Although much work remains to be done, a United Nations global reporting system on HIV/AIDS has already yielded an "unequaled wealth of data" on progress toward meeting UN targets for responding to the global HIV epidemic. An update on the development of the UN General Assembly Special Session on HIV/AIDS (UNGASS) global reporting system appears in a special supplement to JAIDS: Journal of Acquired Immune Deficiency Syndromes. JAIDS is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.
The UNGASS system provides "a good indication of the overall progress in the global response to HIV"—including whether the world community is on track to meet the UN's ambitious timetable for turning the tide in the fight against HIV. Guest editors of the special supplement are Deborah Rugg, PhD, of The Joint United Nations Programme on HIV/AIDS (UNAIDS), Michel Carel, PhD, of Free University Brussels, and Hein Marais, an Independent Writer in Johannesburg, South Africa.
UNGASS Process a 'Catalyst' for Development of National HIV Monitoring Systems
The 11 articles in the supplement provide a look into the development of the UNGASS global reporting system, being implemented as part of the 2001 UNGASS Declaration of Commitment on HIV/AIDS. The UNGASS system provides a framework for biennial Country Progress Reports, which will be used to assess attainment of the UN's Millennium Development Goal (MDG) 6: halting and reversing the HIV epidemic by 2015.
As of 2008, the UNGASS system included data from 147 countries—through the first three rounds of reporting, response rates increased from 54 to 77 percent. The reports have provided unprecedented data on patterns of HIV epidemics, behaviours related to the spread or control of HIV, and progress in implementing programmes essential to meeting the MDG 6 targets.
Several articles present preliminary analyses of data on the global response to the HIV epidemic. At this point—midway to the 2015 deadline for MDG 6—the data show "limited progress" in most areas:
•Only about 40 percent of young men and women worldwide know how to protect themselves from acquiring HIV (compared to a 2010 target of 95 percent).
•Programmes to prevent transmission of HIV from mothers to infants reach only 33 percent of those in need (target 80 percent).
•Rates of new infections in infants born to HIV-positive mothers have decreased by only 25 percent (target 50 percent)
•The 2010 goal for financial investment in AIDS responses—$10 billion—has been met. However, there are concerns about the sustainability of this response, given the global economic recession.
The UNGASS HIV monitoring system also appears to make progress toward another key goal: for countries to "achieve ownership" of the national HIV reporting process. "Countries have come to regard the UNGASS process as more than a reporting exercise at the UN General Assembly," Dr. Rugg and her co-editors write. They believe the UNGASS system has promoted "public accountability" in confronting the HIV epidemic.
Although the establishment of a global HIV reporting and monitoring system is a major accomplishment, many complex issues remain to be addressed. The data collected so far suggest that HIV prevention and treatment programmes will need to be "dramatically scaled up" if worldwide goals are to be met. Yet, as evidenced by the papers in the JAIDS supplement, " The reporting system has provided a catalyst for the development of national systems for monitoring and evaluating HIV programmes and for guiding more effective, efficient, and sustainable responses to the HIV epidemic," Dr. Rugg and colleagues conclude.
Historical redlining continues to affect HIV treatment in affected communities