Annan urges U.S.,
Islamic nations to help gays fight HIV

United Nations secretary-general Kofi Annan on Wednesday challenged the United States and Islamic nations to involve sex workers, drug users, and gay men in HIV prevention and treatment programs. Annan and general assembly president Jan Eliasson opened a high-level three-day conference on AIDS that included thousands of activists, ministers, and diplomats to assess progress so far. Less than half of those infected with HIV have received drug treatment.

Addressing a session of activists, Annan said marginalized people also are in need of treatment for a disease he called "a devastating obstacle to the progress of humankind." The United States, Islamic states, and some Catholic countries oppose the mention of prostitutes, gay men, or drug users, referring to them only as "vulnerable groups" in a final statement that governments are negotiating. To combat AIDS, "it means we must work closely and constructively with those who have too often been marginalized--sex workers, injecting drug users, and men who have sex with men," Annan said.

The secretary-general mentioned no country by name but was asked if he meant to challenge positions taken by a coalition of nations that included the United States.

"I think it should be challenged. We need to be realistic," Annan told reporters. "If we are here to try and end the epidemic and fight the epidemic, we will not succeed by putting our heads in the sand and pretending these people do not exist or do not need help."

The United States, Islamic nations, and others argue that prostitution, drug use, and homosexuality are illegal in many countries and mentioning these groups might be an endorsement.

Experts say that in most nations, AIDS began with sex workers, gay men, and drug addicts who spread HIV through dirty needles. When HIV was not contained among those groups, it spread to the general population.

Annan noted it would be 25 years ago next week that the world had first heard of AIDS. "Since then, HIV/AIDS has unfolded along a pattern we tend to see only in nightmares."

Of the more than 38 million people living with HIV, some 2.8 million people died in 2005, most of them in sub-Saharan African areas where food supplies are scarce and health systems are weak. Some 65 million people have contracted HIV since June 1981, and 25 million have died of it.

The Joint United Nations Programme on HIV/AIDS, the umbrella group leading the global campaign, estimates that about $8.3 billion was spent last year in treatment, prevention, and care of orphans in low- and middle-income countries, meeting a $7 billion to $10 billion target set five years ago. The hope is that nations this week commit to spending $20 billion annually by 2010.

The United States leads the world in commitments to fight AIDS, having pledged more money than any other country, $15 billion over five years, but is expected to be challenged for its emphasis on abstinence. "We're not against abstinence programs as long as it's part of the overall picture," says Peter Piot, head of UNAIDS. "For a 14-year-old girl, it is a human right to be abstinent and not to be married, not to be raped."

Wednesday's opening general assembly session also for the first time heard from an HIV-positive person on its podium--Khensani Mavasa, a South African activist and a representative of the Treatment Action Campaign. "I ask that as you deliberate over the next two days you be guided by the pain and hope which sits in our hearts as people of the world, that you remember that 14,000 new infections and 8,000 deaths occur daily," she said. (Reuters)