UNAIDS: The First 10 Years

Chapter 7Kristan Schoultz, former UNAIDS Country Coordinator in Kenya and now Director, GlobalCoalition on Women and AIDS, described the problem: “A country like Kenya receives a lotof international attention, and the National AIDS Control Council staff could be completelyburdened, from eight o’clock in the morning until five o’clock in the afternoon, by consultantvisits. And often, those consultants, who would all have been brought in by different partners,would be looking at very similar things. So, clearly, when you think about it, the better ideais [to say] ‘Why don’t you donors bring a team together? Let’s not have so many missions’.It’s extraordinary when you actually talk to colleagues in the NACC [National AIDS ControlCouncil] how much time they spend being very gracious and very polite to external visitors,when indeed they should be thinking about policies and strategies and moving the responseforward”.185Mary Kapweleza Banda, Malawi Minister of State responsible for HIV/AIDS, pointed out: “Atthe country level, governments are struggling to fight the AIDS epidemic, while rushing torespond to conflicting and often repetitive donor requirements” 6 .Towards better coordinationThis is not justa question ofbureaucracy goneawry; such chaosimpedes attemptsto save lives, toplan preventionprogrammes andreach more peoplewith antiretroviraltreatment”.This lack of coordination (or ‘harmonization’, the term more often used in developmentcircles) had been a recurrent theme at a number of high-level meetings. In 2002, the UNConference on Financing for Development in Monterrey, Mexico, concluded that the bestway to use aid effectively was through processes led by the countries themselves.The Monterrey Consensus, as the meeting’s final agreement is known, expanded on this andprovided a framework for international cooperation on development. Various subsequentmeetings built on this agreement. In February 2003, the High-Level Forum on Harmonizationissued the Rome Declaration committing donors, recipient countries and bilateral and multilateralinstitutions to harmonize their policies and procedures. Then in April 2004, in Paris,the Development Cooperation ministers and agency heads of the Organisation for EconomicCo-operation and Development (OECD) Development Assistance Committee agreed astatement promising to ‘turn the principles of harmonization and alignment – agreed at theRome High-Level Forum in 2003 – into reality on the ground’. A year later, both low- and highincomecountries joined with multilateral organizations and international aid organizations toendorse the Paris Declaration on Aid Effectiveness. However, the history of development islittered with such declarations, so only time would tell if this one would have any effect.UNAIDS was determined to push for coordination in AIDS work and responded to the callfor reducing transaction costs and duplication. Working with the Global Fund and the WorldBank, the UNAIDS Secretariat initiated consultations in various African countries as well as atglobal level. Peter Piot, UNAIDS Executive Director, explained: “There was really a chaotic6UNAIDS (2004). Press Release, 25 April. Washington, DC, UNAIDS.