UNAIDS: The First 10 Years

Chapter 7Challenges to the “Three Ones” and theUnited Nations Consolidated Plan to‘Make the Money Work’195Documents such asthis by the AfricanCouncil of AIDSService Organizations,the InternationalHIV/AIDS Allianceand the InternationalCouncil of AIDSService Organizations,were developed to helpencourage the involvementof civil society groups inthe coordination of nationalAIDS responses.Inevitably, the road to harmonization, to achieving the “Three Ones” in every affected country,is a tough one. UNAIDS’ role is not an easy one. Mogedal said that it is very hard for UNAIDSto drive change in countries “… because of the way it’s hooked into the UN system. If theyhave a Resident Coordinator in UNDP that wants to drive these kinds of changes along withthem, then they’re able to do that but, if not, they will be a voice in the wilderness”.Salla N’tounga raised another challenge: “It is very difficult to convince countries that if theyreally want to mobilize all the sectors, the coordinating body has not to be in a ministry likethe Ministry of Health but at a higher level. We have succeeded in having these NationalAIDS Commissions established but in most of those countries we still face a conflict betweenthe former unit at the Ministry of Health and the new National AIDS Commission”.Ben Plumley, Director of the UNAIDS Executive Office at the time, commented: “Thebiggest challenge – and it’s not resolved – is that, while donors have in principle agreed toimplement the ‘Three Ones’, the behaviour of their country teams – and indeed of otheroutside stakeholders in-country – hasn’t necessarily been adaptedfast enough. Another issue is how the ‘respect for the leadershipof national governments to implement AIDS strategies’ has beeninterpreted. To some, they mean ownership and direction fromMinistries of Health, with minimal engagement of other sectorseither inside or outside government: to others – and this is whatis so exciting about the ‘Three Ones’ – they mean a genuinelymultisectoral engagement with civil society. It remains a significantchallenge to build this kind of genuine multi-stakeholderownership of the ‘Three Ones’. To this day, one sees continuedscepticism, including from some activist groups and national civilsociety groups, who fear that the ‘Three Ones’ may just be anexcuse to exclude them from the national response”.With the arrival of the Global Fund and the “Three Ones”, thecapacities of civil society – such as nongovernmental organizationsand community-based organizations – are often fully stretched.In the International Council of AIDS Service Organizations(ICASO) report NGO Perspectives on the Global Fund, the pointis made that ‘civil society representatives do not automatically come to the table with theknowledge and skills to participate fully in policy-making; decision-making; priority setting;and programme design, implementation and monitoring’.