Most political leaders seem to be abandoning AIDS and giving up on the drive for universal access. But last week, on 9 March, U.K. Minister of State for International Development Gareth Thomas stood up and said the U.K. wants to see action on the pledge to achieve universal access – a pledge the U.K. pressed for at Gleneagles when it had the G8 Presidency in 2005. And he called on other G8 and G20 members to recommit to moving forward.

Last week he chaired a high-level meeting in the impressive “Moses room” in the House of Lords in London to re-energize the political momentum for universal access – and he asked me to facilite the discussion among donors and the representatives of eight heavily affected African countries.

Minister Gareth Thomas with Annie Lennox and Vuyiseka Dubula of Treatment Action Campaign.

Among those attending were cabinet ministers, heads of national AIDS commissions, and civil society representatives, including people living with HIV. And the global players were there too: U.S. Ambassador Eric Goosby who leads PEPFAR, the heads of the Global Fund and UNAIDS, Michel Kazatchkine and Michel Sidibé, and our own President, Julio Montaner. It was a small crowd, but a stellar one – and one made even more striking when Annie Lennox turned up to add her passion and zeal to the conversation. 

In 2005, Lennox took part in BandAid, the massive fundraiser to “Make Poverty History”, where she sang and spoke movingly about the impact of AIDS on children – a campaign that she has dear to her heart. That same year, many of the rest of us had been around a table similar to the one we were at this past week. That meeting, called “Making The Money Work” and also hosted by DfID and occurring on 9 March, was convened to develop strategies for greater global cooperation as the level of resources for global AIDS initiatives was expanding dramatically.  
 
Back at that time, money was increasing, and we hoped that universal access was plausible – that is why we fought so hard for all UN Member States to agree to that goal. Now, five years later, we left our meeting knowing that universal access won’t be achieved in 2010, but also armed with the evidence that it is most definitely possible.

IAS Governing Council member Alan Whiteside started the meeting with a fantastic review of the state of the epidemic and this was followed by the participants’ reflections on what worked over the last five years, and what more we need to do. As my colleague Global Fund Executive Director and IAS Governing Council member Michel Kazatchkine noted, “We have proof of concept. We have been able to demonstrate that scale up towards universal access is possible, and is happening.” As just one example, he told of Lesotho’s application to the Global Fund to support treatment for 3,000 people.  Just a couple of years later they were back with an application ready to treat 65,000.

A key message at the meeting was how much we have achieved and learned in the past five years – it is quite clear that we can now mount large and effective HIV prevention, treatment and care programmes in many resource-poor settings that have the political will to do so. Evidence is emerging constantly – and we really do know what to do, for example, to stop HIV transmission among people who inject drugs by scaling up comprehensive harm reduction programmes. We should be able to eliminate vertical transmission by scaling up PMTCT progammes to stop babies being born infected. And new data is constantly emerging – like the promising data showing the power of HIV treatment for prevention.

Yet with all that knowledge, we face the sobering challenge of waning political support. We know what works now, but we cannot yet get it to the scale that circumstances demand. As a former DfID staff member, I am proud to see my former colleagues picking up this mantle and charging ahead with the bold commitment we made in 2005. I hope our unified efforts can bring it to fruition – but it will take a lot more than a half-day meeting in London to swing around the political will we need for the resources and commitment to flow.
  
The London meeting provided important insights and information that will help us chart the course ahead. The African contingent talked about the crucial importance of financial aid and the support it is providing to a multi-sectoral AIDS response that is paving new ground in their countries. I was thrilled to hear Zimbabwe’s Minister of Health and Child Welfare Dr. Henry Madzorera speaking out strongly about the importance of protecting lesbian and gay rights in Zimbabwe.

And rightly, much of the attention focused on the money. The Global Fund needs to attract US$20 billion at this year’s replenishment meeting if it is to have a hope of setting the right course towards universal access and the MDGs. One way of pulling in ambitious long-term resources would be a Financial Transactions Tax (FTT). I was impressed to hear Minister Thomas say that, while he could not speak for the U.K. government (never easy a couple of months before an election!), he found the possibility of an FTT giving a portion of the tax to the Global Fund “an attractive idea”.

And, interestingly, despite Canada’s disturbing silence and apparent disinterest in having a substantive discussion on AIDS at the upcoming G8 and G20 summits – which had alarmed many of us – the diplomat representing Canada at the meeting said there would be a focus on AIDS and universal access “in the context of discussions on maternal and child health” at this summer’s G8. Well that sounds promising, but we’ll need to make sure that Prime Minister Stephen Harper really is on board with what she said - and we'll keep pushing for a real focus on AIDS. In 2010 there is no excuse to position universal access as an "add on" issue. The feedback from Korea was more somber – “Koreans know very little about AIDS” – so some work to do there before the second G20 summit in November in Seoul.

Collectively we must now work to ensure that world leaders commit to finishing what we started. The IAS’s new Universal Access Now campaign – rooted in our shared humanity and driven by science – is part of our answer to that challenge.

We are launching this blog as part of the campaign. We’ll use it to keep you up to date and let you know how you can stay actively involved. I hope you will post comments as well. Tell us about the impact of scale-up in your community and what’s at risk as global commitments are waning. Give us ideas for the types of information you would like to read on this blog and the resources we can provide to help you advocate for universal access.