Over 1,700 implementers from more than 70 countries attended the second HIV/AIDS Implementers’ Meeting held in Kampala, Uganda on June 3–7, 2008. The implementers met to discuss lessons learned on scaling up prevention, treatment, and care programs; building local capacity to respond to HIV/AIDS; improving the quality of services provided to people living with HIV/AIDS (PLWHA); and enhancing coordination among partners.[i] The theme of the meeting was “Scaling Up Through Partnerships: Overcoming Obstacles to Implementation.”

 

The meeting was hosted by the Ugandan Government and cosponsored by the United States President’s Emergency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Joint United Nations Programme on HIV/AIDS (UNAIDS); the United Nations Children Fund (UNICEF); the World Bank; the World Health Organization (WHO); and the Global Network for People Living with HIV/AIDS (GNP+)[ii]. The groups came together in an effort to facilitate discussions that will lead to tangible changes in the implementation of HIV/AIDS programs around the world.[iii]

 

At the meeting, implementers called for a renewed focus on prevention strategies in coordination with treatment programs. [iv] Implementers discussed numerous tactics including conducting research on HIV/AIDS, developing vaccines, improving health systems, and expanding human resource capabilities in addition to promoting condom use, male circumcision, and reduction in sexual partners.[v]

 

One key message delivered by meeting attendees was the need to improve health system infrastructures to support treatment, prevention, and care efforts. Joy Phumapi, vice president of human development at the World Bank, pointed out that the AIDS epidemic only serves to highlight how important it is to invest in developing the health services sector.[vi] Meeting participants expressed concern that many African nations have incredibly underdeveloped health systems and few are receiving the help they need to establish the infrastructural framework that can lead to better treatment options and facilities.[vii] Phumapi went on to emphasize the need for countries to develop specified prevention strategies that respond to the needs of the national population.[viii]

 

Susan Kasedde of the UNAIDS regional support team for East and Southern Africa echoed Phumapi’s call for individualized—not one-size-fits-all—answers. According to Kasedde, it is imperative that nations create solutions that respond to the needs of the national population so that funding can be allocated efficiently and correctly.[ix] She elaborated by stressing the importance of analyzing national trends, as well as population-group-specific trends, to better track where to allocate money for prevention, treatment, and care programs so that implementers can actively fight the HIV/AIDS crisis.[x] Many other implementers similarly argued for increased funding accountability by expressing the need for more transparency in how governments allocate HIV/AIDS program funds. Meeting attendees argued that funding must be put towards proven-effective strategies, adding that all stakeholders should be included in developing programs and allocating funding accordingly.[xi] Phillip Mitchell, director of the Hope Clinic in Kampala, criticized the implementers’ discussion about funding by pointing out that the meeting failed to provide information for smaller nongovernmental organizations (NGOs) on how to gain access to funding.[xii]

 

The limitations of the meeting were amplified by the arrests of three protesters from Sexual Minorities Uganda Group (SMUG). According to a police spokesperson, the protesters were passing out distribution cards that read “Gay Ugandans also need HIV prevention” and “Since 1983 up to 2008, zero shillings to HIV prevention for gay Ugandans.” The spokesperson said the protesters were going to be charged with criminal trespassing.[xiii] According to the protesters, they were peacefully demonstrating in an effort to draw attention to a comment made by Kihumuro Auuli, director general of the Uganda AIDS Commission, that no money would be allocated for HIV programs targeting gay men and men who have sex with men (MSM).[xiv] The protesters say they had wanted to deliver a funding proposal on prevention strategies for gay men and MSM to meeting attendees.[xv] The arrests stood in stark contrast to one of the messages of the meeting; that there needs to be increased attention given to known at-risk groups such as commercial sex workers, children, prisoners, and MSM.[xvi]

 

The meeting’s emphasis on funding accountability, improving health systems, and renewing preventions efforts highlighted the need for more to be done in combating and eradicating HIV/AIDS and signaled a continued commitment to fighting the disease. As Michael Sidibe, Deputy Executive Director of UNAIDS, said, “It is time to re-think prevention approaches, tailor them to the realities of the epidemic, and define them not through quick wins and silver bullets, but through a better understanding of communities and practices.”[xvii]

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