children living with HIV/AIDS around the world; care for over 10.1 million people; and prevention of mother-to-child HIV transmission during nearly 16 million pregnancies.

PEPFAR has demonstrated unprecedented commitment to mobilizing leadership and building the capacity of local institutions in the fight against AIDS. The program has also worked to build linkages with other donors and multilateral organizations, including the Joint UN Programme on HIV/AIDS. The strong partnership between the UNAIDS family and our bilateral programs in the field has been mutually beneficial.

President Barack Obama has pledged to continue PEPFAR’s critical work to address the HIV/AIDS crisis around the world and has called on all sectors to partner in the fight.

PEPFAR and the fight against HIV/AIDS are a critical piece of a larger global health agenda outlined by the Obama Administration. Increased commitments of U.S. Government programs to maternal and child health, family planning, health system strengthening will provide much-needed support to countries. This comprehensive approach to health will have long-term benefits to the lives of individuals and families, and contribute to the overall development of the countries in which PEPFAR works.

Partnership Frameworks

To maximize the impact and sustainability of its HIV/AIDS programs, the United States is engaging with host country governments and other partners through Partnership Frameworks. These strategic partnerships are designed to build country ownership by more fully aligning PEPFAR country-led efforts with national strategies, national monitoring and evaluation plans, and the international partner landscape in country.

The United States is now working rapidly to develop these partnerships with host countries and other country level partners. Increasing transparency and promoting greater aid effectiveness through adoption of Paris Declaration principles are conscious goals of this new approach in PEPFAR.

Support for Marginalized Groups and Gender Integration into the Response

We applaud the Secretary General for the focus in his report on the need to redouble efforts to reduce and eliminate stigma and discrimination associated with HIV/AIDS. We share the goal of extending life-saving prevention, treatment and care services to marginalized groups such as men who have sex with men, commercial sex workers, and injecting drug users.

It is essential as highlighted by the Secretary General that Member States and others in the international community also follow through on our commitments to ensure the rights of women and girls in formulating an effective response to the epidemic. This is underscored by many sobering statistics such as the reality that in sub-Saharan Africa approximately 58 percent of all people living with HIV/AIDS are female.

Through PEPFAR the United States proactively confronts the changing demographics of the epidemic, working to reduce gender inequalities and gender-based abuse and expand gender programming throughout prevention, care and treatment activities.

We strongly support the work that has been done at UNDP and UNAIDS to develop a Gender Action Framework to systematically guide the UN system’s efforts to address the needs of women, girls, and the importance of including gender equality in our HIV response and urge continued work on the Action Framework as a top priority for the UNAIDS family.

Health Systems Strengthening

In the overall response to the epidemic, resources will continue to be a challenge, in part because the large numbers of people who need treatment, the success of counseling and testing programs, and growing capacity for AIDS treatment even at primary health centers all create an increased demand for treatment that incurs significant costs over the long term.

One way the United States is committed to responding to this challenge is by continuing to seek efficiencies wherever we can with current programs and by ensuring that PEPFAR resources not only achieve HIV/AIDS-specific goals, but also contribute to long-term strengthening of health systems in communities where we work.

By using HIV treatment as a platform, PEPFAR support has strengthened and extended health systems in many areas including human resources, infrastructure, informatics, commodities logistics, and laboratory services. Although interventions supported through PEPFAR are for HIV/AIDS treatment and prevention, the systems established and expanded over the past five years have resulted in positive health outcomes extending well beyond HIV/AIDS.

Looking to the future, the United States will work with host countries to develop a framework for strategic assessments and identification of priorities for health system strengthening. Health systems strengthening is a key factor in successfully improving health outcomes overall.

Though we have come a long way, we face many challenges ahead in the struggle against HIV/AIDS. Our goals in the 2006 Political Declaration and the health-related MDGs are ambitious even without an uncertain global financial climate. The United States applauds the leadership of UNAIDS in prodding all of us forward and pledges our continued commitment to working with Member States and other partners to transform those political goals into a better life for the tens of millions of people living with or affected by AIDS.


PRN: 2009/129