UNAIDS: The First 10 Years

UNAIDS The First 10 Years222Three scenarios for AIDS in Africaby 2025‘Over the next 20 years, what factors will drive Africa’sand the world’s responses to the AIDS epidemic,and what kind of future will there be for the nextgeneration?’ This is the central question that aninnovative report – AIDS in Africa: Three Scenarios to2025 – published by UNAIDS in March 2005 set outto answer.The report presents three possible scenarios for theevolution of the AIDS epidemic in Africa overthe next 20 years, based on policy decisions takentoday by African leaders and the rest of the world.Piot explained: “These are not predictions. Theyare plausible stories about the future”.Most AIDS programmes are resourced with external funds. Since commitments generallydo not extend beyond five years, uncertainty remains about the level of resources that willbe available in the future. The scenario ‘Tough Choices’ shows what is possible when thereare efficient domestic policies but stagnant external aid; ‘Times of Transition’ describes whatmore efficient domestic policies and increased and high quality external aid could lead to, and‘Traps and Legacies’ shows what might happen if there are inefficient domestic policies andvolatile or declining external aid.The scenarios make it clear that it is not only the extent of expenditure on AIDSprogramming that counts, but how well and in which context it is spent. Major increases inspending will be needed to produce significantly better outcomes in terms of curbing thespread of HIV, extending treatment access, and mitigating impact. However, more resourceswithout effective coordination, gender equality and community participation may do moreharm than good. The scenarios suggest that while the worst of the epidemic may be still tocome, there is still a great deal that can be done to change the longer-term trajectory of theepidemic and to minimize its impact.The project was conceived in 2002, when UNAIDS and Shell International Limited decidedto work together to develop some scenarios that explored some of the possible long-termimpacts of the AIDS epidemic in Africa, looking forward over 25 years. Other organizationswere also invited to join the project, including the United Nations Development Programme,the World Bank, the Africa Development Bank, the African Union and the United NationsEconomic Commission for Africa.