UNAIDS: The First 10 Years

UNAIDS The First 10 Years86Several months later, when visiting WHO headquarters, Cowal saw nutrition manuals for newmothers that stated there was no alternative to breastfeeding. “You would have thought ithad been written in 1964, not 1998, because you would not have known something calledHIV existed”.Susan Holck, now Director of General Management at WHO, recognizes that the issue is afraught and complex one but said that the main concern of the United Nations Children’sFund (UNICEF) was to protect the strides it had made in its breastfeeding policy: “Theywere just not prepared to deal with the challenges of this”.After the meeting, a new task force, the Inter-Agency Task Team on Mother-to-ChildTransmission, was established to develop and publish guidelines and recommendations.Its initial members were UNICEF, UNFPA, WHO and the UNAIDS Secretariat. But, as DeLay lamented, “[it was] a pity that the MTCT [mother-to-child transmission] programmeswere discontinued”. The UNAIDS Secretariat and Cosponsors have been criticized bythe external evaluation of the Programme for not handling this issue well over the pastfew years 15 . Even so, he explained, “this exercise was a good example of how UNAIDS’credibility and convening power and authority were what ‘we all wanted to use’. For USAIDto hold a meeting like that, half the world wouldn’t come”.There would be several more tough battles ahead on prevention of mother-to-childtransmission and other policy matters, but there was also growing recognition thatUNAIDS was a key forum for bringing together the best in research and evidence-basedinformation.The 12 th International AIDS conference debatesthe gap between the South and NorthIn the summer of 1998, the city of Geneva hosted the 12 th International AIDS Conference.The conference theme was ‘Bridging the Gap’ – that is, the growing gap between theNorth and the South in terms of access to treatment. In the opening ceremony, Piot saidthe biggest AIDS gap of all is “the gap between what we know we can do today and whatwe are actually doing”.Journalists 16 such as New York Times journalist Lawrence Altman noted a very differentmood from the euphoria in Vancouver two years earlier – in Geneva there was considerablepessimism. Not only were there no recent scientific advances to celebrate such as highlyactive antiretroviral therapy, but participants also learnt of problems with the new drugs (suchas side-effects) and with vaccine tests, and the apparent hopelessness of providing treatment15UNAIDS (2002). Five Year Evaluation of UNAIDS. Geneva, UNAIDS.16Altman L K (1998). ‘AIDS meeting ends with little hope of breakthrough’. New York Times, 5 July.