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 You are in: Bureaus/Offices Reporting Directly to the Secretary > Office of the U.S. Global AIDS Coordinator > Press Room > Remarks and Presentations > 2005

President Bush's Emergency Plan for AIDS Relief Supports National Strategies on the Ground in the Fight Against HIV/AIDS

Dr. Mark Dybul, Deputy U.S. Global AIDS Coordinator and Chief Medical Officer
Statement before the Roundtable on Treatment, Care and Support at the United Nations General Assembly High-Level Meeting on HIV/AIDS
New York City
June 2, 2005

Thank you, Mr. Chairman. It is a privilege to be here representing President Bushís Emergency Plan for AIDS Relief and the Office of the U.S. Global AIDS Coordinator, Ambassador Randall Tobias.

It is humbling for the people of the United States to stand by those fighting the fight against global HIV/AIDS on the ground, serving and supporting national strategies through the Three Ones.

In support of the Three Ones, last week we hosted a meeting in Addis Ababa, Ethiopia of 400 officials from government, non-governmental organizations, the private sector, community and faith-based organizations, and people living with HIV/AIDS to listen to lessons learned from those on the ground implementing programs. We heard several clear messages related to care and treatment.

After a year of implementing the Presidentís Emergency Plan, we have seen the importance of synergy between prevention, care and treatment. Since only an HIV-positive person can transmit HIV, every care and treatment encounter is an indispensable opportunity for prevention education. Integration of prevention within care and treatment is essential.

A person cannot access care and treatment until they know their status. For example, we estimate that in order to reach the Emergency Planís goal to treat 2 million HIV/AIDS patients, 40-100 million people must be tested. In order to reach that goal, we need innovative approaches.

Several of our focus countries have already started seeing success in this area, introducing mobile units, door-to-door family based testing, and provider-initiated testing. While many had long believed that families would not accept testing in their homes, some areas have seen a 94% uptake when offered door-to-door. In addition, TB, STI, and antenatal clinics have seen an uptake of 60-90% in provider-initiated testing. We must continue to think of and implement innovative approaches to testing.

We strongly heard the message just articulated by the Honorable Minister her excellency from South Africa about the need for sustainable systems. We cannot achieve results without building capacity for quality services. The keys to sustainability are country ownership and good governance, both components of the Monterrey Accord.

Capacity must include all who are willing and able to assist in this fight Ė government, private, NGO, faith-based and community groups, and people living with HIV/AIDS. That is why 80% of the Emergency Planís partners on the ground are local groups.

We must also support policies that utilize community health aides and nurses for care and treatment. In our own country, in places like Alaska, we have seen CHAís and nurses with the appropriate level of expertise provide excellent services to meet patientsí needs.

In meeting patientsí needs, we must continue to focus on quality. It was pointed out that in the U.S. and Europe, 5-10% of those never treated show evidence of drug resistance. In our own state of California, 50% show some evidence of drug resistance.

The decisions we make today will affect the life and death of generations to come. We must insist on quality of services and products, especially as we meet the unique challenges of pediatric treatment and increase our focus on care for orphans and vulnerable children.

The United States is humbled and privileged to be part of countriesí efforts to battle their epidemics. As Secretary General Annan noted this morning, working together we have seen real progress in providing access to treatment. We must replicate and build on these successes.

And so, I will end where President Bush began when he announced his Emergency Plan for AIDS Relief. "Rarely has history offered the opportunity to do so much for so many."

Thank you, Mr. Chairman.


Released on June 6, 2005

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