Initiatives and Commitments by the G8 to Combat the Global Spread of HIV/AIDS

Contents

• The Early Years
• Main commitments in HIV/AIDS field
• Okinawa, Japan, 21-23 July 2000
• Genoa, Italy, 20-22 July 2001
• Kananaskis, Canada, 26-28 June 2002
• Evian, France, 2-3 June 2003
• Sea-Island, USA, 8-10 June 2004
• Gleneagles, Great Britain, 6-8 July 2005
• Conclusions

The Early Years
The spread of infectious diseases was not recognized as an immediate priority during the inception of the Group of Eight (G8). Rather, this agenda was tackled only after an understanding had emerged that economic security – globally and among G8 members – depends directly on the development patterns of other countries and that the goal of sustainable development is unattainable without massive development aid and global assistance to the healthcare sector.

The issue of fighting infectious diseases, namely HIV/AIDS, was first addressed by the G7 in the final document of its Venice Summit in 1987. Subsequently, during the Paris Summit in 1989, member countries agreed on the need for international cooperation in this field. The issue of health protection was further developed in the 1990s. Notably, the Leone Summit in 1996 and Denver Summit in 1997 devoted special attention to infectious diseases. Their final documents mentioned the global threats posed by the spread of HIV/AIDS, tuberculosis and malaria. At those summits, G7 leaders also addressed ways to increase the effectiveness of measures for containing infectious diseases, including steps to improve monitoring and prevention and enhance pharmaceutical research.

By 2000, the fight against infectious diseases gained prominence on the G8 agenda. The Okinawa summit stressed the need for cooperation in this field.

OKINAWA, JAPAN, 21-23 JULY 2000

Main commitments in HIV/AIDS field:

• To strengthen partnership with governments, the World Health Organization (WHO) and other international organizations, industry
• Reduce the number of HIV/AIDS-infected young people by 25% by 2010
• To deliver agreement on a new strategy to harness our commitments

Infectious and parasitic diseases, most notably HIV/AIDS, TB and malaria, as well as childhood diseases and common infections, threaten to reverse decades of development and to rob an entire generation of hope for a better future. Only through sustained action and coherent international co-operation to fully mobilize new and existing medical, technical and financial resources, can we strengthen health delivery systems and reach beyond traditional approaches to break the vicious cycle of disease and poverty.

GENOA, ITALY, 20-22 July 2001

Main commitments in HIV/AIDS field:

• Launching a new Global Fund to fight HIV/AIDS, malaria and tuberculosis
• The New African Initiative

We have launched with the UN Secretary-General a new Global Fund to fight HIV/AIDS, malaria and tuberculosis. We have committed $1.3 billion. The Fund will be a public-private partnership and we call on other countries, the private sector, foundations, and academic institutions to join with their own contributions - financially, in kind and through shared expertise.

An effective response to HIV/AIDS and other diseases will require society-wide action beyond the health sector. We welcome the steps taken by the pharmaceutical industry to make drugs more affordable. In the context of the new Global Fund, we will work with the pharmaceutical industry and with affected countries to facilitate the broadest possible provision of drugs in an affordable and medically effective manner.

Tackling HIV/AIDS, TB and malaria, including through the Global AIDS and Health Fund, is denoted to be one of the key themes of the New African Initiative (The African initiative's objective is to consolidate democracy and sound economic management on the continent. It is a pledge to promote peace and stability, democracy, sound economic management and people-centered development and to hold each other accountable in terms of the agreements outlined in the program. At the same time, Africa recognizes that it holds the key to its own development).

KANANASKIS, CANADA, 26-28 June 2002

Main commitments in HIV/AIDS field:
Recognizing that HIV/AIDS affects all aspects of Africa's future development and should therefore be a factor in all aspects of our support for Africa, we commit to:

• Helping Africa combat the effects of HIV/AIDS
• Supporting African efforts to build sustainable health systems in order to deliver effective disease interventions

EVIAN, FRANCE, 2-3 June 2003

Main commitments in HIV/AIDS field:

• Strengthen the Global Fund to Fight AIDS, Tuberculosis and Malaria, and other bilateral and multilateral efforts
• Improve access to health care, including to drugs and treatments at affordable prices, in poor countries
• Encourage research on diseases mostly affecting developing countries

Health. A G8 Action plan
We will work in partnership with developing countries, the private sector, multilateral organizations and non-governmental organizations (NGOs) to help achieve these health goals.

Fighting HIV/AIDS, Tuberculosis And Malaria
1.1 We express our continued concern at the increase in the global HIV/AIDS pandemic. We welcome the increased bilateral commitments for HIV/AIDS, whilst recognising that significant additional funds are required.

1.2 We reiterate our commitment to fight against AIDS as well as Tuberculosis and Malaria as agreed in Okinawa, through further actions in such areas as institutional building, public-private partnerships, human resource development, research activities and promotion of public health at the community level. We will strengthen our efforts in this fight, both bilaterally and multilaterally.

1.3 We reaffirm our support for the Global Fund to fight AIDS, Tuberculosis, and Malaria. We call upon those that have not yet done so to consider increasing their support to the Global Fund as well as to other multilateral and bilateral efforts to combat these infectious diseases.

From Implementation report by Africa Personal Representatives to leaders on the G8 Africa Action Plan.

Improving Health and Confronting HIV/AIDS

• G8 countries are providing additional support for African efforts to combat the effects of HIV/AIDS, build sustainable health systems and support health research. Since its inception at the Genoa Summit, G8 countries have pledged US$3.2 billion to the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria over a five-year period. Of the US$1.5 billion already committed, 60 percent is targeted to Africa and 60 percent to HIV/AIDS.
• The United States has announced US$15 billion over five years towards the prevention and treatment of HIV/AIDS. Of the 14 countries to receive this money, 12 are in Africa.

SEA-ISLAND, USA, 8-10 June 2004

Main commitments in HIV/AIDS field:

• The establishment of a Global HIV Vaccine Enterprise
• The establishment of a strategic plan to prioritize the scientific challenges, research coordination and product development efforts.

G-8 Action to endorse and establish a Global HIV Vaccine Enterprise
1.We reaffirm our commitment to combating the global HIV/AIDS pandemic.  But the human and economic toll of the AIDS pandemic demands that these activities be complemented by accelerated efforts to develop an HIV vaccine.

We endorse this concept and call for the establishment of a Global HIV Vaccine Enterprise – a virtual consortium to accelerate HIV vaccine development by enhancing coordination, information sharing, and collaboration globally. 

The Enterprise should establish a strategic plan that would encourage the development of a number of coordinated global HIV Vaccine Development Centers;  stimulate the development of increased dedicated HIV vaccine manufacturing capacity, establish standardized preclinical and clinical laboratory assessment.

GLENEAGLES, GREAT BRITAIN, 6-8 July 2005

Main commitments in HIV/AIDS field:

• Provide as close as possible to universal access to treatment for AIDS by 2010
• Strengthen the African Partners Forum and establish a Joint Action Plan
• Agreement to the principles of the Three Ones for AIDS programming at country level
• G8 partners agreed to maximise the full potential of Global Fund resources and ensure greater consistency with existing national priorities, processes and strategies

Africa and Development
The G8 agreed a comprehensive plan to support Africa’s progress. We agreed o boost investment in health and education, and to take action to combat HIV/AIDS, malaria, TB and other killer diseases.

We have agreed to double aid for Africa by 2010. Aid for all developing countries will increase, according to the OECD, by around $50bn per year by 2010, of which at least $25bn extra per year for Africa.

[…] The G8 and African leaders agreed that if implemented these measures and the others set out in our comprehensive plan could, among other things to provide as close as possible to universal access to treatment for AIDS by 2010.

UNAIDS, in partnership with major donors in April 2004, secured agreement to the principles of the Three Ones (one agreed national framework, one national coordinating authority, and one agreed monitoring and evaluation system), for AIDS programming at country level. This commits the G8 to strongly adhere to these principles in our aid delivery and partnerships at country levels, and to support harmonised processes.

G8 members support significant interventions in HIV and AIDS prevention, care and treatment. For example, Africa is a major beneficiary of the US Emergency Plan for AIDS Relief (PEPFAR). As of March 31, 2005, the Emergency Plan was supporting ARV treatment for approximately 235,000 people in Africa.

The UK committed in 2004 to spending ?1.5 billion on HIV and AIDS over three years (with most of this spent in Africa).

Looking ahead
G8 members should implement and support the agreements, ...including narrowing the AIDS funding shortfall, promoting further implementation of the three ones at country level, and promoting better harmonization of support at the international level.

Further support for increasing safe and effective access to antiretrovirals  is needed. However, the effective push on treatment and access to medicines needs to be balanced with continued momentum on prevention. The G8 need to work with Africa to mobilise significant resources to address other priority diseases of poverty, which have a strong impact on child and maternal mortality, such as through scaling up effective malaria prevention and treatment initiatives.

Investing in People
We aim to:

• Achieve  an AIDS-free generation in Africa, significantly reducing HIV infections, and work with WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention, treatment and care, [with the aim of as close as possible to universal access to treatment for all those who need it by 2010. Limited health systems capacity is a major constraint to achieving this and we will work with our partners in Africa to address this, including supporting the establishment of reliable and accountable supply chain management and reporting systems]. We will also work with them to ensure that all children left orphaned or vulnerable by AIDS or other pandemics are given proper support, including through the replenishment this year of the Global Fund to fight AIDS, TB and Malaria; and actively working with local stakeholders to implement the ‘3 Ones’ principles in all countries.
• Build on the valuable G8 Global HIV/AIDS vaccine enterprise, increase direct investment and take forward work on market incentives, as a complement to basic research, through such mechanisms as Public Private Partnerships and Advance Purchase Commitments to encourage the development of vaccines, microbicides and drugs for AIDS, malaria, tuberculosis and other neglected diseases. We note continuing work to explore establishing an International Centre for Genetic Engineering & Biotechnology centre in Africa to help research into vaccines for the diseases that are afflicting the continent.

Conclusions
The G8 has identified the following priorities in fighting the spread of infectious diseases:

• Assistance in the development of public health systems;
• Assistance in the research on and production of medicines and vaccines;
• Assistance in the ensuring equal access to diagnostics, disease prevention and treatment;
• Support the global programs aimed at combating infectious diseases;
• Assistance in the development of cooperation among different sectors of society, including government, the commercial sector and representatives of civil society.

Although G8 countries have so far spent most of their effort and resources containing epidemics in Africa, it should be noted that the spread of HIV in Eurasia has become no less acute of a threat to global stability and development.