It is the scourge of our time. HIV/AIDS has already claimed the lives of an estimated 22 million people, and a further 36 million are infected, including 25 million in Africa. Far from abating, the disease is believed to be infecting 15,000 victims daily. In Africa, it is reported that 5,500 people are dying from AIDS-related conditions every day. The UN estimates that by the end of the decade there will be 40 million AIDS orphans throughout the world. At the UN's millennium summit last September, more than 150 world leaders, including the Taoiseach, Mr Ahern, set the year 2015 as a target date for halting the spread of HIV/AIDS. The special session of the General Assembly which begins today marks the first occasion the world body has convened a meeting at this level specifically to discuss a health issue.
Delegates from 180 countries will gather at UN headquarters in New York, including two dozen presidents and prime ministers. The East River will be a busy place, with more than 3,000 health officials, members of voluntary organisations, business people and political activists in attendance to discuss ways of tackling the crisis.
Strong political leadership is seen as critical to the success of the campaign. Much interest will focus on the attitude of the new US administration: a large delegation will be led the Secretary of State, Mr Colin Powell. Ireland will be represented by Mr Ahern and the Minister of State at the Department of Foreign Affairs, Ms Liz O'Donnell. According to the UN Secretary-General, Mr Kofi Annan, between seven and 10 billion US dollars is needed annually to combat the disease. There will, of course, be contributions from various governments, but Mr Annan has cast the net wider and called for the establishment of a global fund on the issue.
The computer magnate Bill Gates has pledged $100 million. Writing in the Washington Post yesterday, the former US president, Mr Bill Clinton, called on the Bush administration to contribute its share to the AIDS "war chest" by committing itself to pay about $2 billion into the fund each year.
A recent study suggested the poorest countries, inevitably those hardest hit by the disease, would need $9.2 billion a year to tackle AIDS. The sum would be divided almost equally between the cost of treatment for existing victims and the prevention of further infection.
Only a small number of AIDS victims in these countries receive the drugs and other treatments available in the developed world. Already a controversial issue, the cost of drugs is bound to get an airing at the special session.
There is also a lively debate on whether to focus primarily on prevention rather than cure, because even though some drugs are available at reduced prices, the cost is still much too high for the poorer countries. The so-called "triple-drug cocktail" used in the developed world is said to cost over £3,000 a year. The issue poses a moral dilemma: prevention is many times cheaper but you cannot just let people die. Pick a country with a high prevalence of AIDS and you will almost certainly find the state debt is very large, leaving few resources to fight the disease. Various groups and individuals are campaigning for cancellation of the debt to these countries, or at least substantial relief. Sympathy for this view is tempered with concern that corrupt Third World regimes might pocket the cash and spend it on armaments, or villas in Marbella. Informal consultations about the detail of the declaration, which is due to emerge at the end of the special session on Wednesday, were still going on at the weekend. There was a dispute between Western and Islamic countries over an invitation to a San Francisco gay rights group to a panel discussion.
There were also difficulties over a proposed reference in the text of the declaration to gays, prostitutes and intravenous drug-users as groups which were particularly vulnerable and in need of special attention, including "peer group" education on the dangers of AIDS.
The Taoiseach is expected to be the only EU prime minister in attendance. He has a keen personal interest in the AIDS issue, largely based on the scenes he witnessed during a visit to South Africa and Lesotho last year. He subsequently contacted the President of the European Commission, Mr Romano Prodi, to seek a "revitalisation" of the European Union's approach and to raise the issue of access to medicines for poor countries.
As the Minister of State responsible for Ireland's overseas development aid programme, Ms O'Donnell has seen the devastating impact AIDS can have on attempts to build up the poorer countries of Africa in particular. Ireland was one of the first countries to integrate the fight against AIDS into all its development programmes. Among the other Irish participants will be Ms Maura Quinn from the Irish branch of UNICEF (United Nations Children's Fund) which is conducting a campaign for the prevention of mother-to-child transmission of HIV/AIDS. She points out that a single dose of the low-cost drug nevirapine to the mother during labour and to the child in the first three days of life can reduce the level of mother-to-child transmission by half. One dose costs about $4. Unlike the Millennium Summit, the special session will have a fairly tight focus, and its chances of success should be all the higher for that. It is now over 20 years since the first AIDS case came to public notice. The world community has been slow to respond and will now have to dig deep into its pockets and other resources to roll back the deadly tide. It's no time for token gestures.