The Aids epidemic, unless it is brought under control, is one of the greatest threats to sustainable development in many parts of the world, Peter Piot, executive director of UNAids said.

He added that it was striking that the disease was not receiving due attention at the Earth Summit, he said.

“Most of the discussion is on trade issues and we have not succeeded in getting Aids to the top of the political agenda,”he said.

UNAids was calling for the summit to adopt a declaration of commitment which recognized Aids as cutting across all spheres of sustainable development, and not just as a section falling under health.

By creating a major crisis in human resources, Aids brought countries to a cul de sac, he said. It increased poverty and triggered food crises. Illness and death in farming households meant there were less people left to work in the fields. Aids undermined schooling, a key pillar of development, and already one million children in Africa had lost their teachers to Aids.

Productivity was seriously affected by Aids, with up to 50% of company costs going to the effects of the disease. Unless treatment was introduced, there would not be enough health workers to run the health care system. It also put social cohesion at risk and was a factor in social instability. It gave rise to a lot of chain reactions and vicious cycles.

There were solutions, but the epidemic would not be brought under control unless there was a massive injection of resources. $10bn per year was needed to expand prevention programmes to obtain results and to provide support to the millions of orphans.

This funding would come from a variety of sources – domestic budgets, donors, the UN, the World Bank and the Global Fund.

UNAids was working with the Global Fund identifying country by country resource gaps and fundraising strategies.

But the wealthiest countries were still at the bottom of the pile when it came to sharing their wealth with the developing world.  

“We know results are possible,” he said. “There are poor nations today who have less people infected than five to 10 years ago. These countries have also reduced mortality significantly because they have offered large scale antiretroviral (ARV) programmes in the state sector.”

In Uganda there was a large decrease in new infections, especially among young adults.

The “road map” to finding a way out of the crisis included getting leaders at all levels, from the president down to the community leader, to break the silence around Aids. It also meant widening access to treatment – a step that made sense from an economic perspective.

He called on businesses to follow the lead of Anglo, De Beers and Daimler Chrysler who were offering ARVs to their workers, their dependents and the communities that they came from. “In light of their human resource needs, it makes sense to keep their workers alive,” he said. “It is a very important breakthrough.”

But companies could not be expected to act as government, and public private partnerships were needed.

The high price of ARVs was one of the major obstacles to universal access to treatment, and only 30 000 people in Africa had access to ARV treatment, he said. But the view of UNAids was that each country should have an access to treatment plan that would be rolled out – and it did not mean waiting until the healthcare system was perfect before beginning the rollout.