The 4th decade of AIDS: what is needed to reshape the response.

Author:Sidibe, Michel
Position::Unted Nations General Assembly in New York

The international community has reached the first part of Millennium Development Goal 6: halting and reversing the spread of HIV. At least fifty-six countries have either stabilized or reduced new HIV infections by more than 25 per cent in the past ten years, and this is especially evident in sub-Saharan Africa, the region most affected by the epidemic. New HIV infections among children have dropped by 25 per cent, a significant step towards achieving the virtual elimination of mother-to-child transmission by 2015. In addition, today more than five million people are on antiretroviral treatment, which has reduced AIDS-related deaths by more than 20 per cent in the past five years. However, with more than 33 million people living with HIV today, 2.6 million new HIV infections, and nearly 2 million deaths in 2009, the gains made in the AIDS response are fragile.


In June 2011, world leaders will gather at the United Nations General Assembly to recommit to the AIDS response. This High Level Meeting on AIDS is timely, as it will be ten years since the 2001 Declaration of Commitment on HIV/ AIDS, and five years since the world pledged to achieve universal access to HIV prevention, treatment, care, and support.

The opportunity presented by the High Level Meeting is monumental. The global community has the unique responsibility of setting the global AIDS response toward the path of zero new HIV infections, zero discrimination, and zero AIDS-related deaths.

At the meeting, world leaders will be encouraged to construct a new shared responsibility agenda, and a new global social compact for HIV that addresses the rapidly changing dynamics of today's world. With funding availability for the AIDS response dropping, the traditional governance and financing regime is no longer sustainable. It will be pertinent for world leaders to explore ways to harness the opportunities presented by the increasing role of emerging political powers in development, and the strong economic growth in many countries that have the ability to allocate more domestic resources towards funding their national AIDS responses. However, a new compact is needed--one which seeks an optimum balance between external and domestic resources on the basis of a country's capacity to pay and its burden of disease.


The second fundamental area to be addressed in June will be to promote a global renaissance of HIV prevention. Nothing short of an HIV prevention revolution...

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