Achieving the MDGs: Why the AIDS response counts

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Achieving the MDGs: Why the AIDS response counts

24 September 2008

20080923_mdg2_200.jpg
(from left) Dr. Peter Piot, Executive Director
of UNAIDS; Julian Lob-Levyt, Executive
Secretary of the Global Alliance for Vaccines
and Immunization (GAVI); Dr. Tedros
Adhanom, Minister of Health, Ethiopia;
Andrew Jack, Financial Times Pharmaceuticals
Correspondent; Michel Kazatchkine,
Executive Director of the Global Fund;
Ann Veneman, Executive Director of
UNICEF participate in MDG HLM side
event on MDG 6 equity challenge.
23 September, UNHQ, New York.
Credit: UNAIDS/Brad Hamilton

In 2000, global leaders embraced a series of Millennium Development Goals (MDGs) that resolved to make the world safer, healthier, and more equitable.

We are half-way to the 2015 target date and progress is mixed and uneven. To assess the gaps and understand what more needs to be done to ensure nations are on course to achieve the commitments they have made, a High-level Event on the MDGs takes place on 25 September 2008 hosted by the United Nations Secretary-General and the President of the General Assembly.

MDG 6 and universal access to HIV prevention, treatment, care and support by 2010

MDG 6 aims that by 2015 the world will have halted and begun to reverse the global HIV epidemic.

UN Member States have also committed, in a Political Declaration at the General Assembly in 2006, to taking extraordinary action to move towards universal access to HIV prevention, treatment, care and support by 2010. At this juncture it is useful to assess the HIV response.

20080923_mdg1_200.jpg
Dr. Peter Piot, Executive Director of UNAIDS
speaks at MDG HLM side event on MDG
6 equity challenge. 23 September, UNHQ,
New York. (right) Julian Lob-Levyt, Executive
Secretary of the Global Alliance for Vaccines
and Immunization (GAVI)
Credit: UNAIDS/Brad Hamilton

Although Goal 6 specifically addresses the HIV epidemic, an effective HIV response will also support achievement of other Millennium Development Goals. Success in the achievement of the MDGs will also make an impact on HIV epidemics around the world. Addressing the obstacles to universal access to HIV prevention, treatment, care and support services will contribute to the achievement of the broader MDGs. These include addressing stigma and discrimination, human rights and gender inequality as well as ensuring sustainable financing, affordable commodities, strengthened health systems and human resources, and accountability.

“Halting and reversing the spread of AIDS is not only a Goal in itself; it is a prerequisite for reaching almost all the others. How we fare in fighting AIDS will impact all our efforts to cut poverty and improve nutrition, reduce child mortality and improve maternal health, curb the spread of malaria and tuberculosis. Conversely, progress towards the other Goals is critical to progress on AIDS – from education to the empowerment of women and girls.”

- United Nations Secretary-General Ban Ki-Moon speaking at the General Assembly High Level Meeting on HIV/AIDS, New York, June 2008

MDG 1: Eradicate extreme poverty and hunger.

There is a complex relationship between AIDS, poverty and human development, a so-called ‘vicious circle’ within which the impacts of AIDS increase poverty and social deprivation, while socio-economic inequalities increase vulnerability to HIV infection.

With the eradication of extreme poverty and hunger, people may reconsider lifestyle options which put them at higher risk of HIV such as working far away from home or in commercial sex.

Especially in high-prevalence settings, HIV deepens household poverty and slows economic growth. Alleviating the epidemic’s burden helps countries to grow their economies, reduce income inequalities, and prevent acute hunger. In Western Kenya, antiretroviral treatment has led to a large and significant increase in the labour supply. Within six months of starting treatment there is a 20% increase in the likelihood of participating in the labour force, and a 35% increase in weekly hours worked. This brings economic and other benefits to the family including for children’s nutritional status.

MDG 2: Achieve universal primary education.

The HIV response promotes universal education initiatives. Ensuring children’s access to school is an important aspect of HIV prevention, as higher levels of education are associated with safer sexual behaviours and delayed sexual debut and reduce girls’ vulnerability to HIV.

School attendance is a central focus of initiatives to address the needs of children orphaned or made vulnerable by HIV. Better access to treatment helps to minimize the epidemic’s impact on fragile educational systems; it also reduces the likelihood that young people will be withdrawn from school in response to HIV in the household.

MDG 3: Promote gender equality and empower women.

The effects of gender inequality leave women and girls more at risk of exposure to HIV so progress in this Goal is of fundamental importance to the HIV response.

Less access to education and economic opportunity results in women being more dependent on men in their relationships, and some who have no means of support must resort to bartering or selling sex to support themselves and their children. Where women cannot own property and lack legal protections, their dependence within their families is even greater.

The HIV response itself is also helping to drive efforts to reduce inequalities between the sexes. Countries are now monitored on the degree to which gender equity is a component of national HIV responses. Thus, the epidemic has increased the urgency of initiatives to forge new gender norms, and extensive worldwide efforts are under way to develop new HIV prevention methods that women may initiate. HIV has prompted parents, communities, and governments alike to approach the sexual and reproductive health needs of women, girls, and sexual minorities with renewed commitment.

MDG 4: Reduce child mortality.

Deaths due to AIDS among children is declining since 2003 as there is a drop in new infections and more children being put on treatment. However in most-affected countries such as Botswana and Zimbabwe, more than one third of all deaths in children under 5 are due to AIDS.

A key component of a comprehensive HIV response is the scaling up of prevention strategies that can nearly eliminate the risk of mother-to-child HIV transmission.

MDG 5: Improve maternal health.

Women now account for about half of all people living with HIV, and for more than 60% of infections in Africa. Greater access to antiretroviral medicines is improving the health and well-being of women, and pre-natal programmes for preventing mother-to-child transmission help mothers remain in good health to care for their children.

Integration of HIV initiatives with programmes addressing sexual and reproductive health is helping to ensure that women have access to the information and services they need to make informed reproductive decisions.

MDG 6: Combat HIV/AIDS, malaria, and other diseases.

Progress in TB control will greatly benefit the AIDS response as TB, which is mostly curable and preventable, is one of the most important causes of illness and death among people living with HIV.

A strong HIV response yields health benefits that extend well beyond HIV itself. The push to expand access to HIV treatment in resource-limited settings is helping to strengthen fragile health infrastructures and is driving improvements in human capacity in low- and middle-income countries.

MDG 8: Develop a global partnership for development.

Perhaps more than any other issue in our time, HIV has highlighted global and economic inequities, and has galvanized action on international development. HIV has helped place people at the centre of development.

Progress on inclusive, country-owned development strategies will deliver greater success for improved aid effectiveness, strengthened health systems and the AIDS response.

The AIDS response has championed more inclusive partnerships as being key and has pioneered the principle of country ownership through the 'three ones'.

High-level Event on the MDGs: Side events

UNAIDS Secretariat, its cosponsors and partners will host the following side events in relation to MDG 6:

The MDG 6 equity challenge
Organized by the Mission of Ethiopia, UNAIDS, Global Fund to Fight AIDS, TB and Malaria, and the Global Alliance for Vaccines and Immunization (GAVI). The meeting will focus on achieving MDG 6 by increasing access to basic health services, especially the delivery of new health technologies to geographically and socially marginalized communities.

UN system coherence to achieve MDG 6
Organized by the Missions of Ireland and Tanzania, UNAIDS, and UN Development Operations Coordination Office. The meeting will highlight coordination mechanisms to promote and enhance system wide support of national priorities to achieve MDG 6.