AIDS advocates filed into the United Nations last week to help governments get serious about an epidemic that has killed 25 million people—and filed out again over the weekend in a haze of diplomatic doublespeak. “A bunch of pretty paragraphs” is how Jodi Jacobson of the international Center for Health and Gender Equity described the Declaration of Commitment settled upon at the end of the three-day UN Special Session on HIV/AIDS.

Among the main complaints were the Declaration’s failure to commit to specific treatment and funding goals or to name high-risk groups, such as gay men, sex workers and injection-drug users. “It’s sad that 25 years into the epidemic you can’t get people to sign on to basic strategies about how to prevent HIV,” said Gregg Gonsalves of Gay Men’s Health Crisis in New York.

The so-called “civil society” groups invited by the UN to meet with government negotiators each day can be credited with some striking victories: Condoms, needles and harm reduction weren’t even mentioned in the Declaration at first, and the outsiders scored big when UN Secretary General Kofi Annan accused some countries of having their “heads in the sand.” There was also a cementing of ties between nongovernmental groups that may bode well for future collaboration on an international level.

But the groups were hoping for a commitment of $23 billion yearly between now and 2010 in order to fund global AIDS care. Instead, the UN promised to “commit to take measures”—a vague and impractical commitment, according to Jacobson, who says, “Having targets gives us something to strive for and critique progress on.”  

Advocates also said the Declaration’s vagueness about high-risk groups came at great cost. “Girls are an endangered species in some sub-Saharan countries,” noted Gonsalves. “A declaration in support of the empowerment of girls might have raised them a bit out of victimhood and into a status worthy of recognition by their governments.” And a statement about drug users might have helped the campaign to legalize methadone in Russia.

In the end, the Declaration merely mentioned “vulnerable populations,” largely under pressure from the U.S. and several Islamic countries that shared its view that acknowledging specific risk groups might be seen as condoning their behavior.  

The Bush administration’s influence on the final document was a sore spot for many. “I think the U.S. was very clearly working to water down the commitment level,” says Michael Kink of Housing Works, an AIDS service organization in New York—an analysis reportedly held even by one of the administration’s own conference reps.