A chance to change history
Advocacy by WHO and its partners for more global investment in health has begun to bear fruit. Official development assistance and other forms of global health investment are on the rise. Most of the increased spending is for HIV/AIDS. Along with the urgent need to tackle the pandemic, this fact now makes HIV/AIDS the key battleground for global public health. It also gives countries the chance to derive extra public health benefits from the new funds. The opportunity exists to invest these resources so as to save millions of threatened lives through treatment, reinforce comprehensive HIV/AIDS control and strengthen some of the world’s most fragile health systems.
The objective of treating 3 million people in developing countries with antiretroviral drugs by the end of 2005 is a step on the way to the goal of universal access to antiretroviral therapy and HIV/AIDS care for all who need it. This goal far outreaches the capacities of any single organization. Through collaboration linking the skills of many partners, however, these aims can be achieved. The treatment initiative is important not only to tackle a grave health crisis, but also because it is building innovative mechanisms of collaboration in health, linking national governments, international organizations, the private sector, civil society groups and communities. Success in partnership on the initiative will accelerate other areas of global health work.
The initiative adapts lessons from HIV/AIDS programmes in developed countries and builds on the achievements of developing countries such as Botswana, Brazil, Senegal and Thailand in scaling up antiretroviral treatment. An increasing number of effective partnerships will mean that no country has to face the HIV/AIDS treatment challenge alone. UNAIDS has, for nearly a decade, kept HIV/AIDS at the forefront of global consciousness and spurred recognition that only an exceptional response can meet the challenge. Under its leadership, the entire United Nations system has embraced its responsibilities. The creation of the Global Fund has fostered partnership between governments, civil society, the private sector and affected communities. The World Bank has brought innovation, and is joined now by the European Union, bilateral initiatives such as the United States President’s Emergency Plan for AIDS Relief, and the major contributions of individual governments and private foundations, including the Bill and Melinda Gates Foundation and the William J. Clinton Foundation. There have also been inventive new approaches to technical cooperation, such as hospital twinnings through the Ensemble pour une Solidarité Thérapeutique Hospitalière en Réseau (ESTHER), initiated by the French government and now supported by Italy, Luxembourg, Spain and other partners.
Success in expanding HIV/AIDS treatment depends on the engagement of civil society. Without the mobilization of activist organizations and communities, the toll of HIV/AIDS over the past quarter-century would have been far heavier. The momentum for antiretroviral scale-up owes much to the sustained advocacy of treatment activists at local, national and global levels and to nongovernmental organizations such as Médecins Sans Frontières and Partners In Health-Zami Lasante, which demonstrated to the world the feasibility of delivering antiretroviral treatment in the poorest settings. This report shows WHO’s commitment to work closely with national health authorities, the private sector, community-based organizations and others in delivering comprehensive HIV/AIDS programmes on the ground.