The UK Government launched its new HIV strategy “Achieving Universal Access
–The UK’s strategy for halting and reversing the spread of HIV in the developing
world” on 2 June 2008. In the new strategy they renewed their commitment to
children affected by HIV and AIDS, supporting the pledges for social protection
programmes and strengthening health systems in developing countries
Background
The new strategy is based on a
detailed evaluation of Taking Action
and recommendations from large
numbers of organisations in the UK,
including Tearfund and its country
partners, in mid-2007. Tearfund
focused comments on two questions
posed by DFID in the consultation
document based on our own and our
partners’ experience of working with,
and on behalf of, poor communities
around the world:
Questions 5: How can the UK support
stronger and more effective
engagement by civil society,
particularly networks of people living
with HIV and AIDS, and vulnerable
groups (women, adolescents, males
who have sex with males, sex
workers, injecting drug users, and
prisoners) in the global response to
AIDS?
Question 6: What should the UK
Government do to ensure the needs
of children affected by AIDS are met?
What commitments are in the
new strategy?
This strategy commits the UK
Government to support progress
towards a number of specific
targets. They will:
Spend £6 billion on health systems and
services to 2015. This will help
maximise progress on AIDS through
closer integration of AIDS, TB, malaria,
and SRHR, including maternal and child
health services;
Focus efforts on comprehensive HIV
prevention. In the health sector, they
will work with others to intensify
international efforts to increase to 80%
by 2010 the percentage of HIV-infected
pregnant women who receive antiretroviral treatments (ARVs) to reduce
the risk of mother to child transmission,
both in low income and high prevalence
countries.
Work with international partners to
support countries with health worker
shortages to provide at least 2.3
doctors, nurses and midwives per 1,000
people, supporting national plans that
identify the appropriate mix of health
workers.
Work with others to intensify
international efforts to halve unmet
demand for family planning (including
male and female condoms) by 2010, to
achieve Universal Access to family
planning by 2015.
June 2008
Achieving Universal Access
The UK Government
Launches Its New HIV
Strategy
The new strategy will respond to HIV
through initiatives including:
What concerns do we have with
the new strategy?
Over £200 million to support social protection
programmes over the next 3 years. DFID will work
with governments and civil society in eight African
countries to develop social protection policies and
programmes that will provide effective and
predictable support for the most vulnerable
households, including those with children affected by
AIDS.
There is a long-term commitment to HIV and to
strengthening health systems in developing
countries, but we need to raise the question
about whether sufficient funding has been
allocated and if the money will actually be spent
on HIV services. Rather than allocating money
for HIV-specific activities, the £6 billion
announced might go directly to governments’
health budgets, especially because there is no
clear spending targets. It means there are no
guarantees that the money will actually be
spent on HIV services.
Intensify efforts to increase the coverage of HIV
services for intravenous drug users (IDUs) in
countries where they are most affected. Work in
partnership with governments, multilateral agencies,
civil society and through nine bilateral programmes
to improve the international environment on harm
reduction.
Increase by at least 50% funding for research and
development of AIDS vaccines and microbicides over
2008-13, to reduce the impact of the disease on
women and girls.
The strategy will focus on efforts to ensure
that new and existing resources have the
greatest impact through:
Work with others to reduce drug prices and increase
access to more affordable and sustainable treatment
over the long term. This could yield efficiency
savings of at least £50 million per annum – enough
to cover the cost of ARV drugs for an additional one
million people every year.
Ensure the Global Fund to fight AIDS, Tuberculosis
and Malaria implements the Paris Declaration target
on use of common arrangements and procedures,
including programme-based approaches.
Work with development partners, both within and
outside of the International Health Partnership
(IHP), to ensure that sector-wide approaches to
health strengthen the HIV response and that
targeted HIV programmes also strengthen the wider
health system.
The funding allocated is not enough to deliver
on the promise of Universal Access to HIV
prevention, treatment, care and support, and
will not reach those most vulnerable to new HIV
infections.
The UK Government’s decision to commit £200
million towards social protection will help ensure
children orphaned and made vulnerable by HIV
have access to better nutrition and
education. However, we are concerned by the
UK’s decision not to earmark 10% of the HIV
budget specifically for children. This makes it all
the more critical that the new commitments
around social protection and health systems are
effectively reviewed so that the needs and rights
of children affected by HIV and AIDS are
fulfilled.
It is not clear how the funding is going to reach
civil society, who are at the forefront of the
response against HIV, and the most at risk
populations (those who have a problem
accessing HIV services through mainstream
health systems because of stigma and
discrimination).
Currently, two thirds of pregnant women with
HIV in developing countries do not have access
to the services they need to give their babies
the chance to be born free from HIV. The
strategy promised to intensify efforts to reach
more women with these services, but there is
no specific funding plan to meet this goal.
The strategy is also not clear on how the UK
government will support the development of
medicines and diagnostics for those children
living with, or exposed to, HIV.
The strategy includes information on the
effectiveness of the antibiotic co-trimoxazole
when given to children exposed to HIV.
However, four years on from the research that
showed this, only 4% of such children received
it and there is no evidence within DFID’s
strategy to roll-out this simple, cost-effective
treatment for children.
The new HIV strategy fails to address the most
important barrier and that is from international
strategy to national level implementation, where
high level commitment and the channelling of
resources are highly political. The strategy fails
to identify who is responsible for what, the
mechanics, and potential stumbling blocks in
addressing this barrier.
What can you do within your
country?
Partners can play a key role in raising the issues
in the new strategy and participating in
developing the country plans for prevention,
treatment care and support services at national,
local and community levels.
If you are interested in engaging in the new
AIDS Strategy you can access the detailed
documents:
Seven-year AIDS strategy “Achieving Universal
Access – the UK Government’s strategy for
halting and reversing the spread of HIV in the
developing world”
(4 mb);
There is a second document “Achieving
Universal Access” and the companion volume of
supporting evidence “Achieving Universal Access
– evidence for action”
(592 kb) for more
details.
Disseminate the HIV Strategy widely with
other partners and people working with HIV and
AIDS programmes.
You could organize a meeting of other
partners in your community, region or country
to discuss the strategy in detail, its targets,
what they mean, etc. Your government will
engage with DFID in-country co-ordinators to
discuss the new strategy, including funding
commitments and developing an in-country plan
with targets. Ensure that you are aware of
the discussions.
You could also consider calling for a meeting
between yourselves and government
officials to discuss how the DFID commitments
can be incorporated in the national AIDS plans.
As you are developing your lobby and advocacy
plan, you will need to take into account factors
such as: (a) whether your government has a
good track record in responding to HIV; (b)
what the nature of the epidemic is in your
country; (c) what resources are available to
your government and to your organization; (d)
whether there is a history of government-NGO
collaboration in your country and whether your
government is receptive to working with NGOs;
and (e) who the key people are in government
whom you should be approaching.
Lobby to be part of the process. You should
be requesting and/or insisting that NGOs be
involved in the development of any country
plans. The participation of persons living with
HIV and civil society, including faith groups, is
crucial in the design, planning, implementation
and evaluation of donor funded programmes.
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