UNAIDS: The First 10 Years

UNAIDS The First 10 Years260business and nongovernmental organizations, for example, is vital. As US AmbassadorRichard Holbrooke, President and Chief Executive Officer of the Global BusinessCoalition on HIV/AIDS, called for 26 , many companies should offer support, not justdonations but also by ‘enhancing their own activities in offering education, testing,counselling, treatment and a pledge of non-discrimination to employees and theirfamilies’. There is also still a serious lack of meaningful participation of people living withHIV. UNAIDS is now providing support to embark on a re-mobilization of HIV-positivecommunities worldwide.There is a need for increased and sustainable funding. Although funding has greatlyincreased over the past decade, there is still a major gap between what is needed fora sustained response and what is actually being provided. At the 2007 UN GeneralAssembly High-Level Meeting on AIDS, UN Member States recognized that by 2010,US$ 20–23 billion will be needed annually for developing countries to scale up towardsuniversal access to antiretrovirals. But existing pledges, commitments and trends suggestthat the rate of increase might be declining, as indicated by the fact that available fundswere US$ 9 billion in 2007 and will be around US$ 10 billion in 2007.UNAIDS has advocated for funding to be more predictable and guaranteed for the longterm. Volatile funding makes it hard for countries to make long-term plans. As moretreatment programmes are rolled out, and treatment keeps more people alive longer, theneed for funding is also increased. So for some time the financing needs will increase.Many developing countries are able to spend more on their AIDS response, but whetherthey do so depends on the political will to reallocate resources. However, this is not truefor many of the poorest African countries. ‘Fulfilling promises on official developmentassistance, and a continued ring-fencing of AIDS funding by governments, donoragencies and the World Bank, will be essential for many years to come … The worldneeds nothing less than fiscal commitments for universal access to HIV prevention andtreatment services covering at least 10 years’ 27 .The epidemicwill be haltedonly if AIDSis placed firmlyin mainstreamdevelopmentwork.Existing funding mechanisms such as the Global Fund to Fight AIDS, Tuberculosis andMalaria need to be supported and strengthened. From its early days, the Fund has had toendure an almost ‘stop-start’ policy of funding flows from donors; this does not guaranteea sustained response. Developing mechanisms for not only increased but also sustainedand predictable financing should be a priority – as it is for development in general.Getting the relationship right between the Global Fund and UNAIDS will becrucial for more effective multilateral support to the AIDS response in developingcountries. As both organizations are entirely complementary, in theory creating greaterinstitutional synergy should not be so difficult, as long as the will is there in the boardsand management of both.26Jack A (2007). ‘Between hope and despair: why the fight against AIDS is at a turning point’. Financial Times,31 May.27Piot (2007).