Focus Points of the Upcoming UN High Level Meeting on HIV
March 25, 2011
Margaret Reeves
Fellow, Global Health Policy Center
The 2011 High Level Meeting (HLM) on AIDS, which will be convened by the UN Secretary General in New York from June 8 to 10, comes at a turning point in the global AIDS response. 2011 marks 30 years of AIDS, ten years since the landmark UN General Assembly Special Session on HIV/AIDS and five years since the 2006 High Level Meeting where the universal access commitment was made. 
At the same time, there are also changes within the U.S. government’s approach to global health that aim to better integrate HIV/AIDS within a more comprehensive approach that links to broader health efforts including programs that address tuberculosis, maternal and child health, and non-communicable diseases. While this integrated approach is exciting, it makes gaining high-level commitments from countries to remain engaged and accountable in the fight against HIV more important than ever.
Bertil Lindblad, Director of the UNAIDS New York Office, spoke to a small group of stakeholders at CSIS on March 17 to outline the preparatory process and format of the High Level Meeting, and to provide an overview of plans for a Civil Society Consultation on April 8th in New York. Lindblad previewed some expected changes to the format of panels, shared some of his thoughts on probable themes that would emerge, and participated in a discussion on priorities with the audience. You can find a podcast with Bertil Lindbland and more information on the high level meeting here.
I came away from this meeting acutely aware of how important the outcomes of the UN event will be. In a time of global economic strain and waning congressional support for foreign aid, and considering that this may be the last HLM meeting on HIV before the 2015 MDG deadline, it is imperative that the UN delegates produce a new declaration that highlights key issues and provides a roadmap for future engagement. The following are my reflections on issues that need to be addressed at the June meeting.
Shared Responsibility: At present, the U.S. funds 60% of HIV interventions globally. In a time when the U.S. is facing an on-going economic crisis and the foreign assistance budget is under threat of major cutbacks, the global health community needs to share the financing of global health programs more broadly in order to safeguard past achievements and maintain a strong response in the future.
Country Ownership: In keeping with the principle of shared responsibility, recipient countries need to step-up their own commitments to providing financial and political support for public health programs and health system strengthening. The idea of country ownership should extend beyond the government to civil society and private sector players in these countries as well. Broad ownership of the health issues that face the population, public health investments, and the improvements they bring will strengthen commitment and accountability and make foreign aid in global health more of a sustainable partnership.
Setting New Targets: The new UNAIDS vision is “Zero new HIV infections, zero discrimination and zero AIDS-related deaths.” While these are worthy aspirations, they may prove to be so lofty that they fail to garner a response. With this vision as the ultimate goal, the new declaration needs to set a limited number of shorter-term, discreet, achievable goals. Universal access to PMTCT by 2015 for example is something that we have the knowledge to implement, is relatively inexpensive and achievable. The resolution should include three to five clear targets to which countries can be held accountable.
U.S. Leadership on Tough Issues
With increased country ownership comes increased tension between evidenced-based best practice, and individual country policies and practices. This is especially true in areas such as the promotion of gender equity and the protection of fundamental human rights for marginalized populations such as sex workers, men who have sex with men and injecting drug users. The U.S. needs to use its influence to ensure that all governments assure full access to HIV prevention, treatment and care, for all people, especially those who are most marginalized. Ensuring that language is included on universal access for all is one way to broadly cover these issues.
What needs to come out of the meeting?
Because this may be the last HIV HLM, it is especially important to emerge with clear goals and roadmaps to maintain commitment and momentum. The meeting should be an opportunity to take stock of what has been accomplished, what works, and what needs more attention. Most importantly though, communicating a strong message on what can be achieved in the future and the resources and steps that are required to reach the goals must be communicated to decision makers and the public. The new declaration must not only safeguard agreements made in the past, but set forth a plan for how to succeed in the future.
