UNAIDS: The First 10 Years

Chapter 62003 – a year of the significantprogress in funding169When UNAIDS was first established, the globalactions and resources addressing the epidemicwere roughly one tenth of what they were in 2003.‘To be successful in containing the progression ofthe epidemic, another 10-fold increase in the globaleffort will be required by the end of this decade …While this increase is not inevitable, it is no longerseen as wishful thinking’ 29 .US President GeorgeW Bush holds BaronMosima Loyiso Tantohin the Rose Garden ofthe White House in May2007, after deliveringa statement on PEPFAR.White House photoby Eric Draper“The existenceof UNAIDS hasbeen very criticalto the developmentof PEPFAR andthe implementation[of its work].UNAIDS hasplayed a veryimportant role onthe technical side ofproviding data that[are] universallyaccepted …”.Nor was it, as yet more resources were forthcoming.In January 2003, US President George W Bush, in hisState of the Union address, announced the launchingof the U.S. President’s Emergency Plan for AIDS Relief(PEPFAR). It aimed to spend US$ 15 billion over fiveyears, a target representing a huge leap forward ininternational funding for AIDS. Some US$ 10 billion of this was new funding. Although Piotwas disappointed that more of the money would not go multilaterally to the Global Fund,he believes that this was one of the most crucial moments in the history of the epidemic sofar: “… [when] the most powerful person in the world puts 15 billion dollars on the table, itcompletely changes the landscape”.It was a significant moment in the history of AIDS, especially given the limited action ofprevious US Governments in relation to AIDS in the developing world. And other leaderswould follow, including British Prime Minister Tony Blair, who pledged £1.5 billion (approximatelyUS$ 3 billion) over three years in July 2003. A 2002 briefing note to Piot stated thatthe White House was strongly influenced to opt for higher spending levels after receivingUNAIDS’ unpublished analysis of optimal spending allocations among major donors.Michael Iskowitz, former Director of the US Office of UNAIDS, commented: “Despite asometimes contentious relationship between the US Administration and the UN overall,there has been a very solid working relationship between UNAIDS and this administration.UNAIDS has contributed to the implementation of PEPFAR with some very tangible results,particularly in the area of coordination”.Ambassador Randall Tobias, the first US Global AIDS Coordinator, explained that althoughUNAIDS had nothing to do with the design of PEPFAR, “… once those decisions weremade, the existence of UNAIDS has been very critical to the development of PEPFAR and29UNAIDS (2002). Executive Director’s Report to the 13th Meeting of the UNAIDS PCB, December. Geneva,UNAIDS.