Fighting HIV/AIDS: progress, prospects and issues

This report discusses the status of the global fight against HIV/AIDS, region by region, charting progress to date and prospects for achieving the Millennium Development Goal (MDG), which includes to “have halted by 2015 and begun to reverse the spread of HIV/AIDS”.

Following an overview of the state of the epidemic, the paper reviews the current financial commitments that international donors have made and actual spending for the fight against HIV/AIDS. These are then compared against the best available estimates of the resources required to scale up HIV/AIDS activities if enough funding were available to use existing infrastructure to its maximum potential.

The documents states that there is broad high level agreement that a multi-sector approach is required to ensure sustained success against HIV/AIDS. Other important lessons are that ownership and empowerment are key, through mechanisms such as:

• defining national HIV/AIDS programs through a participatory and more comprehensive process, empowering and mobilizing stakeholders from the village to the national level with money and decision-making authority within a multi-sectoral framework
• establishing National AIDS Councils (or equivalents) as legal entities with broad stakeholder representation from the public and private sector
• using exceptional implementation arrangements such as channeling money directly to communities and civil society organizations, and contracting services for many administrative functions such as financial management and procurement, monitoring and evaluation, elements of program approval, as well as capacity development and techniques of Behavior Change Communication (BCC).

The document describes a "new approach" of learning by doing. It calls for continuos monitoring and evaluation of projects to determine which activities are efficient and effective and should be expanded further and which are not and should be stopped or benefit from more capacity building, rather than exhaustive up-front research to determine best practice.

The addendum also discusses how best to remove impediments to progress, and accelerate implementation of HIV/AIDS programs. The overall conclusion is that without significant changes in the way the epidemic is addressed, there is little chance of halting and beginning to reverse the spread of HIV/AIDS by 2015.

[Adapted from author]