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Global response to HIV/AIDS in Africa
How is the international
community fighting Africa’s HIV/AIDS
epidemic?
The Response of the United Nations
Until 1996, the United Nations’ response to HIV/AIDS was
handled solely through the World Health Organization (WHO). By
the late 1990s, however, it was clear that HIV/AIDS was much
more than a health issue in developing countries. In 1996, the
United Nations formed the Joint United Nations Program on AIDS
(UNAIDS). Funded by member states, UNAIDS is comprised of 10
key member organizations – including UNICEF, the WHO, and
the World Bank; since then, together, through UNAIDS, they have
been providing a more coordinated international response to the
HIV/AIDS crisis.
The policy focus for the UNAIDS group has been:
- Leadership and advocacy for effective action in dealing
with the epidemic.
- Providing strategic information to guide efforts in the
fight against HIV/AIDS worldwide.
- Tracking, monitoring, and evaluating the HIV/AIDS epidemic,
and the responses to it worldwide.
- Engaging civil society, and encouraging partnership development,
in the fight against HIV/AIDS.
- The mobilization of resources to support an effective response.
Source: UNAIDS Website.
The underlying philosophy of UNAIDS is that national governments
are responsible for the development of policies to fight HIV/AIDS
in their respective countries. UNAIDS helps governments to decide
what type of aid is needed, and ensure that it reaches the people
who need it most. Country-based staff from each of the 10 member
organizations work with governments, non-governmental organizations
(such as Doctors without Borders), and other groups to plan policies
and decide on financing for various programs. In a 2004 interview,
UNAIDS executive director Peter Piot stated that the goal within
each country is to develop “one AIDS authority, one agreed-on
HIV/AIDS strategy framework, and one framework for monitoring
and evaluation.”
Projects undertaken by UNAIDS include the following:
- Increasing access to antiretroviral drugs through a special
initiative known as the ‘3 by 5’ Initiative.
The goal of ‘3 by 5’ is to provide antiretroviral
treatment to three million people in developing and middle
income countries by the end of 2005. Currently, less than
one percent of HIV positive Africans have access to these
drugs.
- Working, in southern Africa, to help prevent the spread of
HIV and improve reproductive health services for youth.
This is being accomplished through the Southern African
Youth Initiative (SAY).
- Providing life skills for at-risk youth aged 10–24,
in Angola, as well as educating youth, families, and communities
about the dangers of HIV/AIDS. The project is based on
the recognition that persuading young people to alter high-risk
behaviours often requires addressing underlying values
and attitudes.
AIDS Reaches the United Nations Security Council
In January 2000, the United Nations Security Council met to discuss “the
impact of AIDS on peace and security in Africa.” This was
the first time in history the United Nations Security Council
had ever met to discuss an infectious disease, highlighting the
very real threat that HIV/AIDS poses to human security in many
parts of the world. The Security Council subsequently met two
additional times to discuss HIV/AIDS, and a special session of
the General Assembly was held in June, 2001, specifically on
this subject.
All told, several major initiatives resulted from these collective
meetings :
- In September 2000, the UN General Assembly (UNGASS) adopted
the United Nations Millennium Declaration, which included
resolutions to halt and reverse the spread of HIV/AIDS
by 2015. The Declaration also stipulated that special assistance
should be provided to AIDS orphans.
- In June 2001, a special session of the UNGASS adopted a
Declaration of Commitment on HIV/AIDS. This Declaration
outlined the need for more coordinated efforts on the part
of national governments and regional organizations in fighting
the HIV/AIDS epidemic.
- The UN General Assembly endorsed the creation of the Global
Fund. It is an independent organization created to fight
HIV/AIDS, tuberculosis, and malaria around the world.
To learn more about the Global Fund and how the funding mechanism
works, see the Global
Fund web site
As a result of UN action, the amount of funding to fight HIV/AIDS
has increased dramatically. In 1997, international donor countries
donated US $150 million in total to fight AIDS. By July 2001,
some four years later, G8 leaders had agreed to commit US $1.3
billion to the Global Fund, in support of the fight against HIV/AIDS,
as well as tuberculosis and malaria.
Non-Governmental Organizations
Non-governmental organizations (NGOs) are “private organizations
that pursue activities to relieve suffering, promote the interests
of the poor, protect the environment, provide basic social services,
or undertake community development” (Source: the World
Bank, Operational Directive 14.70). NGOs played a pivotal
role in bringing Africa’s AIDS crisis to the attention
of the international community. Today, organizations such as
Oxfam and Doctors Without Borders are playing a greater role
in the policy formation process, working with local governments,
communities, and UNAIDS.
Projects undertaken by NGOs include the following:
- Doctors Without Borders is working to bring Antiretroviral
treatments to poorer areas. For example, with the organization’s
support, a hospital in northwest Ugandan has provided free
ARVs to nearly 1,100 people for two years
- The Bill and Melinda Gates Foundation has pledged over US
$125 million to the International AIDS Vaccine Initiative
(IAVI). The aim of this Initiative is to accelerate the
development of an AIDS vaccine.
- In South Africa, Oxfam is providing funding to a local rape
crisis organization to train HIV/AIDS counsellors.
The World Trade Organization Drug Pact Agreement
The World Trade Organization (WTO) sets the rules for trade between
nations. In 2003, the WTO reached an agreement to allow developing
countries to receive cheaper generic versions of drugs to fight
HIV/AIDS and other life- threatening diseases. It did so by providing
an exception to the Trade-Related Aspects of Intellectual Property
Rights Agreement (TRIPS). Under TRIPS, countries can issue compulsory
licenses to manufacture generic versions of patented drugs in
cases of a national medical emergency. Section 31(f) of TRIPS,
however, states that these generic drugs must be “predominantly
for the supply of the domestic market.” This provision
is of no use to poorer countries that don’t have drug manufacturing
facilities .
The 2003 WTO agreement permits countries to manufacture and export
generic versions of patented drugs under certain conditions.
It strikes a balance between the critical need for affordable
drugs in developing countries and concerns of the United States
that these cheaper generics could be smuggled out of the country
and sold abroad – or back in the US.
Among the key features of the WTO agreement:
- Developed countries have voluntarily agreed not to import
drugs under the agreement, while several developing countries
have announced they will only use the system in the case
of extreme emergency.
- The generic drugs will be used for medical and other emergencies
only .
- Importing countries must specify the type and expected quantity
of drugs needed.
- Importing countries will use special packaging and other
measures to distinguish between patented drugs and the
generic version.
- Importing countries will use security measures to prevent
generic drugs from getting into the wrong hands and being
smuggled out of the country or sold over the Internet.
- Importing countries will pay remuneration to the exporting
country.
- Exporting countries must only produce the amount of generic
drug specified .
To learn more about the World
Trade Organization Drug Pact Agreement
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