UNAIDS: The First 10 Years

UNAIDS The First 10 Years28One cannot overestimate the importance of the fact that some of the six UN cosponsoringagencies did not want a new body and certainly not one that would coordinate or, as theymight see it, control their activities. As Kastberg explained, the UN’s Member States also hadto be engaged in developing an understanding that “in terms of AIDS, UNAIDS had to drawon the best of its Cosponsors to represent a common position that established to the world,‘This is where we stand on HIV/AIDS’”.Kastberg was concerned about widening the involvement among agencies and donorsbeyond those people immediately engaged in the task of developing UNAIDS. At that time,AIDS was, he explained, very much “a specialization of the few, it was using a jargon very fewknew”. This was an issue that “intimidated” many of the senior staff within governments, UNagencies and nongovernmental organizations.During the first three months of 1994, an interagency working group met several times and,with the exception of the World Bank, developed a consensus on the structure and functionof the new Programme. In the lead-up to the meeting of ECOSOC in July that would endorseUNAIDS, disagreements between agencies over the size and structure of the new programmecontinued from the previous year, ‘a number of agencies originally argued for the lightestof mechanisms, with the emphasis strictly on coordination rather than implementation’ 5 .WHO continued to maintain that the new Programme would be ‘administered and locatedin WHO’ 6 .According to Jim Sherry, then Chief of the Health Promotion Unit at the United NationsChildren’s Fund (UNICEF) (who often stood in for its Director, Jim Grant, at the meetingsabout the new Programme), UNICEF was prepared to accept a cosponsored programme butnot if WHO insisted on being ‘primus inter pares’ or ‘first among equals’ – that is, explainedSherry, it was “… they were really going to be driving the show”.The donors were equally in dispute over the form of the new Programme. The UK, explainedDavid Nabarro, then Chief of Health at the Department for International Development(DFID), “wanted a programme that focused on the need for ‘clear and relevant outcomesand high-level coordination to ensure that the international system focused on theseoutcomes, advocacy for the outcomes and monitoring of their achievement, with a smallstrategic Secretariat’. The UK preferred to see improvements in the operation of existinginstitutions rather than the establishment of a new body with executive authority at countrylevel. But other governments wanted an agency with strong field presence. There was – as isnot unusual – a battle about this”.Paul De Lay, who was a senior technical adviser for the United States Agency for InternationalDevelopment (USAID) in 1994, recalled: “We felt very strongly at USAID that to rip out thebudgets and the implementation side was a mistake, while other major donors felt very5Leather S (2001). Historical Background to the Establishment of the Joint United Nations Programme onHIV/AIDS (unpublished).6WHO (1994). Press Release, 21 January. Geneva,WHO.