Report on the Global HIV/AIDS epidemic

National responses to the epidemic: factors that make a difference
At the heart of debt reduction deals under HIPC lies the challenge of agreeing on significant goals in poverty reduction and on measurable indicators of progress towards
these goals. Lending countries will have greater incentives to reduce debt if there are
clear and measurable ways of assessing the benefits. For example, a medium-term
AIDS-related target might be to provide low-cost treatments to a specific percentage of the population suffering from the most common opportunistic infections.
Measurable indicators for monitoring progress would likely include the availability of
specific generic medicines in primary health care centres.
During the first months of 2000, several countries in Africa have started to feature
HIV/AIDS more prominently in their poverty-reduction strategies and in related HIPC
debt relief agreements. This is encouraging. But a concerted effort by a coalition of
interested African government officials, civil society representatives, creditor governments, and United Nations and multilateral agencies will be required to ensure that
debt relief is actually used to mobilize substantially increased funding for AIDS.
Conclusion
Two decades of action against the epidemic have generated important insights into
an effective response. While international political, financial and technical support
are important, lowering incidence and mitigating the epidemic's impacts must be a
nationally driven agenda. To be effective and credible, national responses require the
persistent engagement of the highest levels of government. Countries that have
adopted forward-looking strategies to fight the epidemic are reaping the rewards in
falling incidence. Other countries are yet to see the fruits of their efforts, and in the
absence of rapid and visible results, sustaining a response becomes more difficult.
However, evidence shows that the combination of approaches described in this
chapter have brought about a lowering of incidence in some countries. At present,
and until the arrival of a vaccine, these approaches are the strongest weapons in our
fight back against HIV/AIDS.

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