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Diplomacy in Action

26. Explanation of the U.S. vote on UNGA Resolution 179, "Access to medication in the context of pandemics such as HIV/AIDS, tuberculosis, and malaria" at the UN General Assembly (December 22, 2003)


EOV Access to Medications L.60 Mr. Chairman,

The United States regrets that this resolution will not be adopted by consensus. Throughout the negotiating process, we made numerous attempts to find mutually agreeable language. We are particularly concerned that we were unable to reach consensus on this resolution because of the importance we attach to its subject.

The United States is taking concrete steps to rapidly increase global access to antiretroviral medications, including but not limited to the $15 billion Emergency Plan for AIDS Relief. Yesterday , President Bush and Prime Minister Blair of the United Kingdom made a joint statement on HIV/AIDS. They said, "We will pursue a comprehensive approach h to expanding the delivery of HIV/AIDS prevention, care and treatment, including greater access to safe and effective medicines, better health system delivery. and building a skilled force of health workers. We share a commitment to rapidly increasing the availability of HIV treatment in the most affected countries, to reducing HIV infection rates, and to developing programs to provide care and support for those infected with, and affected by, HIV/AIDS, including orphans and vulnerable children."

The United States regrets that we could not reach agreement on preambular paragraph 13. Despite constructive proposals by a number of delegations, the sponsors insisted on an unbalanced and unhelpful formulation. Let us be clear. The global health emergency is HIV/AIDS, and that emergency requires a comprehensive approach, as we agreed in the Declaration of Commitment two years ago.

The United States also cannot accept the formulation of preambular paragraph 2, for the reasons we expressed in our explanation of vote on L.53. We do not support an entitlement approach; we do not believe that this right should be interpreted as a legally enforceable entitlement, requiring the establishment of judicial or administrative remedies at the national or international levels to adjudicate such presumed rights.

With respect to preambular paragraph 1, the United States is not a party to the International Covenant on Economic, Social and Cultural Rights. Therefore, we cannot reaffirm the Covenant and cannot accept the paragraph as written.

It is unfortunate that the main sponsors were unwilling to make use of language agreed elsewhere that would have resolved our concerns.

For these reasons, the United States called for a vote on this resolution and will vote no. Thank you, Mr. Chairman.

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