Signing Ceremony and Briefing at UNGA Special Session on HIV/AIDS

USUN Press Release #97(01)
June 27, 2001
For Immediate Release

Transcript of Signing Ceremony by Dr. Duff Gillespie, Deputy Assistant Administrator, USAID, and Dr. Peter Piot, Executive Director, UNAIDS, followed by briefing by members of the U.S. Delegation to the UN General Assembly Special Session on HIV-AIDS, June 27, 2001

Extended Briefing by:

Ms. Lynne Lambert, Director, Bureau of International Organizations
Office of Technical Agencies, Department of State

Mr. John Sandage, Attorney-Advisor
Office of the Legal Advisor
Department of State

Dr. Paul Delay, Chief
HIV/AIDS Division, USAID

Mr. Jairo Pedrazza
PWA Leadership Institute
Latino Commission on AIDS

Wednesday, June 27, 2001
At United Nations Headquarters

Dr. Paul De Lay: I think most of you know me. I'm Chief of the HIV/AIDS Division of USAID. I just wanted to briefly go through the format for today's event. The first speaker will be Dr. Duff Gillespie, who is the Deputy Assistant Administrator at USAID, and he will be making a few remarks about USAID and the relationship it has had with UNAIDS. And then he will be followed up by Dr. Peter Piot, who is the Executive Director of UNAIDS. I think everyone here in this room knows him. Then there will be a very short signing event, to be followed up a press briefing for questions and answers. Hopefully, this will be a fairly concise body of time.

And with that, Dr. Gillespie.

Dr. Gillespie: Thank you, Paul. And thank you for coming. We want to take advantage of having Peter here with us in New York to not only give him $17 million but also to have a little bit of an event due to the long association we have had in the very beginning. Actually, prior to the beginning of the creation of UNAIDS, the US was an active party in creating UNAIDS, and the investment that we have made almost -- with this investment of $17 million this year -- totals around $94 million that the US will have given to UNAIDS.

We are very pleased with the investment and the return of the investment that we have gotten. I would like just to highlight a few things that I think the UNAIDS, under Peter's leadership, has accomplished.

First, it has done a magnificent job in raising the awareness of AIDS, not only in the developed countries but, most importantly, in the developing countries. Secondly, to provide a focal point and a dissemination mechanism to get out information, accurate information, to better establish procedures in a very rapid fashion that didn't exist before.

Perhaps most remarkably, one thing that UNAIDS has accomplished is to bring together the diverse parts of the UN system and to have what I think is a unique, coordinated, collegial effort throughout the UN to attack this very extraordinary and terrible disease, AIDS.

Because of that, we will continue to be the largest donor, I hope, to UNAIDS. Peter would like someone else to take on that so that there would be a bidding war between the various donors. (Laughter.) But, seriously, this is an event that is symbolic of our confidence in UNAIDS as an organization and our confidence in Peter Piot as the leader of that organization.

Dr. Piot: Thank you very much, Doctor, for the kind words. You said many things that I was going to say, except the compliments about ourselves. But it is definitely true that if we exist at all, it is thanks to the work during the gestation of UNAIDS where USAID was a major player, and the US Government in general. The US is the largest donor of UNAIDS, and even after the announcement by several donors here at this special session of increased contributions, but if I have all the exchange rates right, the US is definitely still the largest donor.

I would say that I believe that we are good value for money. We are really a small organization. People are often astonished at how much we do with very few people, which is why we have all these (inaudible). But what we try to do is really be as catalytic as possible so that we can influence bigger systems to do a better job on AIDS, and in the first place in the UN system, which is not always easy. So we are a very special type of organization in the UN.

We are also trying to work more than is the tradition in the international arena to work a lot with bilateral donors directly on the ground, and certainly also with USAID. We have several instances in countries where we have -- which we try to play on the comparative advantage of the bilateral donor, with this organization and its funding, and the multilateral system.

For example, we have invested a lot in trying to help countries -- developing countries -- to see what they should do about the priorities, what we call national strategic plans. And getting that right has been a major investment. And that has been something that our bilateral donors, when it comes in in a country, can benefit from; it doesn't have to repeat the exercise, because that provides a framework for the whole effort.

So I really thank USAID and the US Government for the continuing support. It is also important that we continue the dialogue that we have. I think we have developed a very mature and frank relationship, which I also value very highly, because I am the kind of person who would prefer a two-pager instead of a 20-page document.

And so thank you so much for your support and for the continuing constructive interaction.

Dr. Gillespie: Instead of a 20-page or even a two-page report, we have one page, which is -- you sign it and then I sign it, and then -- don't sign, that's my name. (Laughter.)

Dr. Piot: Don't think I sign things without reading. I have read it before. (Laughter.)

Dr. Gillespie: I think we can entertain a few questions now. Larry.

NY Times: Peter, could you clarify what just said a moment ago, you prefer to work with bilateral donors and there are several instances where you can avoid the duplication of repeating the exercise. Can you just fill that out just a bit?

Dr. Piot: Yes. What I said is that very traditionally the so-called multilateral system and the bilateral system, they operate on different fronts, even in the same country. There is very little interaction there. And I always found it absurd. For example, that is also to say (inaudible) by USAID, by your government, the team groups on HIV/AIDS, which will bring together originally the UN family now in many countries have expanded to include also (inaudible) the British donor, the Danes, or whoever is in that country. And that's one example.

And secondly, one of the problems that I think many of the poorest countries are struggling with is that they have very few human resources, and on the other hand, every single donor asks for a separate plan, and so they spend their time making plans. And so what we are offering is a kind of a rolled-up framework, and in order to make sure there is buy-in from all the various partners, we do that together, like with AID.

IIP Washington File: Can you put the same type of relationship in the context of the global fund? I mean, there's a whole new entity. Is that going to mean another donor that is going to be asking -- demanding more resources from developing countries, as you just mentioned. I mean, how is it going to serve, overlay the potential functions of what you're talking about here?

Dr. Piot: Well, we're still in full discussions on how exactly the architecture and the operations of this global fund will look like, but I think that the purpose is really to minimize transaction costs and overhead costs. And the way to do that, I feel, is to use existing structures and mechanisms and to make sure that the work -- the activities of AID, the activities of UNAIDS and the staff -- are being used to support how the money is channeled, how it is monitored, how it is evaluated. But that is a personal view.

IIP Washington File: Well, also, there was in a roundtable today and in the Secretary General's remarks in him mid-day news conference, there were a good number of specifics laid on the table about what the global fund may look like administratively, operationally -- those items of consensus that came -- emerged from the roundtable (inaudible).

Can either or both of you gentlemen comment on how it's shaping up and taking form today?

Dr. Gillespie: I was, unfortunately, tied up and couldn't listen to the roundtable, but there are some areas of consensus. Although, as Peter indicated, the (inaudible) process is very much still in play. But I do feel that it will be, as was said by Kofi Annan, that there will be great emphasis placed on a very lean structure made up of really three parts.

One would be a governance body of some kind. That hasn't been worked out, so I won't try to anticipate what the final makeup of that would be.

There would be a small secretariat that would be staffed, hopefully exclusively, but it may not be possible, of stakeholders seconding people to that. So it wouldn't take away from the corpus of the fund itself.

And thirdly, a rigorous technical review mechanism that most likely will be made up of virtual technical review groups, because the fund will actually cover a wide range of activities and it's hard to visualize a group being able to have all the necessary expertise to cover all the various proposals that would come in. So this technical review would then make recommendations to the board, who would then in turn would put their stamp of approval or disapproval on the particular programs.

And I think it is also important to know that what is visualized is that these proposals would come from the ground up, that they would be based and formulated in the developing countries impacted by AIDS, malaria, TB, or in the case of AIDS, vulnerable for being impacted by the (inaudible).

Washington Post: I have a question for yourself and Dr. Gillespie about how things are happening in the declaration. The Bush Administration at various opportunities and through various people has emphasized that it intends to place its money in prevention programs and that it is its highest priority. The Declaration calls for national strategies that use both prevention and treatment with anti-retrovirals among other forms of treatment and I wonder how comfortable the Administration is with that and if you as a result of what this document that you are signing calls for (inaudible) any change in the way US funding is distributed or the way the President has said he would like it distributed?

Dr. Gillespie: In terms of the -- you said it was signed. You mean the declaration?

Q: Yes.

Dr. Gillespie: Okay. Well, there are a number of people in the room that can expand on the role of the US in the formulation of the declaration. I wasn't very heavily involved in that. But I actually think that Secretary Powell's speech captures the Administration's position on the prevention-to-treatment continuum.

And it is clear that Secretary Powell said prevention, prevention, prevention. It is clear that we, as many, many other donor countries and country, feel that prevention is the highest priority. Treatment is also important. And anti-retrovirals -- that train is out of the station, and we realize that. And Paul De Lay can address this in greater detail afterwards. We realize that. And because of that, we are establishing within USAID a number of introduction projects to try to build for the future, to try to see what is the best way to increase the human capacity, the laboratory capacity, not just for this generation of ARV but for future generations of ARV, which, as you know, are rapidly evolving and hopefully will become less expensive and even easier to use.

So this is something that we are engaged in, and there has just been some misunderstandings of our position. This does not represent a shift in the position at all.

NY Times: Could you clarify whether it is known at this point whether the applications to the fund, when it exists, when it's set up, will only come from governments, which was implied by Secretary General Annan this morning, or whether NGOs, or, for that matter, individuals would apply? Or is this set up specifically for governments? I haven't heard that clarified. If it was, I missed it.

Dr. Gillespie: I can tell you what the U.S. position is. The position of the fund has not yet been established. The U.S. position is that NGOs should be able to apply directly to the fund for funds.

Now, there also is the reality of the situation that some countries may have policies or procedures which mean that the NGOs need to get the approval of the whole country's government, and that's a question of sovereignty and one that the fund certainly would respect.

I think that another common combination will be a consortium of NGOs, host-country government, and, as Peter alluded to, in coordination with bilateral efforts and multilateral efforts that exist in the country.

So I think there will be an encouragement by the fund, I hasten to say that this has not yet been decided upon -- that funds requested under the fund complement and supplement the existing activities that are taking place or are planned in that country.

This goes back to an earlier question: how would this relate to existing programs? And the idea is that it would allow things to be scaled up or fill the gaps there in the current portfolio of activities in a particular country or region.

Dr. De Lay: Peter Piot and Dr. Gillespie have to go, so I think this should be the last question.

Thank you very much.

Q: Thank you.

(Moderator): We have a couple more people to introduce to you now. Dr. Paul De Lay of USAID you know. We also have with us two colleagues from the State Department: John Sandage from Legal was with us yesterday. Today, we also have Lynn Lambert, Director of the Office of Technical and Specialized Agencies, International Organizations Bureau at State.

If you have any additional questions, go ahead.

IIP Washington File: Do you all have a statement about the declaration, where it now stands, how you feel (inaudible) satisfies (inaudible)?

Mr. Sandage: Well, in terms of the drafts, yes.

Ms. Lambert: Our understanding is that it will be formally adopted this afternoon as the second-to-last order of business. And, yes, that was a long process, and we think a very good result. We are pleased with the document.

UN Wire: Could somebody -- one or more of you -- comment specifically on the deletion of the controversial language in reference to the UN guidelines on HIV and human rights, as well as (inaudible)?

Mr. Sandage: Well, as I think I said yesterday, in the early hours of Monday morning, a compromise was reached by all of the interested delegations on the four remaining issues that were open, and the compromise was a proposal by the Rio group, which is Latin America, on how to address the question of vulnerable groups in a way that was specific enough to make clear who was the target audience, but general enough to respect the sensitivities of certain delegations. And the language that the Rio group presented proved to be acceptable to everyone.

And then the remaining issue was what, if anything, to say about the UNAIDS guidelines. And after considerable discussions over the course of yesterday, it was agreed that there would be no reference to the guidelines in this document.

UN Wire: What is the U.S. position on the lack of reference to the UN guidelines? Do you support the deletion or would you --

Mr. Sandage: We joined with the rest of the participating states in having the document not reflect the guidelines. We recognize why the guidelines pose difficulties for some governments. The guidelines remain. They are a publicly available document, and governments that find them useful will refer to them as they formulate their domestic program.

UN Wire: But you don't think that's any great sacrifice in the frame of the declaration to the UN?

Mr. Sandage: I think the declaration is a very strong declaration, and I think it's one that everyone who was associated with it can be very proud.

(Moderator): We have one more person to introduce to you who is also on the delegation: Mr. Jairo Pedrazza of the PWA Leadership Institute. He is also a member of the board of the Latino Commission on AIDS here in New York. He is also the only HIV-positive member of our delegation. We wanted to introduce him to you as well. Please go ahead.

IIP Washington File: Would you address the issue of the controversial language? I mean --

Mr. Sandage: Well, it's an issue that we at the NGOs are satisfied with it. The documents that we have worked throughout the preparatory process is not what we had hoped for, but it's something that we are satisfied with at this point. It (inaudible) for the community to move forward in this process, and we have to have that at the NGO level.

NY Times: Are there any aspects of this document that represented essentially concessions from the US position that you are disappointed with in some way, shape or form?

Mr. Sandage: I wouldn't characterize it that way.

Ms. Lambert: I think it's a committee work. You know, 180-some countries worked on the outcome, because a lot of elements in it that are related to AIDS and a lot of elements in it that are related more to issues of development. And a number of countries felt this was important in their ability to work on AIDS. So instead of a very direct document, we have a very long document with many different aspects of development, health and HIV/AIDS. I think (inaudible) satisfactory.

NY Times: Given the difference in the position about treatment versus prevention, are you disappointed that there is no emphasis on treatment in the document?

Ms. Lambert: I think John --

Mr. Sandage: Well, I was going to add something, which I will just share with you that a delegate said to me yesterday, when the final deal was done, he said, "The US got everything it came here to get; isn't that right?" And I said, "Yes, we did. It's a great document, and we are very pleased with it."

In answer to your -- do you want to repeat your last question?

NY Times: Well, given the fact that there is a difference in opinion about the importance…

Mr. Sandage: The balance.

NY Times: Yes, the balance of prevention and treatment, and there seems to be a consensus in the document that treatment is equally important. Are you disappointed that perhaps resources may be squandered in that direction?

Mr. Sandage: I don't think we are disappointed at all. I think prevention is the first issue dealt with after leadership. It's got pride of place, and we are happy with the text. But obviously treatment is important as well, and we think the document reflects a good balance.

UN Wire: This document has been discussed from the U.S. point of view mainly in terms of what it will mean for U.S. aid, not the organization USAID, but for American aid abroad. But the U.S. presumably is also covered by (inaudible). What will be the implications of the declaration for domestic AIDS policy?

Ms. Lambert: Well, the document contains a number of commitments from (inaudible) governments take on another's behalf for themselves once they undertake to be part of the world community. And I believe that everything in there that the U.S. will be committing to is something that we take very seriously.

UN Wire: Is there anything in there that the U.S. is perhaps not committed to now that will change the result of the document?

Ms. Lambert: I guess I'm not sure, because we -- most of us sitting here take it from the international aspect.

Mr. Sandage: Does your question go to what the relevance (inaudible) application of the document, the declaration, to domestic AIDS policy?

UN Wire: Domestic AIDS policy.

Mr. Sandage: I think what's described in the document -- the priorities, the issues surrounding vulnerability, stigma, discrimination -- are as applicable in this country as they are in almost every other country on the planet, whether they are developing or developed. So if anything, it should read (inaudible) what (inaudible) the domestic (inaudible). It certainly is not counter (inaudible).

UN Wire: Well, again, could we ask our NGO representative to address that point? I mean, do you -- there are very specific mentions in the declaration about what governments should do to address issues of stigma, issues of discrimination. Where do you feel that U.S. policy is on the domestic front in that regard, and what needs to be done in view of this (inaudible)?

Ms. Lambert: Well, I think the document speaks for itself. It's a document of 180 countries coming together. I think our country itself has very good (inaudible) concerns that have been followed. But this is not about the U.S.; this is about consensus coming in other countries. And that's the first and the only way that we should be looking at it. Many countries that otherwise would have never had (inaudible) issue have to approach it. And to that effect, I think (inaudible).

Internally, I think we have very much advantage, because if we, NGOs, that also (inaudible) real issue has demonstrated that. So we have to balance it out. What it means in the context that it is 180 countries. This is not a U.S. document. It is a common (inaudible).

UN Wire: Can I ask you what the role of yourself and the other NGO members of the delegation has been during the Special Session?

Mr. Pedrazza: Of the U.S. delegation?

UN Wire: What has been your role in the delegation?

Mr. Pedrazza: Oh, we've been able to be briefed in the mornings, and we give our input. I think it has good significance, especially for me being a Latino and as a Latino dealing with HIV and AIDS, that my government has included me in this group I think adds a real value and meaning, especially because the Latino community is the second highest (inaudible) with HIV in the United States after the African American community. So to my community, it is a very meaningful step forward. We certainly hope that it is not the first or the last. I hope that the question certainly merits (inaudible).

For me, particularly and personally with AIDS, it has been very valuable because it has shown the rest of the world the importance (inaudible) at the UN can come together -- governments, NGOs (inaudible) approach the decision, and I think the UN, as many of the other governments, have to include people from society in their (inaudible). So I am very proud (inaudible) to be part of (inaudible).