UNAIDS: The First 10 Years

UNAIDS The First 10 Years212selling. Obaid highlighted that an adequate response to AIDS requires that treatment andprevention have equal focus. “We always need to emphasize that an effective response isprevention, treatment and care; we need an integrated and comprehensive package, andwe need to emphasize this package as a whole”.Having made the decision to develop a new strategy on prevention, the UNAIDS Secretariatchose to work with the Bill & Melinda Gates Foundation Working Group on Prevention,rather than setting up another reference group. The collaboration between UNAIDS andthe Foundation has turned out to be a very productive one.A major policy breakthrough on HIV preventionWork started on a major policy document on HIV prevention. For many months, Secretariatstaff worked with Cosponsors and Programme Coordinating Board members to negotiatethe final draft, which contained strongly worded positionson harm reduction for injecting drug users and on sexworkers. PCB members worked as advocates withintheir own countries, negotiating informally with variousgroups, and civil society had an input. Achmat Dangor,former UNAIDS Director of Advocacy, Communicationand Leadership, explained that UNAIDS acted as a facilitator,as in other processes, bringing people togetherand “agreeing to act on what they feel comfortablewith”.Purmina Mane, formerly Director of the Policy, Evidenceand Partnerships Department at UNAIDS, explained:“We organized consultations with civil society to gettheir inputs. Civil society also organized itself to createlobby groups to pressure their own governments toensure that the evidence was reflected adequately inthe document. So we had microbicide groups, vaccinegroups, harm reduction groups, women’s groups, peopleliving with HIV; their inputs were substantial. Of course,managing all these inputs was quite a challenge”.It was a very political process. A major challenge was to reach a consensus on harmreduction and needle exchange to prevent HIV transmission among injecting drug users.Peter Piot, UNAIDS Executive Director, explained that for several months he did not speakout about this issue because if he had, “it would have allowed the many opposing countriesto mobilize against this”. He discussed the various issues with each board member andThe prevention tree –UNAIDS HIVprevention guidelines