UNGASS Day 1

Opening Plenary
See http://www.un.org/webcast/aidsmeeting2008/index.asp?go=102 for webcast

Interesting that Ban Ki Moon raised (quite rightly) in his opening address the issue of removing travel bans on HIV+ people, as did Peter Piot. Had several conversations about that yesterday, and at the same time found that there are plans to lift the US restrictions within the next PEPFAR Bill - only seven conservative Republicans, lead by Senator Coburn are allegedly trying to block the PEPFAR renewal bill with wrecking amendments. But the US is not the only offender here - this is a problem both with short-term and long-term visas for the majority of nations. The Civil Society delegate is now raising the same issue. Looks like this is going to be one of the main themes this morning.

With de Cocks' statement yesterday it is also becoming clear that targeted prevention, treatment access and de-stigmatisation of vulnerable groups should be the main focus of prevention, rather than focussing primarily on general populations (although there is a strong case for maintaining prevention efforts in the wider population, as they still face risks, nevertheless outside of Africa, this is not where the epidemic is really happening). And decriminalisation of vulnerable communities and stopping treating HIV and AIDS as a separate issue, and looking at wider health and social issues are all essential steps. Encouraging to note that DFID has grasped the nettle of strengthening wider health infrastructure.

Dr Anthony Fauci raised the issue of shortage of health personnel as one of the key obstacles to Universal Access, and that wider health and social development. Will this new 'holistic' approach to HIV service development serve to strengthen wider health needs and infrastructure? It is not clear that it has been in the past, and has even detracted from other health priorities. Funders, NGOs and Governments do need to make that wider health and social infrastructure issues are addressed. Again, am encouraged that DFID at least seems to be committed to this approach.

Good to hear Fauci emphasise that we need to learn from countries where prevention has worked, and to engage with Civil Society and faith groups. And sustained, long term funding. I remain ambivalent about the money being poured into vaccine and microbicide research when so little seems to have been achieved in terms of successful prevention to date. However, if either of these approaches ever do work, they could be life savers. But it will be years or even decades and vast amounts of funding to get us to that point - so the question we should be asking is are there shorter-term priorities that should be the focus of these resources?

We are now into individual country reports and feedback. This can followed at http://www.un.org/webcast

We are now heading in to the Civil Society Hearing