Dear Friends and Colleagues,

I am very happy to be here with you today to discuss the AIDS epidemic, which is, I believe, one of the greatest human security threats facing the world today. An estimated 40 million people are now living with HIV/AIDS, with approximately 5 million newly infected last year alone. 95 percent of those infected live in the developing world, where AIDS has emerged against a backdrop of a variety of other human security threats including poverty, conflict and inadequate infrastructure. Its effect has been to make those problems and their consequences far worse.

HIV/AIDS is destroying families and communities and sapping the economic vitality of countries. The loss of teachers to AIDS contributes to illiteracy and lack of skills. The decimation of civil servants weakens core government functions. The burden of HIV/AIDS, including the death toll among health workers, is pushing health systems to the brink of collapse. In the most severely affected regions, the impact of disease and death is undermining the economic, social and political gains of the last past half-century and crushing hopes for a better future.

For years, the world stared at this unfolding human security crisis and debated whether AIDS drugs, which have transformed the disease in the developed world into a chronic, manageable illness, could ever be practically delivered in poor countries. Many experts said treatment was too costly or too difficult to administer in the developing world.

A new report from the World Health Organization and UNAIDS shows that these concerns have been greatly overstated. AIDS treatment works in the developing world. One million people are now receiving antiretroviral drugs in the poorest and most seriously affected nations. HIV treatment access in Africa and Asia has more than tripled in the past year, and continues to accelerate.

What does HIV treatment mean for human security? It means that one million people are now healthy enough to go back to work to support their families and educate their children. HIV treatment strengthens the pillars that keep societies from disintegrating into chaos.

However, one million is just the tip of the iceberg. Another five million people in the developing world are in urgent need of treatment. Equitable access can only truly be accomplished when everyone who needs treatment has access to it. It is for this reason that WHO strongly supports the goal of universal access to treatment by 2010 as announced at the recent G8 meeting in Scotland .

The goal of universal access to both prevention and treatment presents a unique opportunity to make a meaningful impact on international human security. However, a number of important challenges persist and will need to be overcome if millions more lives are to be saved. I would like to briefly summarize 7 key challenges.

The first of the main challenges is that of political commitment. It has been repeatedly shown that high-level political commitment is a prerequisite for an effective national response to the AIDS epidemic. While the commitment is strong and growing in countries like Lesotho , where the Prime Minister has recently taken a public HIV test, many countries still lack the political will necessary to reverse the spread of the disease.

The second challenge relates to financial sustainability. Over the past few years, an unprecedented amount of funds have become available for HIV prevention and treatment from a variety of sources including the Global Fund, the World Bank and the US President's Emergency Plan for AIDS Relief. Developing countries themselves have also increased their financial commitment. For example, South Africa has committed $1 billion of its own resources to support treatment. However, despite remarkable progress there remains a treatment funding shortfall of at least $12 billion over the next three years, and an even greater shortage if prevention is made universally available.

Third, there is an urgent need to address human resource gaps which are currently constraining prevention and treatment scale-up in many countries. Loss of trained nurses and physicians to the private sector, to urban areas, to developed countries and to the epidemic itself has starved the public sector of the people on whom delivery of health services depends. Together with numerous partners, WHO is currently helping countries address the lack of physicians and nurses by shifting tasks away from a physician-centered model and increasing the number of health workers trained in standardized prevention and treatment approaches. Pioneered in Uganda and South Africa , the approach is now in various stages of adaptation and implementation in numerous countries throughout Africa and Asia .

Fourth, there is a need to strengthen systems to more efficiently manage supplies of drugs, diagnostics and other prevention commodities. In many districts, health-care providers are having problems ensuring that supplies are available in sufficient quantities at the right place and at the right time. The WHO response to this challenge has been to establish and coordinate the AIDS Medicines and Diagnostics Service.

The partners in the AMDS are working with countries to develop nationally agreed and properly funded Procurement and Supply Management Plans. In addition to describing who should procure what, the plans define how drugs will be stored, transported, distributed and re-stocked.

The fifth challenge is that of ensuring equitable access to HIV prevention and treatment services. Even where services are available, there has been widespread concern that, due to a variety of cultural and social attitudes, women will not be able to access services at the same rate as men, and the same is true for young people. While our recent findings show that gender equity in accessing treatment has been good, attention is needed to ensure that vulnerable populations, particularly children and young people, refugees and the poor, have access to prevention and treatment services.

Sixth, is the need to integrate prevention and treatment. Whenever possible, HIV treatment should be scaled up alongside prevention, so that health workers and service sites are equipped to deliver an essential package of HIV prevention and treatment interventions. These include offering HIV treatment, testing, and counseling at the same sites, and training health workers to deliver both treatment and prevention messages and interventions.

Finally, donors and partners need to better coordinate their financial and technical support to countries. In many developing countries there exists a vast and complex web of actors working on HIV scale-up, many of them in complete isolation. One forum for promoting better coordination is the Global Task Team, which has made bold and innovative recommendations to address these needs. WHO is also fully committed to the "Three Ones" principle and to concrete actions to make "Three Ones" a reality in countries.

Working together with a variety of partners, including governments, other UN agencies, civil society, including NGOs, faith-based organizations, community and PWA networks, and the private sector, WHO is committed to supporting countries to overcome these 7 and possibly other challenges, thereby playing a crucial role in making universal access to prevention and treatment a reality. By improving the health and livelihoods of millions of the world's most vulnerable people, universal access to HIV prevention and treatment services will have an enormous impact on global human security.

I look forward to discussing with you how, together, we can make this a reality.

Thank you.

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