Huge progress has been made in the fight against Aids but it must be brought to the next level, write Isabella Lovin and Michel Sidibé.

In the past week, we celebrated the tremendous progress that has been made in the struggle against HIV and Aids. In many countries with strong health systems, HIV is no longer a death sentence, but a chronic condition. And Africa has reached a critical milestone: each year, there are now more Africans starting HIV treatment than being infected.

Still, even as we celebrate, we must also mourn the 1.1 million people who lost their lives to the disease this year. HIV still infects 6,000 people every day, and Aids remains a leading cause of death among children, adolescents, and women in Africa.

The movement against Aids has inspired all of us to help the people who continue to be left behind, and to commit to ending Aids once and for all.

Fortunately, we already have the know-how, resources, and, crucially, the political momentum to do this; and at the High-Level Meeting on Ending Aids this year, UN member states made ambitious commitments that will put us on the fast track toward our goal.

What’s more, in September, Canada hosted a successful financing conference for the Global Fund to Fight Aids Tuberculosis, and Malaria, which brought in almost €13bn, replenishing the Global Fund for 2017-2019.

Meanwhile, individual countries have increased their domestic investments, and international partners, big and small, have maintained their support, which is how we will reach the €26bn needed for the global AIDS response in 2020.

However, funding parts of the global health system is not enough. The international community must take a more holistic view and reinforce a global-response architecture that features a clear division of labour and seamless cooperation among various stakeholders.

Ultimately, the goal of such a framework must be to support countries’ own health systems, by marshalling public and private actors at all levels in a given country, so that every facility from the public hospital in the capital to the village clinic is properly provisioned.

Sweden is proud to continue its support for the Global Fund; at the replenishment conference in September, it pledged €270m. The Global Fund is by far the largest multilateral source of financing for efforts to fight Aids, tuberculosis, and malaria; but just like the Global Alliance for Vaccines and Immunization, it is part of a global architecture, and relies on a range of partners to deliver aid effectively.

So, if country-level support for other global-health organisations such as UNAIDS, the World Health Organisation, and the UN Development Programme dries up, continued progress in the fight against HIV and Aids will be at risk.

UNAIDS is setting a powerful example for international collaboration, by organising partners around a common 2016-2021 Strategy to end Aids. This unique partnership brings together 11 co-sponsoring UN agencies, each with diverse sector-specific expertise, and mobilizes various government stakeholders.

One of UNAIDS’ tasks is to encourage national governments to keep Aids high on their public-health agendas, and to invest in joint efforts to end the disease. It is also the only organisation with a mandate to set norms and standards for the global response to Aids, which means that it plays a key role in the current international framework.

UNAIDS maintains a close partnership with the Global Fund. It has a presence in more than 80 countries, and its regional teams provide technical support and strategic information, which helps the Global Fund direct its grants to the right programs, locations, and populations at sufficient scale.

Moreover, it helps to create the social, legal, and political conditions for people to use health services, not least by promoting gender equality and ensuring that populations at higher risk of contracting HIV do not face adverse discrimination.

D

espite its broad mandate and many functions, UNAIDS lacks adequate resources, which threatens past achievements and future programs alike, and poses a danger to people and communities that depend on the lifesaving support the organization helps facilitate.

Sweden and UNAIDS will work together to ensure that the international Aids response continues to transform and save lives.

We will safeguard and empower women and girls, and make sure that vulnerable populations’ voices are heard. However, at the same time, the international community must strengthen the existing framework for managing global-health issues.

As Swedish Prime Minister Stefan Lofven said in Montreal in September: “Today we are focusing on the Global Fund, but tomorrow let’s not forget to provide sufficient funding for the entire global health architecture.”

It is time for the international community to meet that challenge, by pledging to support our global health infrastructure, so that no agency, and no country or person, is left out. n Isabella Lovin is Minister for International Development Co-operation and deputy prime minster of Sweden. Michel Sidibé is executive director of UNAIDS. Copyright: Project Syndicate, 2016.


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