Over the past nine months, global leaders and policy makers have evaluated and renewed their commitment to fighting the HIV epidemic. These efforts led up to the 2011 UN General Assembly High-Level Meeting (HLM) on AIDS, which took place June 8–June 10 in New York City. Here, member states ambitiously committed to bringing antiretroviral treatment (ART) to 15 million people living with HIV by 2015, compared to the 6 million who are currently on ART regimens.[1] Attendees of the HLM also pledged to eliminate mother-to-child transmission of HIV by 2015.[2] These goals reflect a reignited desire to end the HIV/AIDS epidemic 30 years after it began.

 

The recommitment began in October 2010, when governments and organizations donating to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, agreed to fund $11.7 billion for the years 2011–2013 at the Third Replenishment Pledging Conference.[3] Prior to this agreement, there was much concern about anticipated declines in funding. The Global Fund represents an innovative mix of “governments, civil society, the private sector and affected communities” whose work in disbursing resources to prevent and treat these diseases would be literally impossible if funding continued to decrease.[4] However, the $11.7 billion commitment does reflect a 20 percent increase over the $9.7 billion pledged during the Second Replenishment Pledging Conference in 2007.[5] Within the bigger picture, the Global Fund’s 54 donor governments have paid more than 60 percent of the $28.3 billion they pledged to the Fund from 2002 to 2015.[6] Given such recommitments, funding continues to the HIV response, although at a reduced rate.

 

In February 2011, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Michel Sidibé released his annual letter to partners, in which he praised response efforts, acknowledging that “the world has begun to reverse the AIDS epidemic.”[7] Sidibé also outlined the new “Zero, Zero, Zero” vision of UNAIDS: to create a world with “Zero new HIV infections; Zero discrimination [against people living with HIV]; and Zero AIDS-related deaths.”[8] The letter, however, did not ignore the current funding crisis. Sidibé explained the value of reexamining “our models of investments and methods of programme delivery,” while challenging response efforts to “do more with less.”[9]

 

Throughout the spring, the UN released two reports in an effort to evaluate the global response to the HIV epidemic over the last 30 years. The first report, from UN Secretary-General Ban Ki-moon, noted the symbolism of international collaboration. In his introduction, Ban writes, “The response to HIV has become perhaps the most compelling example of the power of international solidarity, evidence-informed action and political commitment.”[10] The second report, AIDS at 30, was released by UNAIDS in early June. This publication is a comprehensive summary of 30 years of HIV history, mainly serving as a retrospect on progress. The report sheds light on the global financial situation, stating that in 56 low- and middle-income countries, 70 percent of HIV-related resources are supplied by international donors.[11] Both reports include explanations of the UN’s five recommendations to take pivotal action in measures against AIDS: end new HIV infections, share responsibilities and build sustainable outcomes, ensure mutual accountability for universal access, break the upward trajectory of costs, and foment a social revolution for women and girls.[12] In the interest of sharing financial responsibilities, both UN reports also called on middle-income countries to begin carrying their own HIV-related costs.[13] Additionally, the Kaiser Family Foundation released its report on pubic opinion surrounding the epidemic, HIV/AIDS at 30, in late June. Kaiser’s national survey has shown that the media remains the public’s central source of information about HIV/AIDS, HIV testing rates have been stagnant since 1997, and that the epidemic is hurting the black community in disproportionate numbers.[14] In a promising finding, the survey observes, “Despite the severe economic crisis of the past several years, more than half of Americans continue to support increased funding for HIV/AIDS, and fewer than one in ten say the federal government spends too much in this area.”[15]

 

The American public and the UN seem to be on the same page. Member states at the HLM recognized the $16 billion donated worldwide to the HIV response in 2010 but also acknowledged UNAIDS ideal targets of between $22 billion and $24 billion annually.[16] Beyond the necessary financial commitment, the report from the HLM emphasizes the importance of access to reproductive and sexual health as well as the value of ending both gender-related inequalities in HIV treatment and discrimination against people living with HIV.[17]

 

“It is imperative that our efforts in the HIV response be more than just financial,” comments Jen Heitel Yakush, director of public policy for the Sexuality Information and Education Council of the United States. “While money is essential and can provide treatment and further prevention, it cannot necessarily end discrimination or erase the stigma attached to HIV. The UN’s commitment to taking a comprehensive approach is promising.”

 

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