UNAIDS: The First 10 Years

The challengesto HIV infection. Thus countries can review, plan, match and prioritize their nationalresponses. A challenge in many countries is the reluctance by national AIDS bodies toinvolve civil society fully – often specifically those people living with HIV. Their voicesmust be heard; their experiences and actions are invaluable to an effective response.259The challenges: a long-term response to AIDSUnlike so many tragedies, such as the tsunami in 2007 or severe droughts, AIDS is acontinuing crisis. The fundamental challenge for everyone working to combat thisepidemic is to sustain a full-scale response to AIDS over at least another generation.UNAIDS must continue its advocacy to ensure that leaders do not lose sight of theexceptional nature – and threat – of the AIDS epidemic. Building and retaining popularsupport for the AIDS cause in both low and high-income countries will be key, as willbe the achievement of results in the fight against AIDS. Thus, UNAIDS and others haveto show returns on the investments of billions of dollars made, so that the latter arecommensurate with the numbers of averted infections, illness and deaths.Activist Zackie Achmat explained: “Everybody said to me why did you not go toToronto [the 16 th International AIDS conference]? I said, Sweetie Dear, there [will] beAIDS conferences for another 100 years and I hope to be around for another 50 ofthem, not for the conference but for those years … the epidemic is going to last a long,long time and we have to pace ourselves. The biggest problem we face is how we focuspolitical leadership on AIDS as an emergency and on AIDS as a long-term issue. And tomaintain that interest in that”.In order to ensure a sustained response, there is a need to retain and develop exceptionalleadership. An exceptional response calls for exceptional leadership to ensure sustainabilityand long-term, funded strategies but political commitment is by definition fragile.Politicians’ horizons are often short, sometimes only as far as the next election or two ratherthan for decades to come; there are so many immediate issues competing for their attention.Despite the considerable growth of political engagement with AIDS since UNGASS in2001, governments are not doing enough. As the UN Secretary-General’s report for the2007 High-Level Meeting revealed 25 , ‘… five years after the Special Session, the availableevidence underscores the great diversity among countries and regions in implementingthe response envisioned in the Declaration of Commitment on HIV/AIDS. Whilecertain countries have reached key targets and milestones for 2005 as set out in thedeclaration, many countries have failed to fulfil the pledges’.As well as retaining and increasing the engagement of political leaders and electedrepresentatives at every level, sustained activism is essential to hold governments andother actors accountable. Engaging the broad coalition of public and private sectors, of25UNAIDS (2007). Declaration of Commitment on HIV/AIDS: Five Years Later. Report of the Secretary-General.Geneva, UNAIDS.