AIDS status & challenges of the epidemic

6. What strategies are recommended by UNAIDS to halt and reverse the epidemic?

• 6.1 Recommendation #1: Sustain and increase commitment and leadership
• 6.2 Recommendation #2: Sustain and increase financing
• 6.3 Recommendation #3: Aggressively address AIDS-related stigma and discrimination

The source document for this Digest states:

Over the last quarter century nearly 65 million people were infected with HIV and an estimated 25 million have died of AIDS-related illnesses. Today it is estimated that close to 40 million live with HIV—yet the vast majority are unaware of their status.

AIDS is exceptional and the response to AIDS must be equally exceptional. It requires ongoing leadership on both the national and international levels. Twenty-five years into the epidemic, the global response to AIDS must be transformed from an episodic, crisis-management approach to a strategic response that recognizes the need for long-term commitment and capacity-building, using evidence-informed strategies that address the structural drivers of the epidemic.

Despite considerable progress since 2001, the consistent leadership necessary to slow, stop and reverse this epidemic is not yet evident. While the Secretary-General’s Report to the UN General Assembly notes many improvements in the global AIDS response since 2001, it also clearly indicates that action overall has been insufficient, with progress uneven within and between countries and regions.

The 2006 Report on the global AIDS epidemic makes the following strategic recommendations to enable countries to deliver on the promises made in 2001. Successful implementation of these recommendations is crucial to halt and reverse the epidemic.

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006), p.
The declaration of commitment on HIV/AIDS: AIDS in conflict or disaster regions,
The road ahead: from crisis management to strategic response, p. 17

For more information on this question, see:
 Chapter 12 From crisis management to strategic response,
Research and development, p.282,
of the full 2006 Report on the global AIDS epidemic  by UNAIDS

6.1 Recommendation #1: Sustain and increase commitment and leadership

The source document for this Digest states:

The Declaration of Commitment on HIV/AIDS calls for the development and implementation of sound national multisectoral AIDS strategies that integrate the HIV response into mainstream development planning, with the full and active participation of civil society and the private sector. As AIDS is a matter of extreme national importance, active and visible leadership on the issue from heads of state and governments is essential to the success of the effort.

National AIDS authorities, working with all partners and stakeholders, must develop or adapt prioritized and costed AIDS plans that are ambitious, feasible and aligned with national development plans.

Civil society must be fully engaged in the development and implementation of national plans. The UNAIDS Secretariat, UNDP and the World Bank will facilitate a participatory process to provide criteria for the development and oversight of these plans.

Countries should ensure the accountability of all partners through transparent peer review mechanisms for public monitoring of targets and regular reporting of country and regional progress.

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006),
The road ahead: from crisis management to strategic response,
Sustain and increase commitment and leadership, p. 18

For more information on this question, see:
 Chapter 12 From crisis management to strategic response,
Sustain and increase commitment and leadership, p.282,
of the full 2006 Report on the global AIDS epidemic  by UNAIDS

6.2 Recommendation #2: Sustain and increase financing

The source document for this Digest states:

Global financing for AIDS has greatly increased, yet funding available today may be just one-third of what will be required to respond to the growing epidemic in a few years. Available funds for the AIDS response in low - and middle- income countries are expected to total US$ 8.9 billion in 2006 and US$ 10 billion in 2007, far short of the estimated need of US$ 14.9 billion in 2006, US$ 18.1 billion in 2007 and US$ 22.1 billion in 2008. By 2008, UNAIDS and its research partners estimate that US$ 11.4 billion will be needed for HIV prevention activities alone, in order to ensure that the world is on track to achieve the Millennium Development Goal of halting and beginning to reverse the global AIDS epidemic by 2015.

• National governments and international donors should significantly increase financing for AIDS by strengthening and fulfilling existing commitments, fully supporting the Global Fund and supporting other innovative financing mechanisms; current efforts to produce a substantial portion of this funding from domestic budgets, especially in middle-income countries, must continue.
• Equally important as maintaining and increasing the flow of resources are efforts to ensure that the money works for people in need. The “Three Ones” principles, which call for the coordination of a national AIDS response around one agreed AIDS action framework, one national coordinating authority and one agreed country-level monitoring and evaluation system, are designed to increase effectiveness in prioritizing activities and targeting resources to achieve the greatest good for people in need.
• Innovative approaches to secure sustainable long-term funding for the AIDS response, including proposals for new international financing mechanisms, deserve serious consideration, as do any other proposals that will help to stabilize funding for a greatly enhanced response to the epidemic.

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006),
The road ahead: from crisis management to strategic response,
Sustain and increase financing, p. 19

For more information on this question, see:
 Chapter 12 From crisis management to strategic response,
Sustain and increase commitment and leadership, p.284,
 Chapter 10 Financing the response to AIDS, p.224,
and for more about he "Three ones":
 Chapter 11 Getting the best out of national responses, p.257,
of the full 2006 Report on the global AIDS epidemic  by UNAIDS

6.3 Recommendation #3: Aggressively address AIDS-related stigma and discrimination

The source document for this Digest states:

Ending the AIDS pandemic will depend largely on changing the social norms, attitudes and behaviours that contribute to its expansion. Action against AIDS-related stigma and discrimination must be supported by top leadership and at every level of society, and must address women’s empowerment, homophobia, attitudes towards sex workers and injecting drug users, and social norms that affect sexual behaviour—including those that contribute to the low status and powerlessness of women and girls.

• Laws and policies that protect women and girls against sexual violence, disinheritance and gender discrimination of all kinds, including harmful traditional practices and sexual violence in and outside of marriage, must be enacted, publicized and enforced.
• Women must be adequately represented in policy and decision-making on AIDS. A 2004 UNAIDS assessment found that women's participation in the development and review of national AIDS frameworks was non-existent in more than 10% of 79 countries and inadequate in more than 80%. ⁹
• Laws and policies that directly challenge gender inequality and bias against people perceived to be at heightened risk for HIV, including sex workers, injecting drug users and men who have sex with men, are also essential. Changes in laws and policies must be accompanied by adequately funded social mobilization campaigns, which should involve networks and organizations of people living with HIV along with all other elements of civil society in their planning and implementation.
• A fully funded plan to achieve universal education and to address or remove barriers such as school fees, compulsory school uniforms and textbook charges is also fundamental to reducing HIV and related stigma.

⁹ UNAIDS/UNHCR (2005). Strategies to support the HIV-related needs of refugees and host populations. UNAIDS/ UNHCR, Geneva

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006),
The road ahead: from crisis management to strategic response,
Aggressively address AIDS-related stigma and discrimination, p. 19

For more information on this question, see:
 Chapter 12 From crisis management to strategic response,
Agressively address stigma and discrimination, p.285,
 Chapter 08 Reducing the impact of AIDS,
Agressively address stigma and discrimination, p.196, and
 Chapter 04 The impact of AIDS on people and societies ,
The weight of stigma and Discrimination, p.86,
of the full 2006 Report on the global AIDS epidemic  by UNAIDS