Article: Security Council Discusses Connection Between Peacekeepers, HIV/AIDS

19 January 2001

Article: Security Council Discusses Connection Between Peacekeepers, HIV/AIDS

Holbrooke praised for bringing issue to the council

By Judy Aita
Washington File United Nations Correspondent

United Nations -- Just a year after the Security Council held its historic session on HIV/AIDS, council members gathered January 19 for their third discussion of the issue, paying tribute to U.S. Ambassador Richard Holbrooke and the United States for making the AIDS pandemic a matter of international security.

"The simple fact that the world's ultimate tribunal on questions of peace and security devotes its attention to AIDS sends a powerful message: AIDS is a serious matter for all the world's peoples," said Dr. Peter Piot, executive director of UNAIDS (the Joint United Nations Program on HIV/AIDS).

Piot, Undersecretary-General for Peacekeeping Jean-Marie Guehenno, and Security Council ambassadors paid tribute to Holbrooke for his advocacy and his initiative in using the U.S. presidency of the council in January to hold the first meeting in the history of the Security Council on a health issue -- HIV/AIDS.

"I can think of no better legacy to leave the world than to have ensured that the United Nations Security Council now regards support for the global fight against AIDS as among its core business," Piot said. The council's deliberations on AIDS, Piot said, "have been enormously helpful."

The council meeting helped transform the way in which AIDS is viewed, focusing attention on the destruction it has caused, how widely it has spread, how insidiously it has exacerbated conditions of poverty and vulnerability, the long-term effects of its impact, and its threat to the security of nations and people, Piot pointed out.

British Ambassador Jeremy Greenstock said that Holbrooke started the process that has "helped to break the worldwide silence on AIDS, ... made us think differently about the issues," and brought "sheer political intensity" to the issue, which helped improve the U.N.'s activities.

The council met for the second time in July 2000 and adopted resolution 1308 recognizing the effects -- both positive and negative -- that peacekeeping activities have on HIV/AIDS around the world. Since then many countries have revamped their AIDS plans to include all government agencies, have looked for new resources, and have discussed the issue at high-level summits around the world. But most of their goals have not been met, including equal access to effective care and treatment, especially essential drugs.

In the past year there were 5.3 million new HIV infections around the world and 3 million people died as a result of AIDS, more deaths in one year than ever before. Sub-Saharan Africa remains the worst-affected region, accounting for three-quarters all AIDS deaths, Piot told the council.

But infection rates have been rising significantly in Central America, catching up with the Caribbean as the world's second-hardest-hit region. Major epidemics continue to grow in Cambodia and Myanmar, and in Eastern Europe the epidemic "has been explosive," he said.

Before the council meeting began, Piot, representing UNAIDS, and Guehenno, representing the U.N. Department of Peacekeeping Operations (DPKO), signed a "cooperation framework agreement" committing both entities to improving the ability of peacekeepers to become advocates and actors for the awareness and prevention of HIV transmission. The agreement is intended to strengthen cooperation between the two operations on developing codes of conduct, voluntary and confidential testing and counseling, care and treatment of affected peacekeepers, a guaranteed adequate supply of condoms for peacekeepers, and AIDS education.

Guehenno said that "a number of peacekeepers, like any sample of people from around the world, are likely to have been infected by HIV prior to deployment, particularly bearing in mind that some peacekeepers come from countries with high prevalence rates. It is also a fact that some, though certainly not all, of our peacekeeping missions are deployed to parts of the world where there is a relatively high incidence of HIV/AIDS.

"These few basic points alone should leave absolutely no one in doubt," he said. "It is undeniable that there is a risk for peacekeepers to transmit HIV, or to contract HIV, while they are on mission. And it stands to reason that this must have happened already."

The U.N. does not have data on the incidence of transmission because in many cases both the countries that are supplying the troops and the countries to which they are being sent lack the capacity to collect the epidemiological data. Thus, there is no baseline data against which to judge the impact of a peacekeeping mission on the incidence of HIV/AIDS where it is deployed.

The U.N. has been developing training procedures on the issues of HIV/AIDS, conducting seminars and issuing booklets on the problem. DPKO is also producing a "pocket card" with basic facts on codes of conduct and HIV/AIDS awareness and prevention, and it is looking for funding to translate it into all the languages of U.N. peacekeepers, the Undersecretary-general Guehenno said.

Guehenno added that the program must be continually evaluated because "if even a small minority of personnel in the field continue to demonstrate risk behavior, then we have clearly not succeeded in making them aware of the dangers that they might pose and/or that they might face."

Holbrooke expressed the wish that the council's resolution on AIDS and peacekeepers, passed on July 17, 2000, as resolution 1308, "will become as famous to U.N. followers and people who care about this issue as other Security Council resolution numbers" over the years dealing with the Middle East and the Balkans. But he said that the resolution "should not be the end of the process, but only a cornerstone for future efforts."

Resolution 1308 calls on the troop-contributing countries to create effective strategies for HIV/AIDS education, prevention, voluntary and confidential testing, counseling and treatment of personnel.

Using the booklets given out to peacekeepers and planners as examples of what needs to be done, Holbrooke said: "I question whether the books are conceivably usable for U.N. peacekeepers. Written five years ago, you have to have a magnifying glass to find what AIDS does to you. On page 10 in very small print -- and this is the only mention -- it says, 'All people who are HIV-positive eventually die.' ... Why isn't that on the cover?"

The booklets, he said, "are not user-friendly to the average soldier in the field" because they are "technical ... wordy ... not clear cut, and out of date."

With no mention of resolution 1308 in the booklets, "the commanders in peacekeeping do not know that this is a mandated responsibility from the Security Council," the ambassador continued.

Testing troops before beginning a peacekeeping operation is a complex and controversial issue for DPKO and UNAIDS. Under the present structure of the U.N. every country contributing troops sets its own standards for testing and treatment. Some countries, such as the United States, will not send a soldier overseas unless he or she has been tested. If they test positive, they are not sent overseas but given treatment. But other countries do not test because they consider it socially or culturally unacceptable, it is too costly, or the rate of infection is so high that they don't want to reveal that they will not be able to field a peacekeeping force, the ambassador noted.

Holbrooke pointed out that there are three vacancies in the office of medical services and said that not only should those be filled, but DPKO also should create an office dedicated specifically to HIV/AIDS. He also suggested that the cost of AIDS testing be included in the cost of peacekeeping operations so that it will not be the responsibility of the troop-contributing countries.

"We spend billions of dollars on peacekeeping, we spend millions to protect our peacekeepers from terrorist attacks and from hostile forces -- but I don't think we're spending even $500,000 yet to protect them from HIV/AIDS," he said.

The U.S. Defense Department was given and additional $10 million for fiscal year 2001 by Congress to assist other nations with education, prevention and testing. Holbrooke said that "$10 million is not a lot, but in this particular field it can be very helpful."

(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)