UNAIDS: The First 10 Years

Chapter 4But too many political leaders were still in denial, and resources for HIV prevention and carewere risible compared with what was needed. UNAIDS itself was struggling to attract theresources to operate effectively.75The Western media were beginning to write more seriouslyand more often about the challenge of the epidemic.UNAIDS contributed to this increasing awareness aroundthe world through regular press releases, campaigns,the World AIDS Campaign and media partnerships. Amedia analysis of the programme undertaken by CARMAInternational 6 , an independent evaluator of performancein the press, revealed ‘that UNAIDS has already obtainedsubstantial results not only when raising awareness aboutthe epidemic, but also when soliciting media coverage ofwhat needs to be done and what UNAIDS is currently doingto respond to the epidemic’.Access to care remaineda central challenge tomoving the AIDSresponse forward.WHO/A.WaakHowever, faced with grim pictures of skeletal men and women, and of young orphanscaring for even younger brothers and sisters, there seemed little room for optimism aboutcombating the epidemic in the developing world as a whole.Access to care remained a central challenge. As the health economist, William McGreevey,told an invitation-only World Bank audience in May 1998: “The brutal fact [is that] ‘those whocould pay’ for Africa’s AIDS therapy – the pharmaceutical industry, by way of price cuts, and‘rich country taxpayers’ by way of foreign aid – are very unlikely to do so” 7 .Most activists were too preoccupied with their own battles, especially in the United States ofAmerica (USA) where drugs were available but unaffordable to many, to tackle the challengesof the South. As Gregg Gonsalves from New York’s Gay Men’s Health Crisis explained, “whenantiretroviral therapy arrived on the scene in the US, cost was still an issue because of theabsence of a national healthcare system. … There are 48 to 50 million Americans uninsured,so there was a waiting list for AIDS drugs – the issue of access came up pretty quickly”.UNAIDS’ Drug Access Initiative, launched in 1997 ( see previous chapter) had shown,admittedly on a small scale, that treatment could be provided in low-income countries. DrJoseph Perriëns, now Director of AIDS Medicines and Diagnostic Services at WHO, was oneof the people who initiated the programme. “This initiative was very important because,between 1997 and early 2000, UNAIDS was able to demonstrate that, with moderateinvestment in the supply chain and in clinical service delivery, mainly training and someinvestment in laboratory infrastructure, it was possible to generate positive treatment6UNAIDS (1997). Progress Report, 1996–1997. Geneva, UNAIDS.7Gellman B (2000). ‘An unequal calculus of life and death’. Washington Post, 27 December.