THIS year’s UN General Assembly High-Level Meeting on AIDS from June 8-10 in New York will be a time to reflect and set a renewed agenda not only for the AIDS response, but for global health as a whole. It will be a time to rethink. The HIV response has been associated with a number of varying outcomes. Some are good and some not good enough. While there have been a number of views regarding the impact of the global AIDS response on health systems in the past, there is now compelling evidence that the global tide of the HIV epidemic is starting to turn: the rate of new infections is in decline, and almost six million people are on life-saving antiretroviral drugs. Despite these gains, the world still falls short of achieving universal access to HIV prevention, treatment and care, which was the fundamental principle at the inaugural UNGASS meeting in 2001: for instance, 7,000 new infections occur every day and 1.8 million people lost their lives to AIDS in 2009. Faced with this reality, this year’s High-Level Meeting is a key turning point for global health, not just AIDS. It is an opportunity to ensure that commitment to AIDS, public health and development increases at the global and local levels. It is time to reinforce the call for a rapid expansion in the number of donors, and ensure that emerging economies such as Brazil, China and Russia can make significant contributions to global health and increase funding for domestic development programmes.
The global AIDS response has provided us with understanding of how to scale up innovative concepts while localizing their implementation. It has a lot of lessons to offer on how to research agenda to develop and be addressed to provide locally relevant, evidence-based and cost-effective interventions. These lessons can be applied to cardiovascular and other non-communicable diseases, whose burden and link with HIV in developing countries is now being increasingly recognized. The High-Level Meeting will be an opportunity to strengthen country ownership and scale-up effective approaches in community mobilization, and demand creation and community systems that create synergies with other Millennium Development Goals and integrate HIV with public health and community development. Coming at a time when the UN has called for increased commitment to women and children’s health, the High-level Meeting must demonstrate leadership in tackling the challenges that AIDS causes to millions of women and children and build on successes and learning of the past to strengthen integration of HIV with sexual and reproductive health. The AIDS epidemic, as well as other pandemics such as bird and swine flu demonstrate the increasing globalization of public health risks, which call for increased collaboration to tackle. The meeting presents an opportunity to create a momentum to leverage multi-national and private sector partnerships for AIDS service delivery, research and innovative financing into broader health and development goals. Our experience made us aware that HIV/AIDS could have consequences far beyond the immediate health risks. The tendency of the virus to strike at the middle-generation- the productive backbone of society – meant those 30 years of developmental progress was under threat. With so much at stake, we realized that a rapid, unprecedented response is imperative. In the light of these issues and their implications for all countries, at a special session of the UN General Assembly in June 2001, 189 Heads of State adopted a Declaration of Commitment on HIV/AIDS, where they concluded that: “the global HIV/AIDS epidemic, through its devastating scale and impact, constitutes a global emergency and one of the most formidable challenges to human life and dignity,  as well as the effective enjoyment of human rights, which undermines social and economic development throughout the world and affects all levels of society – national, community, family and individual.” We took steps to consolidate and strengthen our involvement in the global effort against HIV/AIDS.