"The 20th anniversary of the first diagnosis of HIV infection has come and gone. ... Headlines made when UN Secretary- General Kofi Annan appealed for the world to act on the global emergency AIDS represents have been superseded by other events. It's back to business as usual. Or is it? "It must not be. The AIDS crisis is as real now as a few months ago, and it will continue to grow unless the world is constantly reminded of it and plans to stem the epidemic are turned into action. ... The effects of globalization mean that there no longer is such a thing as a localized health problem. The HIV/AIDS epidemic is a global emergency and it calls for global commitment and action. ... Frighteningly, it has taken 22 million deaths and 13 million orphaned children to act as a global alarm clock. ... The onus is on us -the health care professionals -to make sure the momentum is kept up. We must intensify our efforts by working together, agreeing on best practices, reaching more people, and measuring our results. A broad range of organizations are now helping governments and societies to intensify their response. ...

"Prevention is and will be our central focus. While finding the best care for the millions living with HIV is a moral imperative, it is even more important to prevent hundreds of millions more from becoming infected. We must enable the most vulnerable groups, including young people and women, to prevent being infected with HIV and to access treatment for other sexually transmitted diseases. This calls for frank discussion about the causes and prevention of these diseases. We must not shy away from promoting condom use, the most effective method of prevention known. ...

"Many say that in bringing needed medicines to the poorest countries, price is only one factor, and they are right. But many also say that bringing complicated HIV/AIDS treatment regimens to poor settings is impossible. These people are wrong. ... WHO is focusing our efforts on developing care regimens that are workable and safe in low-resource settings. We are helping those who provide care to select and use cost- effective regimens that reflect local circumstances as well as individual needs. Much work is needed if we are going to give quality care to a substantially larger number of people living with HIV. Essential action also includes fostering research and development of diagnostics, microbicides, and vaccines; monitoring and surveillance of HIV incidence; and ensuring blood safety.

"There are several hopeful signs. Investments in research -to develop vaccines, diagnostics, and effective medicines, often in conjunction with WHO and the UN Joint Programme on HIV/AIDS -have increased dramatically. At the G8 Summit in Okinawa in 2000, the G8 nations made plans to increase support for investment in confronting HIV/AIDS and promoting health in the world's poorest communities; they strengthened their commitment this year in Geneva. The G8 proposals have been bolstered by the UN Secretary-General's call in April for a Global Health and AIDS Fund. Since then, governments, private entities, foundations, and individuals have committed almost $1.5 billion to the fund. ...

"As health care professionals, we may sometimes feel overwhelmed by the massive gaps between what is needed and what is available to help communities fight HIV. We know, however, that we have no choice but to respond to the millions of individuals whose lives are destroyed or severely compromised each year by this virus, and the tens of millions more whose standards of living are put in danger." The author is the Director-General of the World Health Organization.

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