Mutual Accountability Needed to End AIDS

Co-authored with
Gemma Oberth, Senior Researcher, AIDS Accountability International, Cape Town, South Africa

African leadership on AIDS is on the rise while, with some exceptions, political and financial commitment in the wealthiest nations has been stalled since the end of the last decade. In 2011, low and middle income country spending on HIV surpassed global giving for AIDS for the first time. It was also the year more people eligible for anti-retroviral therapy received it than those who didn't. This hard won progress is fragile. Collective global action is what's needed to make it continue.

What are the chances of renewing the commitment that characterised the global AIDS response of the previous decade? If the recently concluded G20 and the June G8 summits are any indication, the prospects are decidedly mixed. Both summits raise reasonable questions about whether political leadership on AIDS is flagging in many of the world's leading economies.

Healthy workforces are central to the G20's goal of robust economic growth, but as the G20 accountability report illustrates the premier forum on the global economy continues to neglect health issues. The 2013 G8 Summit marked the first time in over a decade that neither HIV/AIDS nor the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) was mentioned in the Communiqué. This stands in stark contrast to the 2005 Gleneagles Summit, when G8 leaders promised to double aid to Africa and to make access to AIDS prevention and treatment universal in 5 years. Lacking a forward vision on AIDS, the G8 leaders of today appear content to rest on the laurels they described in the G8's latest Accountability report.

Conversely, efforts to intensify African leadership and commitment may be just hitting stride. One example of progress is the African Union (AU)/NEPAD Accountability Report on Africa-G8 Partnership Commitments, 2013, the first ever themed accountability report on delivering results to end AIDS, TB and Malaria in Africa. It was put together with an inclusive preparatory process that could teach the G8 a thing or two about accountability reporting.

The technical validation group was comprised of a diverse team of experts, international organizations and African civil society representatives, including the Cape Town-based AIDS Accountability International, who worked hard to produce a report that would generate greater financial and political commitment and leadership in both African and G8 countries. They hoped to send a clear signal that Africa needs reliable partnerships and global solidarity now, more than ever.

AIDS Accountability International cites the AU Roadmap on Shared Responsibility and the Abuja +12 Summit that followed the AU's 50th Anniversary Summit as further evidence of African resolve. AAI welcomed the Abuja +12 Summit's comprehensive Declaration as well as its focus on deepening commitment on the continent and pressing all African countries to make contributions to the GFATM.

We will know soon enough if the world's wealthiest countries are ready to get back in the game. The first test will take place at the UN Special Event to take stock of Millennium Development Goals (MDGs) progress and kick off the process of finalising the post-2015 agenda. At issue is whether AIDS remains a priority after the MDGs expire in less than 1000 days. As home to 34 of the world's 49 Least Developed Countries, Africa has strong reasons to see that AIDS, TB and malaria rank high on the global post-2015 agenda.

The second test will be the 4th Replenishment of the GFATM that takes place before years-end. Africa's stake in the outcome is considerable, since more than 90 percent of treatment of AIDS in Africa is still funded from external sources. In an encouraging move, wealthy donor countries have been stepping up. Earlier this month five Nordic countries made pledges that were also meant unlock a larger U.S. contribution to the GFATM.

Building on forward progress like the 25 percent decline in new HIV infections in sub-Saharan Africa is unlikely without the continued partnership between Africa and the Global North. In the coming months, we will see if wealthiest countries and Africa demonstrate mutual accountability, or if it is left to another generation to find a solution that is already within our grasp.


Rob Lovelace is Senior Fellow, Trade Union Sustainable Development Unit
Gemma Oberth is Senior Researcher, AIDS Accountability International, Cape Town, South Africa