UNAIDS: The First 10 Years

MalawiMalawi231Malawi, a sub-Saharan country landlocked by Mozambique, Tanzania and Zambia, isone of the poorest in the world. AIDS has had a particularly devastating impact on thiscountry. Since the first case was diagnosed in 1985, an estimated 650 000 Malawians havedied of HIV-related illnesses 1 . In 2007, HIV prevalence among adults aged 15–49 was14.1% 2 , and approximately 500 000 children lost one or two parents to AIDS in 2003 3 .The majority of people living with HIV in Malawi are women, estimated to be 58%of the 810 000 adults living with HIV 4 . Vulnerability to HIV remains high due to thecompounded effects of poverty, low education levels, discriminatory practices against girlsand women, poor farming methods and drought 5 .Nevertheless, those working in the development community share a strong sense ofoptimism about Malawi’s capacity to respond to the pandemic. From its beginnings as asocially cohesive democracy in 1994, Malawi took deft and decisive steps to respond toAIDS. The political machinery it established for this – one consultative planning process,one coordinating authority and mechanisms for monitoring and accountability –provided a solid foundation for a participatory and well-coordinated AIDS response, andembodied the principles known as the “Three Ones” that UNAIDS would eventuallyuphold as a paradigm.Malawi has also been a ‘preferred development partner’ from the donors’ perspective.Donors have been encouraging harmonization and collaborative work in Malawi,and have also been showing their commitment to fostering country ownership of theresponse to AIDS. The most striking example of this occurred in 2004, when four donorsmoved away from project-type funding and provided support directly to the governmentby pooling their funds under the direct management of the National AIDS Commission 6 .The United Nations played a significant role in helping Malawi develop its political andfinancial arsenal against the disease.Malawi’s response to AIDS: early daysMalawi gained independence from British rule in 1964. For the 30 years that followed,President Hastings Kamuzu Banda maintained a totalitarian grip on the country 7 . Underthis regime marked by political and social repression, insufficient attention was paid to1Malawi Country Profile. www.Avert.org.2UNAIDS (2007). Malawi Country Profile 2007. Geneva, UNAIDS.3UNAIDS (2004). Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Diseases: Malawi, 2004update. Geneva, UNAIDS.4UNAIDS (2007). Malawi Country Profile 2007.5Office of the President and Cabinet (2005). Malawi HIV and AIDS Monitoring and Evaluation Report 2005.Follow-up to the Declaration of Commitment, Department of Nutrition HIV and AIDS (UNGASS). Lilongwe,Government of Malawi, December.6Malawi Joint United Nations Programme on HIV and AIDS at a Glance: Forging New Ways to Fight HIV andAIDS (unpublished manuscript). Geneva, UNAIDS.7Malawi Country Profile. www.Avert.org.