AIDS is the real weapon of mass destruction -- UN Secretary General
Africa Recovery (New York) BROADCAST TRANSCRIPT December 14, 2003 Posted to the web December 14, 2003 On 28 November the British Broadcasting Corporation (BBC) posted an online audio interview with UN Secretary-General Kofi Annan about the struggle against HIV/AIDS. The interview can be heard at: http://news.bbc.co.uk/2/hi/africa/3244564.stm The transcript of this important broadcast appears below in its entirety. It has been edited slightly for clarity. The Secretary-General was speaking to Ms. Carrie Gracie on "The Interview" programme for BBC World Service radio. It is reproduced by the UN publication Africa Recovery with the permission of the BBC. For an excerpt from the Africa 2003 guidebook, click here. (Adobe Acrobat). To buy the book, click here. Hello and welcome to The Interview. I'm Carrie Gracie and today I'm in the Secretary-General's suite on the 38th floor of the United Nations headquarters in New York. My guest is the UN Secretary-General Kofi Annan. Welcome to The Interview. Thank you very much. I'm happy to be here. Over the past two weeks the BBC World Service has been running an AIDS season and we've heard many aspects of the illness. But today we want to get a sense of your personal contribution and whether you think that you're winning the battle. So I want to start by asking you about the enemy. When did you first realize what a serious enemy you were up against with AIDS? I think it was when I discussed the issue with the World Health Organization [WHO] and UNAIDS [the Joint UN Programme on HIV/AIDS] and looked at the figures and the statistics and the devastation it was causing in many African countries, and at the attitude of the leaders. We needed leadership. We needed leadership at all levels. But it was most important to get the presidents and the prime ministers speaking up and that was not happening. I thought we should do whatever we can to raise awareness and to get them involved. And your sense of the problem, is it all from talking to leaders and talking to officials or have you been out there on the ground talking to sufferers? I've been out there on the ground talking to sufferers. In fact, my wife and I were in Lima just last week and we had a rather painful experience with a group of women who had set themselves up to help AIDS sufferers. They had with them a nine-year-old. The mother and the father had died of AIDS. She was left with her grandmother who was illiterate and didn't know what to do. When we met them, she was getting no assistance at all, so I called my UNDP [UN Development Programme] colleague there, the resident coordinator, and I said "can't we do something for this girl?" And of course he's going to try and see if PAHO, [the Pan-American Health Organization], WHO's regional organization, can help her. But we were both quite struck. We knew this was happening but we hadn't expected it. I've seen the situation in parts of Africa where I've visited AIDS patients in villages, where you see a grandmother and lots of grandchildren but no mother, no father. And yet you go to a place like Mozambique, to a small clinic which is doing a lot, which is following pregnant women, ensuring that the children are born free of AIDS and following the mother to try and protect her so that they can have their mother as well and they do not become one of the 14 million plus orphans. I've also lost some very close friends, including people who worked here in the UN, and that also hits you. So you've watched individuals struggle through the course of the illness? Exactly, so for me it's not statistics -- it's not statistics. I've seen the human suffering and the pain. What is even more difficult is when you see somebody lying there dying who knows that there's medication and medicine somewhere else in the world that can save her, but she can't have it because she's poor and lives in a poor country. Where is our common humanity? How do you explain to her that in certain parts of the world AIDS is a disease that can be treated, that one can live with and function, but in her particular situation it's a death sentence. It's a tough one. And how do you explain it? You try to explain to them about what you are trying to do and what you are trying to get the governments to do to increase assistance -- not only in areas of treatment, prevention and education and also getting the youth and the women's organizations involved. It may not necessarily help her particular situation, but at least it's good for her to know that action is contemplated, action is on the way. If it will not save her it will save others. That in itself is consoling, but its not good enough. This is why I'm rather pleased with [WHO Director-General Lee Jong Wook]'s approach of trying to get the AIDS medication to 3 million people in five years [sic]. Today we have 300,000 people on the medication. This is the World Health Organization initiative? Yes. It's called three by five. Three million by the year 2005. Yes. We'll talk about that in a moment, but first I want to get a sense of how you feel when you're faced with these people asking you, "Why can't I have the drug?" It is extremely difficult and I can tell you I've really tried very hard. You may know that I've had several meetings with the chairmen of the seven top pharmaceutical companies to press for reduction in the prices of these medications -- to get across to them that whilst I respect and support intellectual property, it is extremely difficult not to make the medication accessible to the poor. We need to be able to balance it. And they have reduced some of the prices. In some cases, like neviripine, in some countries they're giving it away free. This is the drug for mother-to-child transmission for pregnant mothers? Exactly, which I consider the cruellest of all transmissions. So you press and push and try and get as much as you can. And governments are becoming engaged. For the person who is lying there, in some cases like the child I mentioned in Lima, you are able to get them some assistance, but it doesn't always happen that way. With others you cannot immediately get them assistance. And does that make you feel angry or does it make you feel distressed? Both. I feel angry, I feel distressed, I feel helpless to live in a world where we have the means, we have the resources, to be able to help all these patients, and what is lacking is the political will. How do you generate that political will to ensure that assistance reaches them? And of course with somebody like myself who tries to speak for the poor and the voiceless, you sort of feel you're failing, you're not getting enough done. You walk away a bit depleted and upset -- really upset if not depressed. What more can you do, though? When you ask yourself "what more can I do," what answers do you come up with? I think we should continue our efforts to mobilize the societies to play a role. We should get the leaders to speak out against discrimination, the stigma that is attached to it. We need resources, we need resources to assist these people. We are operating at a relatively low level. We estimate that by 2005 we will need $10 bn worldwide per annum to fight the disease. Today I'm trying to see if we can get $3 bn a year for the next five years going into the Global Fund [against AIDS, Tuberculosis and Malaria, an international funding agency]. I would want to see $1 bn from the European Union per year for the next five years, $1 bn from the United States government and $1 bn from other sources -- multi-year commitments over the next five years. And of course, the rest of the resources will have to come from elsewhere. But that money is not forthcoming, is it? I mean, people started off with great protestations about how much they were going to contribute two years ago, but it's not coming. It's not. I am disappointed. We've got several billion dollars and I'm grateful for that, but it's not enough. We need much, much more. Because you said when you launched the Global Fund, you said you needed $7-10 bn a year. At the moment, the global fund has been able to hand out $2 bn over two years. You're miles short. Does that make you feel -- you talked about a sense of personally failing -- does that make you feel that there's some failure on your part? Failure on my part and insensitivity on the part of those with power and the resources -- insensitivity on the part of those who should develop the political will to do it. And I'm badgering. I'm talking to them. I'm pushing. And how do you do it? Say I'm sitting across from you now, I'm George Bush. I've just announced that I'm going to provide $15 bn for AIDS over five years, but I'm only going to give a small part of that to the United Nations and the rest I'm going to hand out piecemeal myself. How do you persuade me? I explain that if you want to start from scratch and develop it yourselves and build the necessary administrative structures and mechanism, obviously you're not going to be able to spend the $3 bn or so in a year. But if you were to use existing structures which the Global Fund and the UN family have established, you should be able to use much of that money to reach the needy who need it today and not tomorrow. And that I'm also encouraging them to put as much of the money as possible into the Global Fund. Initially they had said $1 bn to the Fund and I said "well if it is $1 bn initially, it's not too bad." But then I discovered that it was $1 bn over five years. But I think we haven't given up. I've talked to senators, I've talked to others. I've spoken with President Bush himself, who is very sensitive to this issue of AIDS. [We need] to raise the level of contribution to the Global Fund, which has to date given grants to about 93 countries. Wherever I go, they tell me how helpful this has been, and of course they are all looking for additional support. If we do not replenish the funds and the Global Fund were to fail, I think it would be a very serious indictment of the leadership in the world today. And is it an indictment of them on a humanitarian basis or is there an argument from self interest that you can use to persuade them? Both. From humanitarian -- from moral -- grounds and self interest. Basically, it is a security problem in some of these countries. I mean, if you take some of the African countries in Southern Africa, AIDS is taking away not just the present but the future. It's taking away some of the most productive men and women. Schools are losing teachers. Hospitals are losing doctors. The civil service is depleted. In the past we talked of training people and civil servants. Here in some of these countries we may have to talk of replenishment or perhaps even bringing in people from outside. It's decimating the security forces and the police. It is a really serious problem, and it's not just in Africa. It's spreading very fast in Asia, in Eastern Europe and in the Caribbean, and even in this country it's on the way up. So those who think AIDS is over are dreaming. It is one of the most serious epidemics the world has ever faced and we need to really, really get serious about it. We talked about what you want from the developed world. Now let's talk about the leadership in those countries faced with epidemics emerging. What's the problem with leadership? Why isn't it coming? Some refuse to talk about this because of cultural reasons. We had a situation where one African leader was going to give a speech -- I don't want to embarrass him by naming him -- and the speech was prepared for him, where he was urged to encourage young people and the population to use condoms to protect themselves. He said, "I can't utter the word condoms, I'm the father of the nation. You can't ask me to encourage the youth to be promiscuous." But this is saving lives. And is that what you said to him? Yes, I said that to him. I said, "This is saving lives." I spoke to another African leader who was also entirely against the use of condoms and said, "Mr. Secretary-General, we don't want to associate you with the word condoms. You shouldn't even be using that word or speaking about it." I said, "Mr. President, I've even written to the Pope about it to see how we can work with the Catholic Church on prevention, on education, on treatment and care." And he looked at me and said, "Mr. Secretary-General, when it comes to condoms, the Pope and I are one." I said, "Mr. President, but your people are dying. We're talking about saving lives and this is a very serious business -- and God will understand." And did you change his mind? I didn't. And this is the frustration. These are the painful experiences you sometimes have to go through. And then if I walk away to see one of the dying patients and they were to look up and say, "Help me -- get our president and the leaders to help us." You can't tell them the attitude of their president. I say, "We are pressing the president. We are going to push." Sometimes you have to speak out to put them on the spot. At the same time you want to be able to work with them and encourage them to do what is right and what they have to do and not to turn them off. And it is really really, very very painful. So you can't shout at them in public. You have to apply this pressure privately. I do both. I apply it privately -- very bluntly. In public I speak out and push the leaders to act. Push them to lead. Push them to think of their people. Push them to save lives, but without naming them individually. It's very hard, isn't it, because a lot of the groups most affected by AIDS are very marginalized groups anyway. I was just reading the Epidemic Update published by UNAIDS and the stories are horrific of the rise in the problem -- injecting drug users, the male-to-male transmission, homosexuality, the sex workers. And of course all over Africa, Sub-Saharan Africa, the stigmatization of people with AIDS. If you have people who are marginalized, they can't speak up for themselves. If their governments aren't going to speak up for them, then who is? This is the real test. This is why I speak out as often as I can. That is why I became engaged in the fight and made it my personal priority and I fought very hard to make it the priority of the UN family of agencies. But I think we need to also get civil society [involved]. NGOs have been very effective partners and they've been active in sometimes embarrassing and pushing the governments to do the right thing. We've seen women's organizations at the grassroots level, and this is very important because today in Africa, AIDS has a woman's face. Over 50 per cent of the infected are women and often they are the innocent victims. We really need to empower the women to take care of themselves and get the young people involved. And I have seen in these countries where the campaign is mounted by the head of state and it goes down all the way to the village level. In Senegal, for example, they are even using griots -- a griot is an oral historian -- to tell the story, to talk to the people about it. We visited them a couple of years ago and my wife asked this woman griot, "Are you embarrassed to talk about sex and all these things frankly to the people in their village?" She said, "This is death. There is no embarrassment in death. There is no embarrassment in trying to save lives." And it's that kind of spirit that I want to see in the African leaders and the leaders around the world whose populations are threatened. I want to see them adopt the attitude of this griot in Senegal that we met. She was very inspirational. So Mr. Annan, are you winning the war? Well, I would wish to think so, but I'm not. I'm really not winning the war. I'm not winning the war because I don't think the leaders of the world are engaged enough. I also appeal to communities and societies everywhere to become engaged in the struggle. They cannot leave it to their leaders alone. So in a way you're talking to the people over the heads of their governments. I'm talking to people over the heads of their governments. They should take on this fight. They should not be afraid to speak up. They should not be afraid to challenge their governments to do something about the epidemic. It is their lives. It is the lives of their children, their sisters, their mothers and their brothers and fathers. And they have the right to demand support. They have the right to demand action from leaders whose main and major responsibility, after all, is to ensure the safety and welfare of their people. Because obviously that has happened in the developed world. People with HIV/AIDS-related illnesses are getting anti-retroviral drugs. There are prevention measures in place. Is that because they have political rights, because they are vocal? Or is it because these societies are rich? I think you have both. We shouldn't forget the history of the disease. At the beginning, the community that was hardest hit by HIV/AIDS was either here or in Europe and they organized themselves very effectively to get attention from their governments. They had a voice. They were organized and they also knew how to use the media and the press. When you go to the developing countries, you don't necessarily have that capacity. You described them as the voiceless and the poor and they need others to speak up for them. But give them a bit of help, a bit of encouragement and a bit of organization -- they can surprise all of us. I want to bring up with you an example of someone with a voice. We talked last week to a Ugandan woman who'd been HIV-positive for many years and she did feel angry about some things. She asked me to ask you when we can expect the many people who need medication in the developing world to get it. When will they get their medication? That is a difficult question to answer in terms of a time frame. In fact, the major [AIDS medicines] campaign, which has been launched by the World Health Organization, is 3 by 5 -- 3 million people by the year 2005. The estimates are that 6 million people need it today. So that is half of the 6 million people. If you were to get to the 3 million by 2005, and you were to extrapolate from there, hopefully you would be able to give it to them by 2007-2008. I'm also hoping that there will be developments -- that the medication will be cheaper, we'll be able to come up with one 3-in-1 [combined medications] tablet to be able to assist them. I'm also hoping that the world will wake up and realize that we need to get the medication to those who really need it and lessen our self interest. Many governments have described it as a security problem and yet we are not giving it the kind of attention we are devoting to terrorism and weapons of mass destruction. For people in some of the countries we are talking about, AIDS is the real weapon of mass destruction, and what are we doing about that? On that point. your special envoy on AIDS in Africa, Stephen Lewis, has called spending on the Iraq war and the war on terror obscene and he mentioned a figure of $200 bn and set it alongside the annual spending on AIDS -- a total of possibly $3 bn. Is that obscene? My own view is that we need to fight all the threats. I call the fight against terrorism and weapons of mass destruction the sort of hard threats -- hard threats because people see immediate blood, immediate war. But the soft threats -- poverty, the AIDS epidemic, environmental degradation -- are also with us. And in many societies they are wreaking much more havoc than the terrorists are and we need to tackle all these threats. We don't have a choice. We don't have an option. Some say there was a tragic missed opportunity. That the world was gearing itself up to tackle AIDS. That it was facing up to these soft threats in the year 2000, the year 2001. But then on September 11 the twin towers came down, the attack on the Pentagon and the whole world changed. It became the war on terrorism. It became then weapons of mass destruction, war in Iraq and the world lost its focus on AIDS. Is that how you see it? Let me put it this way. I hope if we had not had 9/11, many more resources would have gone to AIDS. But I can't be sure. I can't be sure because I have seen other situations where it has not happened. Let me give you the example of Somalia. When we mounted -- the international community mounted -- that major operation in Somalia, the US forces withdrew and we put in a UN force, the blue helmets, to take over. The military expenditure was about $1.5 bn a year. At one point, we needed $150 mn for the humanitarian operation -- and the deployment was seen as humanitarian intervention. We couldn't get the $150 mn. So really, when you ask me if there had not been a 9/11, if there had not been war in Iraq, would we have gotten all the resources that we needed, for AIDS and the fight against the epidemic, I really can't answer that. I must say I have to be honest, because what is more important? The fight against the epidemic that saves millions or the war and the fight against terrorism? This is why I'm saying we need to draw up a balance. We need to tackle these issues right on. And I think the capacity and the resources are there. We have to develop the political will to get to them. Three million people, we think, died of AIDS this year -- 2 million of them in Africa. If those kinds of numbers were dying in the rich part of Europe or in North America, then all of this would be different, wouldn't it? All of it would be different because the population would have demanded action. The politicians would want their votes and would act to be able to tell the mothers, the brothers and the sisters that "we are fighting your fight, we are saving your children, and yes, vote for me." But this is distant and not everybody sees it the same way. And yet we have common humanity and we need to be sensitive to the needs and concerns of others. And as an African watching so many people on your continent die, does that feel like injustice? It is worse than that. It does feel like injustice, but it also indicates a certain incredible callousness that one would not have expected in the 21st century. And how will history judge us for what you describe as this incredible callousness? Harshly. Very harshly. And I don't think we will have any defence. What about you? How will history judge you and your role? That is for others to decide. I think it would be not only improper but perhaps even immodest to talk about my role. I would prefer you and others to tell it. As the saying goes, "A man cannot see himself except through a reflection of a mirror." So be my mirror and tell me about my contribution. We mentioned talking to people over the heads of their government. What would you like to say to all the listeners to the BBC World Service about AIDS? About what they should do to help? I think what I would want to tell them, that we face a real serious epidemic -- an epidemic that is destroying societies and countries. And the leaders of these countries -- if they're going to have a country and a country with a future to lead -- they'd better pay attention to this epidemic. They'd better pay attention to the youth, the vulnerable groups in society, particularly the women who are not empowered, who are often abused and are often subject to violence, which also leads to increase in the AIDS epidemic. The [leaders] should speak up. They should end the silence and the stigma and the discrimination that is attached to the disease. And that when it comes to AIDS, silence is death. And if they do not speak up and help their people, their deaths will be on their consciences. Kofi Annan. Secretary-General of the United Nations. Thanks for joining us for The Interview. Thank you very much. The Mulindwas Communication Group "With Yoweri Museveni, Uganda is in anarchy" Groupe de communication Mulindwas "avec Yoweri Museveni, l'Ouganda est dans l'anarchie" [Non-text portions of this message have been removed] ------------------------ Yahoo! Groups Sponsor ---------------------~--> Buy Ink Cartridges or Refill Kits for your HP, Epson, Canon or Lexmark Printer at MyInks.com. Free s/h on orders $50 or more to the US & Canada. http://www.c1tracking.com/l.asp?cid=5511 http://us.click.yahoo.com/mOAaAA/3exGAA/qnsNAA/TTwplB/TM ---------------------------------------------------------------------~-> **********Keep Hope Alive!!!************* Win upto =N=150,000.00 ... 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