DREAM Conference, Community of Sant’Egidio

DREAM Conference, Community of Sant’Egidio

Friday, May 27, 2005

Katherine Marshall, World Bank

 

 

Opening Remarks

 

It is a pleasure to return here, friends and colleagues, fellow warriors.  We could not be gathered to discuss a more important issue.  It is our imperative duty and our privilege to do all we can, together as well as individually, to keep the focus on HIV/AIDS.  We must never forget the harsh realities and the human face of this pandemic, even as we look forward with hope and determination.  This meeting is a special venue that allows us to do just that that.  

 

This meeting also comes at a critical time, as the world looks to the major upcoming meeting of the G8 countries in July and a major stock-taking summit at the United Nations in September.  The topic of HIV/AIDS and the strong focus, so well reflected here, on Africa are critical to the success of that event.

 

All gathered here know well the global HIV/AIDS statistics: in a sense, we can never hear them too often, though always we need to translate the numbers into people.  The close of 2004 saw some 40 million people around the world HIV-positive or afflicted with full-blown AIDS.  More than half are women, and some 2.2 million are children.  More than 95 percent of people living with HIV/AIDS live in developing countries. Some 5 million—or 12.5 percent —contracted the disease during 2004; the majority were less than 25 years of age.  More than 3 million people died of AIDS-related causes during the year.   In 1990, less than 1 million children in Africa had lost one or both parents to HIV/AIDS.  By 2001 that number had ballooned to 11 million, and it is projected to rise to 20 million by 2010.  The pandemic rages on, and the battle against it must rage on as well.

 

We must continue to learn what works and what does not in terms of treatment and prevention and we must move forward.  We have come far in the two and a half decades since AIDS has been our reality, but we have far to go. 

 

I highlight 10 points for today’s agenda:

 

·         There is a moral imperative to address the question of children, specifically in terms of the priority objective here of ensuring that babies are born healthy, even if their mothers are HIV/AIDS infected, and more generally, in putting the priority in action on children.  This has been a neglected area, and it is a critical one.   Every day, 2000 babies are infected with HIV during pregnancy, at birth or through breastfeeding. Most infants that contract HIV/AIDS today will die before their fifth birthday.  Using the best tools to prevent mother-to-child transmission, as Sant’Egidio is doing, is critical, yet the stark moral question of saving the mothers and preventing young women from being infected is clearly part of the solution.  We need also to pay much closer attention to the situation of children orphaned or made vulnerable by HIV/AIDS.  Faith-inspired institutions play the major role here, yet links among institutions and with the major development institutions are weak.  There is far more we can do, together.

 

·         We also need to turn our attention much more sharply to the situation of mothers and of women.  The well-being of mothers very much informs the situation of their children.  I have heard of HIV-positive mothers in some places who are worried if their babies are born healthy, they will survive them and then face uncertain futures on the street.  These are some of the most difficult situations imaginable.  Maternal health is critical.  Beyond, the old image of HIV/AIDS as a disease of men is no longer true.   Women are the main sufferers today, in countless ways.  There is far far more we can and must do to address the issues that specifically and primarily affect women.

 

·         HIV/AIDS puts into stark relief the real consequence of inequities in today’s world.  The cruel reality of our world is that there is medical technology available which prevents the transmission of HIV/AIDS from mother to child, but those without access to this technology will not be protected.  Where a child is born, and how wealthy her or his parents are, is largely determinant of a child’s future.  It is an easy moral equation to make things more equitable; this is of course very difficult in practice.  We can work today to identify real steps we can take to advance the dialogue here.

 

·         The dynamic of HIV/AIDS is such that it has surprised us often, and will again.  Great humility and creativity are needed when we approach this pandemic.  We cannot be complacent or continue as we have.  HIV/AIDS demands all our powers of creativity, resourcefulness, learning, and capacity for change.  This calls more than ever for us to work together and learn together.

 

·         Crucially, we need to put the spotlight on Africa and what can be done about the devastating impact of AIDS on the Continent, its individuals and communities.  But we cannot forget other parts of the world where the Pandemic is set to take off, critically India and Eastern Europe.  These contexts raise a whole spectrum of different issues.

 

·         In this work of combating HIV/AIDS, partnerships are absolutely vital.  Noone can succeed alone.  We must be creative and open to exploring new and dynamics kinds of partnerships.  We must set goals together and hold ourselves accountable for meeting them.

 

·         We need to discuss the tough issues—the dynamics of an inequitable world, the different ideas that faith traditions and organizations have about preventing HIV: these are difficult issues to broach together when we disagree about how to proceed.  But we must discuss these issues because we must proceed.

 

·         We need to balance our pace of moving on HIV/AIDS work with the quality of the work we want to achieve.  We want to move fast but we cannot stand for shoddy work or work that is not entirely thoughtful and coherent.  This applies with particular force for management of programs. We cannot allow corruption to weaken our programs, or our cause.

 

·         Sant’Egidio has a very special and critical role, at the global, national and community levels.  It is also a special and vital partner of the World Bank.  Sant’Egidio has shown powerful links between poverty, exclusion, and social injustice and the HIV/AIDS pandemic, it never lets us forget the moral dilemmas and the moral imperatives we face.  Yet through the spirit of learning and friendship Sant’Egidio also shows us what partnership can mean in the 21^st century.  We aim to develop this partnership as we move ahead. 

 

·         We have an opportunity today to explore the.  complex issues of how HIV/AIDS is linked to broader issues of social organization, politics and development.   We know that HIV/AIDS is not primarily a health problem that can be solved by doctors and ministries of health alone.  Success calls for engagement of all parts of society – business, politicians, religious leaders, academics, and civil society.  The question is thus how to balance focus and discipline in looking at specific programs with this understanding of the whole and capacity to perceive the many and complex links.  Prevention, care, treatment, research for better techniques, underlying factors related to HIV and issues of injustice all need to be brought to the table.  The AIDS pandemic is dynamic and comprehensive, and, in turn, we must be dynamic, far sighted and structural in our response.