UNAIDS: The First 10 Years

UNAIDS The First 10 Years250 United Nations collaboration and CosponsorsThe bitter disagreements about the establishment of UNAIDS, and between Cosponsorsand the Secretariat for many years afterwards, were a barrier to the much-needed collaborationbetween agencies – the reason for setting up UNAIDS in the first place. However, therehave been significant improvements at all levels in recent years.Individually and in collaboration, cosponsoring organizations work on many different areas,and have been at the forefront of setting the global agenda on AIDS.Hansen explained: “[UNAIDS] began to create a space in which the agencies could sort outtheir comparative advantages and see what unique role each of them could play. Nobodyshould be trying to duplicate WHO’s role or take it away; no one should be trying to horn in onwhat UNICEF alone can do, or what UNICEF does best, and, obviously, the Bank had certainroles, skills and access that the rest of the UN family did not. And this helped each of us tosee how that would contribute and give us a comfort level that, even if we weren’t worryingabout some aspect of the epidemics, one of the other agencies was covering that”.“I would arguethat UNAIDSis probably thebest success wehave [in terms] ofcoordinated actionacross differentagencies, but itis not a goldstandard”.“And, of course, success is mixed so far, but I think it is a much more cohesive and betterorganized response – certainly than it would have been without UNAIDS”.The former UN Deputy Secretary-General, Mark Malloch Brown, noted the constraintsUNAIDS has faced in terms of collaboration: “I would argue that UNAIDS is probably thebest success we have [in terms] of coordinated action across different agencies, but it is nota gold standard. We have a huge way to go, I think, and in this history of the first 10 years, toomuch time has been spent trying to get Country Teams to work together, trying to get themto act strategically from the base of what needs to be done, rather than from the base ofdividing up the spoils of AIDS money between them, and I think it’s been an issue that’s ledto a fair amount of reform, but it’s also been an issue that shows the limits of reform so far”.Piot agreed: “We wasted a lot of energy and time on bureaucratic processes because of turfwars and entrenchment, the unwillingness of UN agencies to give up territory. There was alsothe competition for funds. The recent openness to reform is helping us greatly”.Stephen Lewis, the former Special Envoy of the UN Secretary-General for HIV/AIDS in Africa,is strongly critical of the UN response: “I think that the absence of leadership, which UNAIDScould not overcome, at the centre of the UN system has resulted in far less progress than shouldotherwise have been the case. There is no question in my mind that, when history is written,when the significant history of the pandemic is written, the inability of the UN to orchestratea response far more vigorous, far more effective, far more searching than the response we’vehad thus far, that that will be seen as one of the sad components of the pandemic. That is not– I don’t really believe that’s a commentary on UNAIDS. I think it goes much further than that; Ithink it goes to the heads of agencies and to the Heads of the [UN] Secretariat”.