Madame Chairman,

Prime Ministers and Ministers,

PCB members,

Colleagues and Friends,

I would like to thank the Government of Jamaica and His Excellency, the Honourable John Junor, Minister of Health of Jamaica for your warm island hospitality in welcoming us here for the 16th meeting of the UNAIDS Programme Coordinating Board.

As Peter and others before me have stressed, it is most fitting that we meet in the Caribbean, a region that is the second worst affected by HIV/AIDS, and which like other regions is experiencing rising rates of HIV infection among women, particularly young women.

To be precise, I will have a number of messages to convey since we all agree that the face of HIV and AIDS is increasingly women and young.

Given this trend and its implications for families and communities, it cannot be business as usual. We must be more strategic in our efforts to mainstream gender into the overall macro context of the country and micro context of the communities and certainly in our response to AIDS. By doing so, we will not only reduce the impact of HIV and AIDS on women and girls, we will also reduce the impact on boys and men, and reverse the spread of the epidemic. And this is the first message.

As part of the implementation agenda and priority for 2005, UNFPA is focusing on the links between reproductive health and HIV. This focus is absolutely critical to the area of gender, women and HIV/AIDS. And this is the second message.

Today, the overwhelming majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Since reproductive health programmes reach millions of women and young people and have a long history of advocacy and community mobilization and outreach, they play an important role in reducing the incidence of new HIV infections over the coming years.

As the Ambassador for HIV and AIDS of Sweden has referred to the meeting to link HIV and reproductive health, I would like to inform you that this past June, UNFPA and UNAIDS, in collaboration with Family Care International, convened a high-level global consultation in New York on linking sexual and reproductive health and HIV/AIDS, as one clear strategic intervention.

The participants issued a call to commitment to strengthen linkages between sexual and reproductive health and HIV/AIDS in order to achieve more relevant and cost-effective programmes with greater impact.

Several specific recommendations were made including the greater involvement of people living with HIV and young people in the design and delivery of sexual and reproductive health and HIV/AIDS initiatives and in providing expertise in programming. The Commitment also calls for ending stigma and discrimination.

The Programme of Action of the International Conference on Population and Development, and the Key Actions adopted at the ICPD five-year review, provide us with a clear roadmap for efforts in this area.

The ICPD Programme of Action stresses the central importance of women’s empowerment, girls’ education, gender equality, male responsibility and sexual and reproductive health and reproductive rights in the wider battle against HIV and AIDS. Within the context of sexual and reproductive health, it called for an expansion of services in four ways that are of direct relevance and importance to HIV prevention:

• To move beyond a narrow focus on family planning to include the identification and treatment of sexually transmitted infections;
• To acknowledge and address the sexual and reproductive health needs of adolescents;
• To address violence against women and girls; and
• To reach out to men.

Therefore, I propose that PCB adopt a clear position on the linkage between HIV and AIDS and sexual and reproductive health. And this is the third message.

In the last decade, progress has been made. This was brought forth clearly in the ten-year review of the ICPD Programme of Action, which has just concluded.

Increased services are available to prevent and treat sexually transmitted infections, which increase the risk of HIV prevention. Greater efforts are being made to reach out to young people both in and out of school, and increasingly youth-friendly services are being provided. Progress has been made in reaching out to men, especially those in uniform who work with the police and armed forces. UNFPA has reached out to armed forces in over a dozen countries in the Latin America and Caribbean region as part of joint efforts to prevent the spread of HIV and AIDS. And there is now greater awareness and commitment to end violence against women and girls. But we must go further.

Together we must build a “one stop shop,” - the THREE ONES as Peter Piot keeps on repeating. And this is the fourth message.

The Global Coalition on Women and AIDS, which Kathleen Cravero has presented, provides a forum to share ideas and to make further progress in this area. The Coalition adopted six principles. I would like to highlight the fact that it certainly is a powerful forum for advocacy and networking. But most importantly it has brought to the top of the gender and HIV agenda two issues: young girls and AIDS, and the role of women living with HIV and AIDS as actors and resource persons in addressing HIV and AIDS programmes and especially in programmes. They have lived through it and we can learn from their rich, albeit painful, experiences. And this is the fifth message.

The joint report of UNAIDS, UNFPA and UNIFEM, which we issued together at the Bangkok Conference, entitled, Women and AIDS: Confronting the Crisis, provides a set of concrete recommendations to address the triple threat of gender inequality, poverty and AIDS.

Since the ABC approach is necessary but not sufficient for many women and girls due to their social, cultural and economic vulnerability and disempowerment, or their low risk and high vulnerability as Geeta Rao Gupta has clearly stated, we must simultaneously embark on efforts for women’s empowerment and the protection of women’s rights. We must promote zero tolerance of all forms of gender-based violence. Stopping discrimination and violence against women and girls must be a priority. Laws must be strengthened and enforced. Perpetrators must be brought to justice. And this is the sixth message.

And we must step up efforts to ensure that condoms are used consistently and correctly. Condoms are the single, most effective prevention tool at our disposal and we must ensure that they are universally available as part of a comprehensive response. At the same time, we must increase access to female controlled methods of prevention, such as the female condom and the development of microbicides. And this is the seventh message.

UNFPA is committed to the closer alignment of our work to existing and emerging regional agendas on AIDS. I am pleased to announce that UNFPA has just formalized its long-standing collaboration with CARICOM through the signing of a Memorandum of Understanding between our organizations.

My friends,

There is no doubt that we have to think and do things in new ways. And we have to think big because the epidemic continues to grow. We must all work together to scale up our response.

We must ensure that resources and services reach and involve the most vulnerable and marginalized people. We must support and strengthen community-based efforts. And we must join hands not as individual UN agencies but as one UN system programme on AIDS committed to the people we serve and to the achievement of greater results.

UNFPA welcomes and embraces the UN reform. We are proud of our membership as Cosponsors of UNAIDS and we will continue to push for a stronger partnership and joint programming support of the implementation of the THREE ONES through the Resident Coordinator System and the UN Country Teams and through the various regional and global structures and mechanisms. And this is the eighth message.

Madam chairperson, all of our discussion is about behavioural change. It is about behavioural change in terms of: 

• Power relations between women and men, mindsets, beliefs, attitudes, values, etc.
• How we view sensitive issues such as sex workers, MSM and drug injecting users and their needs as well as their role as actors;
• And how we all work together as one UN family, as multilateral and bilateral systems and as programme countries.

Behavioral change is very slow while action is required immediately. Finding our collective ways between these two required actions is at the heart of programme implementation. And that is the ninth message.

We are living through a difficult environment that is characterized by increasing isms—fundamentalism, conservatism, and all other exclusionist “isms”. We need to build solidarity among us in order to implement a proactive and courageous programme for HIV and AIDS and its link with reproductive health. And this is the tenth message.

Finally, I would like to end by repeating what the representative of Women Living with HIV AIDS in Africa told us in the first meeting of the Global Coalition on Women and AIDS, held in London in 2003. She said, “What will kill us more than AIDS is despair; please give us hope.” I believe that agreeing on action and pushing the implementation with scaled up responses is the hope that we can all provide.

Thank you.