An atmosphere of apprehension and behind the scenes turmoil permeated the opening of the United Nations General Assembly Special Session on HIV/AIDS. The three-day session, June 25-27, is known by the unfortunate acronym of UNGASS.
Its purpose is to focus world attention on the epidemic, craft structures to administer the $7-10 billion annually that UN Secretary General Kofi Annan has said is necessary to combat the plague, and dozens of other things depending on who you listen to.
About 2,000 demonstrators marched through the streets of Manhattan June 23 to urge dramatic changes in confronting the global pandemic of AIDS. It was organized by the Health GAP Coalition, an international coalition.
Rain disrupted the initial assembly for the march. It stopped for the duration of the march, but the skies open up again with torrential downpours just as they reached their destination of Bryant Park. The rally was shortened but no less lively.
"Drop the debt 100 percent," chanted the sodden crowd. Cancellation of Africa's international debt is a major point for one set of players where alliances may change from issue to issue. It would end the $250 million a week drain that those nations make in interest payments just to the International Monetary Fund.
The theory is that this money could then be spent on healthcare for the people of those nations. It is likely that some would, but the reality is that other portions would be disbursed in the same ways that the original debt was acquired, on the purchase of weapons, prestigious but inappropriate development projects, and be squirreled away into secret Swiss bank accounts.
"This is the day when business as usual has to stop, at the UN and in the western countries of the world," said South African Mercy Makhalemele. "We call on the U.S. and other wealthy countries to invest multiple billions" to assist developing countries in building their health infrastructure.
She compared it to the Marshall Plan that rebuilt the shattered landscape of post-World War II Europe. What she did not mention was the billions of dollars in aid that developed nations have given the developing world over the last decades, often with little lasting impact.
Many AIDS advocates are dismayed that this is the first time the UN has held a special session dealing with HIV. Part of the explanation was seen in the continuing deadlock over language in documents that the UNGASS hopes to approve.
AIDS advocates have proposed what they see as a realistic approach to dealing with issues of women's rights, homosexuality, prostitution, and injection drug use. They are pushing for language that includes these groups as those at greatest risk for infection and utilizes peer education a part of a prevention program. Much of their language is framed in terms of basic human rights.
Some developing nations see this as western cultural imperialism attempting to impose its values upon them. Many Islamic nations and the Vatican have opposed including language on homosexuals, prostitutes, and drug users in the UN document as an attack upon the traditional family.
The American delegation, which includes few AIDS advocates and many social conservatives, has vacillated during the negotiations. Their concerns include not wanting to appear to confer special status on the stigmatized groups and wanting to blunt the call for treatment as opposed to care and prevention.
The U.S. positions led the group Human Rights Watch and others to charge that the U.S. was attempting to "censor" the UN document and promote "the denial and discrimination that have helped spread the disease."