Which institutions have played a key role in developing international public policy on the HIV/ AIDS epidemic? With what outcomes?
With the emergence of the devastating human immunodeficiency virus (HIV), the cause of the AIDS disease in the late 1970’s two major international institutions or bodies have led the way in making HIV/AIDS a globally recognized predicament. The United Nations and their specialized agency for health, The World Health Organization, have been the two major contributors in developing International Public Policies on HIV/AIDS and therefore lead the way in attempting to reduce and eventually eradicate this global epidemic.
The World Health Organization was formed in April 1948, its objective as set out in its constitution is the attainment by all peoples of the highest possible level of health… a state of complete physical, mental and social well being. Therefore with the gradual realization that HIV/AIDS was not just confined to particular regions but was fast affecting every corner of the globe, the United Nations through the World Health Organization was quick in implementing International policies to help deal with such a large-scale quandary. The World Health Organization was the first institution of its kind to implement particular policies relating to HIV/AIDS and as a result of this organization, a global strategy on HIV/AIDS was launched in 1987.
This program generally known as The Global AIDS Mobilization supported countries in developing national AIDS programs and promoting international widespread collaboration. Furthermore later that year The World Health Organization initiated the Special Program on AIDS, later known as the Global Program on AIDS (GPA). The Global Program on AIDS played an essential role in establishing national AIDS programs, improving the management capacities and coordinating international research aimed at finding effective ways to fight HIV/AIDS in more than 150 countries world wide. In addition The Global Program of AIDS was the first program to announce a new policy relating to anti discrimination laws. However, many may view this statement as ineffective, as its non-discrimination proclamation failed to specifically identify HIV/AIDS sufferers as a group of people who should not be placed under such a stigma.
Furthermore the World Health Organization has also received much support from other key actors in the international arena, such as nation states and non government organizations. Non government organizations are voluntary, non state and non profit associations. A significant development occurred in regards to HIV/AIDS international public policy making in January 1988 with the world summit of health ministries. Emerging from this meeting was the declaration known as the London Declaration on AIDS Prevention which called for the “involvement of all relevant governmental sectors and nongovernmental organizations in creating the supportive social environment needed to ensure the effective implementation of AIDS prevention programs and humane care of affected individuals” (C. Jï¿½nsson ; P. Sï¿½derholm, 1996:125). This proved particularly important in respect to the involvement of national governments and in particular non government organizations. “We are dealing with the prime public health concerns of our time. We are focusing on conditions with a major impact on the poor and disadvantaged … and we are working alongside a broad range of partners, maximizing what we can achieve together” (www.who.org. civil societies discussion paper one). Although non government organizations have acted through the World Health Organization and have assisted in policy making suggestions, thus far they have not actually created any International Public Policies
The World Health Organization’s Global Program on AIDS, has further helped implement particular policies in different national governments. Through the program known as the National AIDS Program (NAP), the World Health Organization has channeled numerous amounts of funding through national governments and to well-respected non government organizations in order to create successful national aids policies. For example through the financial and technical assistance of the World Health Organizations, the United States and numerous funding agencies such as the German Technical Cooperation and the Canadian International Development Agency a successful national aids program has been successfully implemented in Jamaica. As a result of this support the Jamaican government was able to put into practice a more productive and successful program and has been able to receive assistance in policy planning and management. In particular in 1992 an extensive STD Control and Prevention campaign was launched under the new policy of double protection. As a result of this program Self-reported condom use at last sex among men increased from 54% in 1992 to 77% in 1996, and 43% in 1992 and 73% in 1996 for women. In addition it has significantly increased HIV/AIDS awareness as education is now more readily available. However although success has been evident in almost all programs undertaken, it is also argued that these programs should become much more effective and currently suffer “from the drawback of being virtually identical, lacking country relevancy, and making inadequate reference to existing resource constraints” (Collins & Rau, 2000:37).
The increasing diversity and the rapid expansion of the HIV/AIDS epidemic soon made it apparent that this issue was too large for just one organization. The United Nations taking the lead from the World Health Organization became increasingly involved in the HIV/AIDS issue and soon became the key player in the development of international public policies. The joint United Nations HIV/AIDS Program (UNAIDS) was implemented in January 1, 1996 after the General Assembly Resolution, which not only acknowledged the diversity of this HIV/AIDS issue but also called for numerous cosponsors of the United Nations System to become actively involved in the global AIDS effort.
The Joint United Nations HIV/AIDS Program has been seen by many as the continuation of the Global Program on AIDS, however many differences have been implemented to further its success. A key example of its diversity and expansiveness is that it bought together different agencies belonging to or affiliated with the United Nations. These include the six original Cosponsors – the United Children’s Fund (UNICEF), the United Nations Development Program (UNDP), the United Nations Population Fund (UNFPA), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the World Health Organization (WHO) and the World Bank. These organizations were then later joined by the United Nations International Drug Control Program (UNDCP) in 1999 and by the International Labour Organization (ILO) in 2001. Through the conjunction of such a wide variety of contributors the United Nations AIDS program has been able to play a major role both assisting national government and in creating international public policies. Furthermore it has allowed the HIV/AIDS epidemic to be addressed by the large scope of areas it affects therefore making implementations of policies more relevant and thus more effective. As each individual organization has a comparative advantage in its field it is therefore able to better judge the implications HIV/AIDS has on particular areas of life. For example UNICEF has implemented education policies in areas such as Zambia and Cambodia, where with community support they have been able to raise awareness and run specific programs in public schools educating young people on the causes and effects of HIV/AIDS.
Non government organizations are an extremely valuable asset to UNAIDS, and although they do not implement international policies, they play an extremely important role on the UN coordinating board and nationally throughout the globe. Through their country specific expertise, they participate and play a key role in implementing national policies and programs. Furthermore five non government organizations actively participate on the UN coordinating board, a key player in the implementation of international public policies, this is particularly significant as UNAIDS is the first United Nations program to include non government organizations in its governing body. Through this, non government organizations are able to contribute and offer their view points on numerous International issues and as each non government organization represents one of five regional areas: Africa, Asia/Pacific, Europe, Latin America/Caribbean, and North America they are able to offer key a insight and input into particular policies which may affect their region both positively and negatively. Overall however predominantly country specific non government organizations, representing particular developing regions are still finding it difficult to actively participate in International Policy making as this tends to be dominated by other sectors of the United Nations. On the whole non government organizations have nonetheless played a key role in the UNAIDS overall success and have arguably gained a reputation of quite a high status not seen in any other large international institution previously.
A major success by The Joint United Nations AIDS Program was the Declaration of Commitment on HIV/AIDS which came into being as a result of the United Nations General Assembly in 2001. The declaration sets targets for reducing infection rates, methods of treatment, prevention and protecting the rights of people living with HIV/AIDS, “It is a blueprint from which the whole of humanity can work in building a global response to a truly global challenge” explained UN Secretary General Kofi Annan.
More prominently the Declaration holds countries accountable to act, sets goals to measure performance and requires that international community – including the UN agencies-supports them as they proceed to implement more robust programmes” (United Nations, 2003, www.unaids.org/about/what.asp:05.05.2003)
The declaration of commitment, although not country specific, aims to provide national governments with specific policies which may be implemented domestically to further help eradicate the HIV/AID epidemic. However, this has at times proven to be difficult, particularly in states where the Catholic Church or other religions hold a high status, as the state ultimately holds the right to disregard particular international public policies and more importantly holds the power to refuse to implement them. In order to reduce this difficulty whilst staying sensitive to particular beliefs and cultures, The United Nations has introduced Theme Groups, which at a national level help to promote effective and individual programs to further reduce the HIV/AIDS epidemic. UN theme groups contribute international knowledge and research to particular areas and nation states and provide monitoring and evaluation; resource mobilization and resource tracking; policy advice and technical services; and partnership development with civil society and the private sector. It may be viewed that although theme groups do not directly relate to International Public Policy making, it is an outcome which has resulted from them and simultaneously achieves the equivalent objective – reducing the HIV/AIDS epidemic.
In conclusion The World Health Organization and The United Nations have been the two major institutions which helped HIV/AIDS to become a globally recognized predicament. Through doing this numerous programs and International Public Policies have been formed which have allowed HIV/AIDS to be dealt with on a global scale and helped lead the way to reduce this wide spread epidemic.
Altman, D. (1999) AIDS and Questions of Global Governance, in Pacific Review, Volume 11, NO 3 October 1999.
Altman, D, (1999) Globalization, Political Economy, and HIV/AIDS, in Theory and Society, No. 28, 1999.
Collins, J & Rau, B (2000) AIDS in the context of Development, UNSRID Programme of Social Policy and Development Paper Number 4, UNSRID
Gardner, H (etd) (1995) The Politics of Health: The Australian Experience, Melbourne, Churchill Livingstone.
Jï¿½sson, C. & Sï¿½derholm, P. (1996) IGO-NGO Relations and HIV/AIDS: Innovation or Stalemate? In T. G. Weiss & L. Gordenker (eds), NGOs, The UN, and Global Governance, Lynne Rienner.
Mann, J & Tarantola, J.M (1996) AIDS in Word II: Global Dimensions, Social Roots and Responses, New York, Oxford University Press.
Palmer & Sort (2000) Health Care and Public Policy: An Australian Analysis, Melbourne, Macmillan Publishers.
The United Nations 2003, United Nations AIDS (UNAIDS),
<http://www.unaids.org> (accessed 05.05.2003)
The World Health Organization 2003, The World Health Organization,
< http://www.who.org> (accessed 05.05.2003)