UNAIDS: The First 10 Years

Chapter 8213UNAIDS ExecutiveDirector Peter Piotdistributing condomsduring the InternationalAIDS Conference inBangkok.Getty/PornchaiKittiwongsakuleventually all except the Russian Federation and the United States of America agreed toharm reduction. “China changed their policy; that was a big coup”.The draft new paper on prevention of HIV was presented to and, after fierce debate, endorsedby the 17 th PCB in June 2005. For the first time there was an internationally agreed comprehensivepolicy on HIV prevention. “This is a true milestone in the response to AIDS”, explainedPiot, “and UNAIDS was clearly fulfilling its role as the world’s reference point in AIDS policy”.Ben Plumley, Director of the UNAIDS Executive Office until March 2007, explained that thiswas really “a big success, generating approval from the PCB for the UNAIDS HIV preventionpolicy was profoundly significant for the global AIDS movement – to my mind, as importantas the ground-breaking agreements on reduced ARV [antiretrovirals] pricing in 2000. Thepolicy is truly comprehensive and reaffirms the importance of developing ABC and harmreduction strategies. Not all PCB members were comfortable with every aspect—the USAstands out 8 , given its policy of not funding harm reduction programmes in internationalassistance. However, the key achievement was the building of consensus around UNAIDSwork on those most sensitive and politically charged of HIV prevention issues”.As Piot explained, there are many ‘turf wars’ on prevention among academic HIV preventionexperts and among different agencies; “with the approved prevention policy we now havean agreed menu of what to do”.8When the Prevention Paper was agreed at the PCB meeting in June 2005, the USA made a statement that itcould not fund needle and syringe programmes because such programmes were inconsistent with currentUS law and policy. The PCB noted the statement, and that this external partner cannot be expected to fundactivities inconsistent with its own national laws and policies.