Mr. Chairperson, distinguished Russian Government Officials, Representatives from CIS countries, International Organizations, and Civil Society,
I am very pleased to be here together with you this afternoon at the closing session of this important and successful Forum. The discussions have been productive but now it is time to roll into action.
Allow me to share with you the main messages or lessons that were conveyed by the different participants over the last three days.
First the prevalence and the dynamics of the epidemics of HIV and TB suggests that MDG6 will not be attained in the region unless concerted action is taken.
Second, to attain our common goal requires a sharp improvement in the effectiveness of HIV and TB prevention and treatment programs anchored in strengthened health systems; and
Third, to attain MDG6 requires sustained political commitment and new partnerships.
These messages should guide us in the way forward. Let me reiterate these messages shortly.
First, given that the prevalence of HIV/AIDS among adult people in some of the CIS countries is now close to 1 percent or more, the window of opportunity for reversing these epidemics as called in by the MDG6, is closing fast. And the increasing HIV/TB co-infections, will only compound the negative human social and economic impact of these dual epidemics over the medium term.
It should be clear to all of us now that unabated, HIV/AIDS and multi-drug resistant TB could hasten the current population decline in some of the CIS countries, particularly in the Russian Federation and Ukraine, and, in the medium- to long-term, affect socio-economic development, since young working age people are at highest risk.
Second, given this situation, what can we do before the window closes?
As we heard in this Forum over the last couple days, we must make optimal use of resources now flowing from the governments, Global Fund to Fight AIDS, TB and Malaria, the World Bank and other donors. It is imperative that CIS countries maximize the value of available resources as measured by generating good health outcomes as the current economic slowdown and large fiscal deficits afflicting developed countries may constrain the flow of development assistance in the years to come, and through second round effects might also reduce the impact availability of natural domestic resources as well.
If the MDG6-related targets for HIV and TB are to be met by 2015, the CIS countries must sharply improve the effectiveness of their AIDS and TB programs, by eliminating the false dichotomies of preventions versus treatment, vertical programs versus health systems, as well by adopting strategies that have worked well in other countries such as Canada and Australia to prevent the spread of HIV among intravenous drug users and their sex partners that are driving the HIV epidemic in the CIS countries. Ensuring the adherence to treatment programs by TB patients is critical to prevent the further escalation of multi drug resistant TB.
And this calls for a major rethinking of strategies in the CIS countries. Scientific evidence clearly supports needle exchange and substitution therapies as part of broader social support and health programs as the most cost effective strategies to arrest the spread of HIV among intravenous drug users.
CIS countries also need to continue to find ways to further lower the cost of anti-retroviral drugs, so that the government’s promise of full and free access to HIV treatment can be met for the infected population in need. The full scale implementation of the Stop TB Strategy, as part of strengthened health systems, needs priority attention as well.
Third, and finally, allow me to reiterate, that the governments of the CIS countries need to make the attainment of MDG6 targets a key priority in the upcoming years if the 2015 targets are to be met. This requires a sustained, high level political commitment reflected in the allocation of more domestic resources are in the establishment of broad public and private partnerships to support the national response. Indeed, this type of partnerships at the national level is critical to ensure the long term sustainability of country efforts.
Following the example of Bill Gates of the United States and Carlos Slim of Mexico, the two richest men in the world, or the dynamic Brazilian Business Council against HIV/AIDS, private sector leaders in the CIS countries, whether in the oil and gas, mining, car, food, or utility services sectors, can protect workers from HIV and TB by starting active prevention and awareness campaigns in their own workforce. Indeed, these leaders have a social responsibility role to play and can make a huge difference by reaching out to the wider community through corporate campaigns, business partnerships and coalition building.
It would be important to reach on to the Coordinating Council of Business Unions of Russia or similar bodies in other CIS countries, and encourage them to adopt similar approaches as they make good business sense, and good development sense.
The World Bank is strongly committed to work in partnership with UNAIDS, Global Fund, and WHO to support the development of a much stronger response in fighting the dual epidemics of HIV and TB in the CIS countries with the goal of helping them attain the MDG6 targets by 2015.
The World Bank is also keen to support the development of scaled up bilateral donor initiatives such as the ones launched by the Russian Government since the 2006 G8 Meeting held in St Petersburg. We could do it in the CIS by using as examples the successful partnership already established between the World Bank and the Russian Government to support malaria control efforts in Africa, in controlling the spread of avian influence, and in implementing the education for all global initiative.