Realising universal access to HIV prevention, care and treatment

24 May 2006

In 2005 G8 governments committed to universal access to HIV prevention, care and treatment. This commitment from the world's richest governments was endorsed by all UN Member States at the World Summit at the end of 2005. From that moment, all the world's governments have formally accepted the challenge of: "Developing and implementing a package for HIV prevention, treatment and care with the aim of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it."

These statements of global commitment mark a turning point in global AIDS policy, and came about because the continued spread of HIV and the heavy burden of AIDS continue to undermine communities, nations and global development.

Civil society has always played a crucial role in pushing for greater political commitment on AIDS, and the events last year were good examples of that work. High level advocacy, linked to grass roots activism, is increasingly forcing governments to make a stand against AIDS. This is what happened leading up to the G8 and World Summit meetings, and this is what will continue throughout the High Level Meeting on AIDS in New York in May/June 2006.

The task of making universal access real and meaningful in AIDS-affected communities is the most important work now. This is why the High Level Meeting on AIDS is so important. As the world's governments come together to reflect on the progress of the AIDS response since the first UNGASS meeting in 2001, new global targets need to be set, and targets for national action on AIDS must be comprehensive and ambitious.

Early in 2006, in response to the G8 and World Summit commitments, UNAIDS and the UK's Department for International Development led a process to develop a blueprint for progress on the universal access target. The focus for this process was a Global Steering Committee, which was established and made up of national governments, donor governments, UN agencies and representatives from global civil society. National and regional consultation events also took place.

The Committee produced a report that has now become a report from the UN Secretary-General Kofi Annan to the High Level Meeting on AIDS. This report, and the debates on its content - in particular the national targets it sets - will form a substantial part of the deliberations at the UN High Level Meeting.

The International HIV/AIDS Alliance surveyed its country partners to identify the barriers to universal access in developing countries in Africa, Asia, Latin America and Eastern Europe. We want to bring these perspectives to the High Level Meeting to ensure that the agreements made in New York truly address the issues facing community based organisations responding to AIDS in developing countries across the world.

The main barriers to achieving universal access are:

  • Funding for HIV/AIDS needs to be increased and needs to be disbursed in line with long-term needs to ensure a sustainable response
  • Civil society needs financial and technical support in order to strengthen and scale up its efforts
  • Health care systems need support, strengthening, and expanding in order to make universal access a possibility. New cadres of health care workers drawn from community organisations will be the mainstay of HIV service provision
  • Anti-retroviral treatment and other HIV services, including essential commodities, must be provided free and must be accessible
  • Stigma and discrimination need to be confronted and overcome in communities and health care settings in order to achieve and sustain universal access. Stigma and discrimination act as major obstacles to the access to and uptake of HIV services.

The success of the High Level Meeting in New York next week will rest on the degree to which it addresses these problems.