UNITED NATIONS (AP) - U.N. Secretary-General Kofi Annan challenged world leaders Wednesday to face reality and understand that to stop the spread of AIDS, they must protect the people most vulnerable to virus.
In unusually forceful comments, Annan was essentially hoping to spark action among leaders gathered for a three-day General Assembly High-Level Meeting on AIDS meant to chart a course on fighting the virus and delivering treatment to all those afflicted by it.
A day after a major U.N. report found the disease had slowed in its spread but is still a grave epidemic, representatives of civil society groups said Islamic nations don't want any mention of "vulnerable groups" — a catch phrase that includes homosexuals, sex workers and drug users — as the world discusses future action on fighting AIDS.
"We need to be realistic. We need to be able to protect the most vulnerable," Annan told reporters. "We will not succeed by putting our head in the sand and pretending that these people do not exist or they do not need help."
The comments addressed what will be one of several controversial issues faced by the summit. Civil society groups and aid groups in the field say the issue of vulnerable populations is central to combatting AIDS. They also want a focus on empowering women and giving comprehensive sexual education to kids.
However, many countries, including Islamic nations and some conservative Latin American nations, have opposed those ideas, largely for ideological reasons.
In a split with its stance from 2001, the United States said it supported mention of marginalized and vulnerable groups.
"We would love the mention of vulnerable populations — generally, specifically, we have no objection," said Kirsten Silverberg, who heads the State Department office responsible for U.N. matters.
Earlier Wednesday, Annan warned the meeting that the world has fallen far short of its promises five years ago to fight the virus. Efforts to fight AIDS among women and children have failed and young people still have little understanding of AIDS, he said.
According to the report released Tuesday, a worldwide survey has found that nearly 40 million people worldwide are living with HIV/AIDS. India now has the largest number of AIDS infections, but the epidemic still remains at its worst in sub-Saharan Africa, where per capita rates continue to climb in several countries.
Women's vulnerability to the disease continues to increase, with more than 17 million women infected worldwide — nearly half the global total — and more than three-quarters of them living in sub-Saharan Africa, the report found.
The virus "has spread further, faster and with more catastrophic long-term effects than any other disease," Annan said. "Its impact has become a devastating obstacle to the progress of humankind."
The three-day meeting comes a week before the 25th anniversary of the first documented AIDS cases — June 5, 1981. It is meant to review promises made in a similar conference in 2001, and chart a course to provide universal access for AIDS prevention and treatment.
Civil society groups said they feared that there was not a real sense of urgency among diplomats at the meeting to put forward specific proposals or shed outdated ideas about the virus.
"Even though AIDS should be everybody's problem and issue, and everyone should care about it, I'm sorry to say that for the most part the diplomats in this building either don't care or don't know," said Adrienne Germain, president of the International Women's Health Coalition.
Most of the targets from 2001 have not been met. Among the biggest failures was the so-called "3 by 5" target — of getting treatment to 3 million poor people infected with AIDS by the end of last year.
Peter Piot, head of the U.N. AIDS agency, said he hoped the meeting will generate new funding to fight the disease, which needs between $18 billion and $22 billion each year to be fought effectively. It gets about $10 billion a year now.
"We need to commit to a strategic approach that recognizes AIDS both as a long-term priority as well as an emergency that requires an immediate response," Piot said. "In other words, we need to run a marathon at the pace of a sprint."
Yet many nations, including the United States, have resisted setting large targets, and appeared unlikely to change their stance. The U.S. delegation, for example, wanted to strike language from a final declaration that would call for universal access to treatment by 2010.
Britain's development secretary, Hilary Benn, planned to call for poor nations to develop 10-year plans to fight HIV/AIDS, the British Foreign Office said in a news release. Benn will also ask the international community to "back these plans with long-term and predictable finance."
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