Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

efforts to scale up, a sound strategic plan based on epidemiological evidence and
best practices will at least ensure basic coverage.
Strategic planning of national responses is neither easy nor quick. But as the experience of a number of countries has proved - for example, Botswana, Cambodia,
China, Cote d'Ivoire, Dominican Republic, Guatemala, Honduras, Malawi,
Mozambique, Papua New Guinea, Romania and the United Republic of Tanzania -
it can be done effectively, and the process itself is critical in bringing on board a wide
range of actors whose commitment is key to successful outcomes.
4. Multisectoral and multilevel action
Successful programmes involve multisectoral and multilevel partnerships between
government departments and between government and civil society, with AIDS
being routinely factored into individual and joint agendas. Only a combined effort will
"mainstream" AIDS and establish it firmly on the development agenda.
Multisectoral and multilevel partnerships make sense for all stakeholders.
Government sectors and businesses are affected in multiple ways by a serious epidemic and hence have an important stake in participating in AIDS prevention, care
and support at all levels, but especially in ensuring sustained, large-scale programmes. Ministries of Labour for example can mandate workplace prevention programmes in the private sector. Ministries of Defence can use their budgets to implement programmes for the military, and Ministries of Education for teachers, schoolchildren and their parents. Private firms can contribute in cash and in kind. While
Ministries of Health undoubtedly have a critical role to play in responding to the epidemic, leaving the management of the overall national response to them is unlikely
to prove effective in the longer term. NGOs, who are trusted by vulnerable populations, are best positioned to support prevention programmes in collaboration with
these communities themselves. The mass media can promote safer behaviour and
tolerance through their own channels.
5. Community-based responses
The eventual outcome of the AIDS epidemic is decided within the community.
People, not institutions, ultimately decide whether to adapt their sexual, economic
and social behaviour to the threat of HIV infection. They are the subjects of the
response to AIDS, not merely the objects of outside interventions. Therefore,
responses to HIV are in the first instance local: they imply the involvement of people
where they live - in their homes, their neighbourhoods and their workplaces.
Community members are also indispensable for mobilizing local commitment and
resources for effective action. In particular, people living with HIV/AIDS must play a
prominent role and bring their unique experience and perspective into programmes,
starting from the planning stage.

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