UNAIDS: The First 10 Years

UNAIDS The First 10 Years194 Progress in countriesHow are countries doing in terms of the “Three Ones”? By the end of 2005 and early 2007,there was clear improvement in establishing these new principles. Most countries had achievedthe “First One” – that is, a national AIDS action framework or National Strategic Plan. Forexample, the Lao People’s Democratic Republic has developed a new National Strategy andAction Plan on HIV/AIDS and sexually transmitted infections for 2007–2010, with the supportof UNAIDS. The Plan prioritizes prevention and care activities in terms of specific groups suchas sex workers and their clients, drug users, mobile populations, vulnerable youth and menwho have sex with men. It also prioritizes provinces and districts based on selected vulnerabilitycriteria such as areas with high HIV prevalence and high population density, areas thatare tourist and business centres offering high levels of entertainment, as well as areas thatare on crossroads or have highly mobile populations 17 . It aims at a 90% reach for preventionprogrammes targeting vulnerable groups, and nearly 100% coverage of treatment and care forpeople in need.Unlike in the Lao People’s Democratic Republic, few country plans are specific about priorities,and approximately 40% of plans are neither costed nor budgeted 18 . This obviously limitstheir usefulness in providing overall guidance to all who are working in those countries onprogrammes for AIDS. External donors are less likely to ensure the work they fund meets acountry’s priorities when these are only vaguely presented.Inevitably,the road toharmonization,to achieving the“Three Ones”in every affectedcountry, is a toughone. UNAIDS’role is not aneasy one.By the end of 2005, 85% of countries reported having established the “Second One” – onenational coordinating authority for the AIDS response. Moreover, according to a UNAIDSsurvey, 81% of countries have additional coordinating mechanisms on AIDS 19 . For example,the Global Fund’s Country Coordinating Mechanisms (CCMs), while providing much neededfunding, can lead to a confusion of roles when it comes to policy making: ‘In some countriesthe CCM makes de facto policy decisions through funding decisions related to investmentin some areas and not others. The UNAIDS survey also states that in 32% of the countriessurveyed, the national AIDS authority does not play a significant role in the CCM’ 20 .There has been an improvement in the state of monitoring and evaluation – the “Third One”– in many countries, though, in 2005, more than 40% of countries rated national monitoring andevaluation efforts as average or below average. More countries have a dedicated monitoringand evaluation budget and share monitoring and evaluation results with UN agencies, bilateralagencies and other partners. But ‘much more progress on data-sharing is needed to maximizeevidence-based decision-making’ 21 .17National Committee for the Control of AIDS (2005). National Strategic and Action Plan on HIV/AIDS/STI2007–2010. Geneva, UNAIDS, July.18Buse K, Sidibe M, Whyms D, Huijts I, Jensen S (2007). Scaling up the HIV/AIDS response: From Alignment andHarmonization to Mutual Accountability. Briefing Paper, Overseas Development Institute, London, August.19UNAIDS (2007). Effectiveness of Multilateral Action on AIDS. Report to the 18th Meeting of the UNAIDS PCB,June. Geneva, UNAIDS.20Ibid.21Ibid.