Context:

• The recent issues faced by UNAIDS programme that threatened its very existence and its affliction on global AIDS response.

What is UNAIDS?

• Joint United Nations Programme on HIV and AIDS (UNAIDS) is an innovative joint venture of the United Nations family which brings together the efforts and resources of 11 UN system organizations to unite the world against AIDS. These are UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, the ILO, UNESCO, WHO and the World Bank.
• The UNAIDS is the main advocate for accelerated, coordinated and comprehensive global action on the HIV/AIDS epidemic.
• UNAIDS is established in the year of 1994 and has its headquarters at Geneva (Switzerland), where it shares some site facilities with the World Health Organization (WHO). It is also a member of the United Nations Development Group.

Mission of UNAIDS:

• The mission of UNAIDS is to lead, strengthen and support an expanded response to HIV and AIDS that includes preventing HIV transmission, providing support and care to those already living with the virus, reducing the vulnerability of individuals and communities to HIV and alleviating the impact of the epidemic.
• UNAIDS seeks to prevent the HIV/AIDS epidemic from becoming a severe pandemic.
• The main goals of UNAIDS include – advocacy and leadership for effective actions against this deadly disease; technical support and strategic information for guiding efforts against HIV; strategic partnership development and engagement of civil society; resource mobilization for supporting an effective response, etc.

Major steps taken by UN towards alleviation of AIDS:

• UNAIDS since its establishment in 1994 has been able to successfully mobilise world opinion to mount an exceptional response to an epidemic which has consumed over 20 million lives with still no effective treatment or cure.
• The UN General Assembly Special Session (UNGASS) 2001 was a game changer with the adoption of a political resolution that itself was exceptional in many ways.
• The creation of a Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and the slashing of prices of AIDS drugs by Indian generics have brought treatment within the reach of many countries.
• Today some 22 million people are under antiretroviral therapy (ART) and preventing mother to child transmission of HIV has become an achievable goal by 2020.
• The organisation has provided leadership to many countries which in 10 years (2001-2010) could halt the epidemic and reverse the trend.

Fallbacks in Elimination of Aids Epidemic:

LACK OF POLITICAL WILL

• Regions such as eastern Europe and Central Asia and West Asia are nowhere near reaching that goal, with many countries such as Russia witnessing a raging epidemic among drug users and men who have sex with men (MSM) communities.
• With the top leadership in UNAIDS exhorting countries to bring AIDS “out of isolation” and integrate with health systems, the political leadership in many countries have thought that AIDS is no more a challenge.

INACCESSIBLITY OF “ART” BY MARGINALISED SECTIONS:

• There has been the thinking that the AIDS epidemic can simply be treated away by saturating antiretroviral therapy (ART) coverage.
• It is forgotten that AIDS affects the poor, the marginalised and criminalised communities disproportionately as they face challenges in accessing the ‘test and treat’ programmes.

LACK OF AWARENESS GENERATION

• The ever-increasing number of young people who are joining the ranks of vulnerable
• populations do not get prevention messages like in the past.
• National programmes do not any more consider condoms, sexual education and drug harm reduction as central to the prevention of HIV transmission that results from unprotected sex and drug use.

 LACK OF FUNDING

• Funding for nongovernmental organisations and community-based organisations working on prevention has virtually dried up.

 INCOMPETANT LEADERSHIP

• Third has been the weakening of country leadership of UNAIDS in many high prevalence countries. Senior country level positions are, in many instances, held by people who do not possess the core competence to constructively engage political leadership to undertake legal reforms and provide access to services to marginalised populations.

FIZZLING OUT OF CIVIL ACTIVISM

• But the biggest setback has been the lost voice of vulnerable communities which was the main driving force of AIDS response.
• Activism surrounding AIDS has suddenly fizzled out emboldening many countries, especially in Africa, to further stigmatise and discriminate by enacting new laws that criminalise vulnerable sections of society.

CHARGES AGAINST UNAIDS LEADERSHIP

• The charges against one of the senior most staff and his exit from the organisation have seriously compromised UNAIDS at a time when the global response needs its leadership the most.
• There are even suggestions that AIDS should go back to the World Health Organisation (WHO) where it originally belonged to some 25 years ago.

Way Ahead:

• Since ending AIDS is also an integral part of the Sustainable Development Goals (SDGs), The lessons learned in responding to HIV will play an instrumental role in the success of many of the SDGs, notably SDG 3, good health and well-being, and the goals on gender equality and women’s empowerment, reduced inequalities, global partnerships and just, peaceful and inclusive societies.
• With 1.7 million new infections and one million deaths occurring every year, we can’t afford to drop the ball half way. The commitment to end AIDS by 2030 is ambitious but not impossible to achieve.
• What we need is a reenergised UNAIDS with a strong and fearless leadership from a person of high integrity and commitment along with a sincere effort to remove the deadwood from the organisation.
• The new executive director should take up the unenviable task of not just restoring the credibility and relevance of the organisation but strengthening its presence at country level and making it more meaningful to the communities which look to it for leadership.