UNAIDS: The First 10 Years

UNAIDS The First 10 Years14Africans had sex with monkeys. The African scientists were appalled. Scepticism anddenial among African leaders were reinforced when it became clear that the exaggeratedestimates presented at the conference were wrong. Peter Piot had been amazed as hewatched ‘some of the world’s most prominent scientists’ presenting estimates of HIVin Africa ‘that were absolutely stratospheric, off the charts.’ He ‘ knew from firsthandexperience that the numbers presented here were gross overestimations.’ 17In 1986, five years after the first CDC Note on AIDS cases, WHO’s Executive Boardrequested its Director-General to seek funding to develop activities on AIDS. By thistime, it was hard to deny that AIDS was an international threat to global health. At theWorld Health Assembly in May, the Ugandan Minister of Health declared that his countryhad AIDS, and asked WHO for help; other African countries followed suit 18 .Wealthy donor countries inevitably chose WHO, the UN agency designated to combatglobally endemic threats and facilitate the sharing of medical knowledge among MemberStates, as their ‘middleman’ in providing assistance. Donor nations also chose the routeof multilateral rather than bilateral assistance because they did not yet have specificinternational programmes of their own.In August 1986,Mahlerannounced:‘We standnakedly in frontof a pandemicas mortal as anypandemic therehas ever been’.As Mahler explained at an informal meeting on AIDS during the World Health Assemblyin 1987: ‘A number of major bilateral donors have stated clearly that their bilateralefforts to combat AIDS have been constrained by political sensitivities and inadequateknowledge, expertise, experience and financial and human resources … That is why theyhave decided to complement WHO’s Programme and centrally-funded activities’ 19 .So the Control Programme on AIDS was set up within WHO in 1986, and Mann, by thenone of the world’s leading experts on the epidemic, was appointed its Director from hispost as Director of Projet Sida in Zaire. Mann had warned that ‘one to several millionAfricans may already be infected’ 20 .The first few months of the new Programme saw major efforts to raise money fromdonors (like most of WHO’s new programmes, the Control Programme on AIDS did notreceive money from WHO’s core budget) and to increase public awareness about thedisease and its impact. Mann was a persuasive advocate and he succeeded in convincinga sceptical Mahler of the scale of the challenge. In August 1986, Mahler announced: ‘Westand nakedly in front of a pandemic as mortal as any pandemic there has ever been. Inthe same spirit that WHO addressed smallpox eradication, WHO will dedicate its energy,commitment and creativity to the even more urgent, difficult and complex task of global17Behrman G (2004). The Invisible People. New York, Free Press.18Berridge (1996).19WHO GPA (1992). Report of the External Review of the World Health Organization Global Programmeon AIDS. Geneva, WHO GPA, January.20Iliffe (2007).