GETTING TO ZERO 2011–2015 unaids Strategy
Income inequality within countries and the polarization of population groups at opposite ends of the economic spectrum have become increasingly pronounced (9). These trends also imply greater internal and cross-border movements of people and the associated potential for HIV risk and vulnerability. Developmental efforts, including the HIV response, must more rigorously engage the low-income and vulnerable people within countries rather than low-income countries per se. The response must also contend with continued shifts in the development cooperation architecture. Even as the HIV response has begun to successfully reposition itself as being integral to wider development and human rights efforts, funding flows for HIV remain fragmented, reflecting the continued proliferation of initiatives and implementers. Despite widespread recommitment to the principles of aid effectiveness, true national ownership is still far from assured, and the interests of the global South, including those of civil society and people living with and affected by HIV, exercise too little influence in the global AIDS governance architecture. Middle-income countries must assume greater responsibility for domestic funding of their responses, address internal inequity and engage in South–South partnerships grounded in principles of human rights and aid effectiveness. Emerging economies are wielding more clout in global negotiations on trade, development, human rights, intellectual property rights and other issues. This will have profound implications for many drivers of HIV and the response. The historical role of the BRICS countries (Brazil, Russian Federation, India, China and South Africa) in relation to the World Trade Organization Agreement on TradeRelated Aspects of Intellectual Property Rights (TRIPS Agreement) and essential medicines is a potential advantage for the HIV response.
AIDS and the Millennium Development Goals: working together for greater impact The Millennium Development Goals are interlinked: progress on one goal supports progress in others. There are many opportunities to simultaneously advance the response to HIV and to achieve other Millennium Development Goals, lowering overall costs and increasing the impact of investments. AIDS-related illnesses are a leading killer of women of reproductive age, and almost one in five maternal deaths worldwide in 2008 was linked to HIV (10). In six hyperendemic countries, AIDS is responsible for over 40% of child mortality (11). People with latent tuberculosis (TB) are increasingly becoming infected with HIV and developing active TB. Of the estimated 1.8 million people who died from TB in 2008, more than 25% were living with HIV. HIV has dramatic consequences for entire communities. Most people who die from AIDS-related illnesses are young adults—among the most economically productive members of society. Across the world, an estimated 17.5 million children have lost at least one parent to HIV. Treatment, hospitalization and loss of income, as well as providing care for family members living with HIV and for orphans, results in a high economic burden for households (12, 13).
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