Written by Susann Roth, Senior Social Development Specialist
Combating the spread of HIV/AIDS has been a major component of the Millennium Development Goals (MDGs) but many of those fighting the disease wonder it will get the same attention in a much broader post-2015 development agenda.
The current suggestions for goal areas after 2015 include a single one on health, namely to: “Ensure healthy lives”. HIV/AIDS is just one of a number of communicable diseases mentioned in sub-goals under this broad health target.
Is this sufficient? Should combating HIV/AIDS disappear from the MDG successor framework given that most countries have met their MDG target?
The answer is definitely not, even as the global context for development has changed substantially. When the MDGs were developed, the cold war had just ended, poverty had gained new attention, especially in Least Developed Countries, and the donor landscape was well defined and clear. These were also the early days of HIV/AIDS, and the beginning of a huge civil society movement to gain support to fight the disease. As a result, MDG 6 was developed, the Global Fund and Global Alliance for Vaccines and Immunisation (GAVI) were established, and high profile funding assistance came to the fore.
Fast forward to 2013 and poverty is no longer a feature of Least Developed Countries only but also of Middle Income Countries where 70% of the now poor live. Official Development Assistance is falling, the traditional donor landscape with a post-colonial approach to aid is changing, new donors are appearing and the economic growth centers in the South are gaining more and more importance. National interest and economic diplomacy are increasingly taking center stage.
Many countries have met their HIV/AIDS targets and the disease is no longer perceived as a risk for everybody, but mainly for high-risk groups. These are often communities who are the most vulnerable and discriminated against, and there are signs that their vulnerability is increasing in a world where inequality is rising, especially in Asia and the Pacific.
For that reason alone, HIV/AIDS needs to stay in the post 2015 development agenda. Having it there will raise attention to the need to provide equitable access to health services for vulnerable groups.
Moreover, the fight against HIV/AIDS has provided some key health lessons that have been shared:
- The importance of producing, analyzing and using data for decision-making.
- The need to establish obligations of national health systems to provide care for the chronically ill.
- The importance of working on Intellectual Property rights to provide affordable treatment for all.
- The need to recognize that health is a human right.
- The role of civil society as a powerful and influential player in rallying support for health.
Giving HIV/AIDS a prominent role in the post 2015 development agenda is about ensuring that global public health threat remains recognized, and that investment in prevention for all continues. Just as critically, it keeps the focus on the need to provide equitable and affordable health care (prevention, diagnostics, acute and chronic treatment) to the poor, the marginalized and the forgotten.