UNAIDS: The First 10 Years

Chapter 6Chapter 6:Changing the United Nations landscape incountries, 2002-2003145At the end of 2001, nearly 29 million people were living with HIV (about one fi fth wereaged 15–24), and 3.2 million had been newly infected. In 2002 1 , global expenditure onAIDS was US$ 3164 million; in 2003, it was US$ 4730 million 2 .The momentum of the previous years continued, in part spurred on by the 2001 UnitedNations General Assembly Special Session (UNGASS) on HIV/AIDS. Early in 2002, theExecutive Director’s testimony to the Committee on Foreign Relations of the United StatesSenate set the scene for the challenge and expectation of the biennium: “We are now in aposition to make a leap forward – a leap that will for the first time put us ahead of HIV”.However, the grand words and Declarations of 2000 and 2001 had yet to be turned into actionand concrete resources. The epidemic was not levelling off and, while there were some realresults on the ground (for example, declines in HIV prevalence in Addis Ababa, Kigali andKampala), the performance of national programmes in many countries was still wholly inadequate.Only 1% of pregnant women in heavily affected countries had access to services forthe prevention of mother-to-child transmission, despite clear evidence of its effectiveness.In France and the United States of America, fewer than 5% of babies born to HIV-positivemothers were themselves infected; in developing countries, the average remained between25% and 35% 3 . Most newborn babies infected with HIV die before the age of five years 4 .UNAIDS warned that it would take several more years for current efforts to result indeclining HIV prevalence trends, particularly in Southern Africa, a region with 2% of theworld’s population but almost 30% of the world population living with HIV 5 . A majorchallenge in countries was the inadequacy of health systems and severe lack of humanresources (the result of AIDS deaths and migration to richer countries and better paid jobsin the private sector or nongovernmental organizations) that would hamper the effectivespending of extra resources.12007 AIDS epidemic update, November 2007.2UNAIDS Resource Tracking Consortium, July 2004.3Dabis F, Ekpini E R (2002). ‘HIV/AIDS and maternal and child health in Africa’. The Lancet, 359 (9323).4UNAIDS (2004). Global Report 2004. Geneva, UNAIDS.4UNAIDS (2004). AIDS Epidemic Update. Geneva, UNAIDS.