REVIEW OF
THE PROBLEM OF HUMAN IMMUNODEFICIENCY VIRUS/ACQUIRED IMMUNODEFICIENCY SYNDROME
IN ALL ITS ASPECTS (ITEM 179)
FIFTY-FIFTH SESSION OF THE GENERAL ASSEMBLY OF THE
UNITED NATIONS. STATEMENT BY THE DELEGATE OF CHILE MR. GERARDO ATEAGA
New York, November 2nd 2000
Mr. Chairman,
Let me preface my statement by reiterating what was
stated in the declaration signed by the Minister for Foreign Affairs of Chile,
Ms. Soledad Alvear, and twelve other distinguished women Ministers for Foreign
Affairs this past 12 September here in New York that "the HIV/AIDS
pandemic is an urgent foreign policy issue with humanitarian, security,
economic and development implications that threatens decades of hard‑won
progress, and which extends beyond the means and competence of any one nation
or entity to counter".
Indeed, Mr. Chairman, we are confronted with a
problem that concerns not only the countries most affected but the
international community as a whole. Today more than ever before there is need
to make available development assistance and additional financial resources to
implement policies and programs to stop the spread of HIV/AIDS and provide
treatment to all those currently affected.
The need for financial assistance and international
cooperation assumes particular urgency in the case of our brothers on the
continent of Africa, particularly those countries south of the Sahara, where,
as we know from the reports of the Secretary-General, UNAIDS and the World
Health Organization, more than 24.5 million people are affected by HIV/AIDS.
The United Nations, in collaboration with civil society and the private sector,
must increase its efforts to provide assistance to the peoples of Africa most
affected by the pandemic. This is a moral duty for an Organization founded on respect
for human rights and fundamental freedoms, especially where it is a question of
protecting the basic right of every human being, which is the right to life.
Mr. Chairman,
The Government of Chile considers the problem of HIV/AIDS as a
phenomenon that transcends the bounds of a strictly health problem and involves
socio‑cultural, psychological and economic aspects that call into
question the traditional models of human relations as well as the way in which
we develop and manage our social policies.
The restoration in 1990 of our traditional democratic
system led the new authorities in Chile to approach the problem by taking into
account its particular characteristics and complexity. To that end the National
AIDS Commission CONASIDA, was established with a mandate to promote and
facilitate processes aimed at helping the society to prevent and alleviate the
biological and psycho‑social impact of HIV/AIDS and sexually transmitted
diseases (STDs), based on standard technical criteria and on the Government principles
of participation, decentralization, equity and inter-sectorality. All of this
through study and dialogue, respect for human dignity and increased autonomy
for the individual".
CONASIDA prepares an annual plan of action based on
the principles of strategic planning and taking into account the results of the
evaluation of earlier periods, the indicators provided by constant review of
the situation of HIV/AIDS and the prior pursuit of joint initiatives with
organizations of people living with HIV, men who have sexual relations with
men, the organized community, health services and committees that provide
advisory services on clinical health matters, on sexually transmitted diseases
and on prevention and ethics.
CONASIDA carries out its activities on the basis of
four elements that are key to the success of its programs. These are:
Participation: This fundamental component in the search for a cure for AIDS is being
carried out in Chile with the involvement of the various structures of the
health and other concerned sectors of the State and with an active relationship
with nongovernmental organizations, the private sector and scientific
societies. A good example of joint projects is the first Chilean conference on
AIDS, which was organized by CONASIDA in 1999, the coordinator of groups of
persons living with HIV, and UNAIDS. Mention should also be made of the
elaboration and participatory execution of projects such as the provision of
psycho‑social support for continuing treatment for HIV/AIDS, which formed
part of the joint project with UNAIDS to improve access to medicines.
Intersectorality: By the very nature of the problem of AIDS, this strategy takes on
vital importance and encourages work and joint initiatives with other
ministries, public services and other organs of State, regional governments,
municipalities, the private sector, non‑governmental organizations and
community‑based organizations.
Decentralization: Health services management commitments, shared resources, local
initiatives in the formulation and execution of projects, ~ and the allocation
of funds through competitive bidding are all modalities designed to build local
management capacities and to more effectively respond to local needs.
Equity:
The allocation of resources for drug treatment and prevention programmes, in
particular, is done on the basis of criteria for distribution such as:
vulnerability, impact of the epidemic and state of advance of the illness.
Mr. Chairman,
The strategies adopted by Chile have enabled us to make
considerable gains, which, together with the development of new treatments,
have improved the life expectancy and quality of life of affected persons.
Permit me, Mr. President, to highlight a few of these advances:
Impact of
the epidemic:
·
Population studies show
that between 1992 and 1999, the proportion of persons infected by HIV/AIDS
stabilized at a maximum rate of 0.04 per cent of pregnant women who test
positive, which ranks the epidemic as incipient. The number of consultations
for sexually transmitted diseases is also stable, reaching a maximum of 3.5 per
cent in 1999.
·
The number of confirmed
tests for HIV/AIDS has been stable since 1996, which supports the findings
arrived at in studies of prevalence.
·
The annual rate of
increase of the AIDS epidemic has been declining over the past decade and fell
to 20.4 percent in the five‑year period from 1992 to 1997.
Impact on the population:
·
A population survey by
the World Health Organization showed that in Chile in 1996, 98.1 per cent of
those surveyed were aware of at least 2 means of preventing the transmission of
the HIV virus, independently of their level of education.
·
There has been a
gradual change in the attitudes of persons to the perception of risk, which,
when measured by population studies to evaluate social communication campaigns,
shows that the number of those surveyed who declared that we are all vulnerable
increased from 6.9 per cent in 1991 to 28.2 per cent in 1994. It is believed
that this figure has increased significantly since then.
·
Discrimination against
persons living with HIV/AIDS has also been measured in a population survey
carried out in 1998. It reveals that 75 per cent of the population is willing
to share social spaces, such as places at work and at school with persons living
with HIV/AIDS.
Adoption of preventive conduct:
·
The importation of
condoms increased by some 483 percent between 1990 and 1998, according to
figures from the Central Bank.
·
Declared condom use for
the last sexual contact outside of a stable partner was 40.5 per cent of those
surveyed who declared that they had another partner. This survey was conducted
among persons aged 15 to 26 years old in 1996 by the National Foundation to
Combat AIDS, a private organization.
·
Some 82 per cent of
those who declared that they had more than one partner, among persons aged 18
to 69 years use condoms, according to a survey conducted in 1998 by CONASIDA.
·
The Ministry of Health
set up a telephone consultation hotline, known as FONOSIDA. In 1999, calls
about at risk conduct accounted for 23.3 per cent of calls from adolescent's
aged 15 to 19 years and 41.55 per cent of calls from young people aged 20 to 24
years. Among sexually active men who called, 23.2 per cent of them declared
that they were men who had sexual relations with other men, thereby
demonstrating that the population groups that are most vulnerable are more
likely to seek access to this medium.
Legislation:
·
Legislation has been
drafted to promote prevention and non‑discrimination against persons
living with HIV/AIDS. The draft legislation was submitted by the executive
branch and has already been approved by the Chamber of Deputies. It is
currently being considered in the Senate.
Health
Sector:
·
Chile has experienced
an increase of 320 per cent in public spending for treatments between 1996 and
1999. There has also been a significant increase in the quality of anti‑retroviral
treatments and in the number of persons treated. Nevertheless, in September
2000 it is estimated that 50 per cent of ~those seeking treatment receive
coverage, with 750 patients receiving a double cocktail and 750 a triple
cocktail of drugs. This coverage is achieved thanks ~to a protocol that was
elaborated with the participation of CONASIDA and specialist doctors and with
the agreement of the National Coordinator of Persons Living with HIV/AIDS.
·
A decline has been
noted in the rate of prevalence of AIDS‑related illnesses. During the
period from 1989 to 1997, the diagnosis of the pathology declined among
adolescents and young people and increased among adults.
·
A 100 per cent coverage
exists for treatment to prevent the vertical transmission of HIV, namely, ACTG
076, prescribed for pregnant women who have tested positive in order to prevent
the transmission of the virus to the child.
Projects with the most vulnerable
sectors of the population:
·
Through agreements with
specific non‑governmental organizations, CONASIDA provides technical and
financial support, incorporating this approach into its annual commitments to
provide health management services and now also in regional work plans.
Projects are being implemented with organizations of persons of homosexual
orientation, such as: "Educational campaign for the reduction of the risk
of transmission of sexually transmitted diseases and HIV/AIDS between men who
practice homosexuality, in Regions I, II and IX and in the Metropolitan
Region"; "Comprehensive action to prevent HIV/AIDS among gay and
bisexual men through peer education in the Metropolitan Region and two communes
of the V Region"; and "Action by Citizens to change their attitudes
towards HIV/AIDS and homosexuality in the Metropolitan Region and in Regions
II, V and VIII". Programs are also being conducted with adult sex workers,
such as for example "Prevention of HIV/AIDS and STDs among vulnerable
population groups".
Integration
of HIV/AIDS into the management strategies of the Ministry of Health and Social
Services:
·
The focus of these
strategies depends on the epidemiological situation and on the vulnerability,
particularly of homosexuals, women and young people, persons active in the sex
trade and drug users. All the Regions of Chile have implemented projects that
vary in scope and coverage and which are targeted to vulnerable populations.
Communal intersectoral activities:
·
Joint projects have
been elaborated between social organizations for the prevention of AIDS in the
communes with the highest concentrations of urban populations in those regions
with the highest incidence of AIDS or which are potentially at risk.
Mr. Chairman,
Before I conclude, I wish to reiterate the commitment
of the Government of Chile to continue to seek solutions to the scourge of AIDS
and to cooperate as much as our resources permit with those countries that are
most affected by this pandemic. We must not forget for even one moment the
sacred right to life that is inherent in e very human being. In 1999, Chile
lost more than 1000 precious lives of children, women and men afflicted by AIDS
and there are thousands of others who, if treatments and access to them are not
improved, are also at risk of losing their lives. For the sake of them all, Mr.
Chairman, without exception we must redouble our efforts to combat HIV/AIDS.
Thank you very much Mr. Chairman.
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