Islamic governments, with the connivance of the conservative Bush administration, succeeded in watering down the final declaration of commitment to strategies and targets to beat the global Aids pandemic at the UN yesterday by excluding any reference to gay men.
Human rights groups had been lobbying hard to ensure that those in high risk groups for HIV/Aids who are often on the margins of society - gays, prostitutes and intravenous drug users - would be pledged explicit help in the declaration which set the seal on three days of talks.
But Islamic governments, with Egypt, the Gulf states, Pakistan and Malaysia as the most vocal, had fought hard against the original wording, which said there must be strategies to help "men who have sex with men".
They based their opposition on cultural and religious values which in some countries mete out punishments to homosexuals.
The US delegation, conscious of President George Bush's backing from the moral right, had argued that there was no need to specify which groups were most vulnerable to the disease.
The result of this unlikely coalition of interests is a declaration which speaks of activities rather than individuals. Countries should put programs in place by 2003 to address activities "such as risky and unsafe sexual behavior". Injecting drug use is specified as a risk and there is a convoluted but discernible reference to prostitution in the phrase "all types of sexual exploitation of women, girls and boys, including for commercial reasons".
Kofi Annan, the UN secretary general, acknowledged that there had been problems over the declaration but he said it was important that they should be discussed.
"The debate has begun and it is not going to go away," he said. The world now had "a clear battle plan for the war against HIV/Aids … a blueprint from which the whole of humanity can work to bring a global response to a global challenge".
Frances Kissling, president of Catholics for Free Choice, said: "The conservative Catholics and evangelical Christians are seen as the base of Bush's support and to satisfy them, the administration has taken positions on reproductive health services and Aids that threaten the health of men and women."
The declaration sets out detailed strategies to combat the pandemic, including the care of the 15m Aids orphans, the need for leadership, prevention strategies and treatment. But those campaigning groups who had hoped the UN special session would lead to widescale distribution in poor countries of the antiretroviral drugs that keep people with HIV alive and well in the west will go home disappointed.
An early draft of the declaration suggested that states should look at intellectual property rights where it might affect their access to medicines. Kenya has recently passed laws to enable it to import or make cheap copies of expensive but essential medicines, after the defeat in South Africa of drug companies which wanted to block similar legislation.
But the US delegation is thought to have been behind a turnaround in the clause. It now talks of "strengthening pharmaceutical policies and practices … in order further to promote innovation".
© Guardian Newspapers Limited 2001