Expert Claims UNAIDS Should Be Shut Down

The joint United Nations Program on HIV/AIDS, on which significant
effort has been focused, is damaging health systems and distorting
health financing, writes Roger England, Chairman of the
Health Systems Network, in a View & Review feature released on
May 9, 2008 in BMJ. As a result, he believes that
UNAIDS should be closed down immediately.



He writes that the amount spent on HIV in comparison the amount spent
on other diseases in disproportionate. Instead, England believes that
the money would better invested in such efforts as strengthening
general health services, and in funding action for other diseases, such
as pneumonia and diabetes, that kill more people and might have more
effective intervention tactics.



HIV globally accounts for 3.7% of mortality. However, 25% of health aid
and a large proportion of domestic expenditure is allocated for HIV
interventions. England points out that the global catastrophe once
predicted with the AIDS epidemic has not occurred, and in comparison
draws attention to the fact that global HIV deaths do not overtake the
number of deaths of children under five years old in India. He claims
that its recognition through a division of the UN, the disease has
become more than just an ailment to prevent and cure. "With its own UN
agency, HIV has been treated like an economic sector rather than a
disease."



England argues that billions of pounds have been wasted by national
AIDS commissions in the UK and in the funding of obscure projects and
disciplines. This money should be used to strengthen public health
systems in developing countries that could achieve controlled
transmission of HIV.



In addition, he says, the enormous attention paid to HIV in terms of
aid has created parallel financing systems, employment structures and
organizational setups that have overall weakened national health
systems and put much needed structural reform to the side.
Additionally, HIV-dedicated funding provides no incentive for
sustainable country systems, achieves poor value for the money given,
and increases the country's dependence on aid.



He puts forth that only 10% of the ten billion US Dollars per year
which is dedicated to HIV is actually needed for the two million people
receiving treatment presently for free. By putting the remainder of HIV
funding to general health budgets, a huge step forward could be made in
developing country health systems, allowing them to prioritize and
improve prevention and treatment of a whole range of diseases.



Finally, he says, a UN agency dedicated to a single disease is a
liability, so UNAIDS needs to be shut down. He says this "not because
it has performed badly given its mandate??¦but
because its mandate was wrong and harmful. Its technical functions
should be re-fitted into WHO, to be balanced with those of other
diseases."



The writing is on the wall for UNAIDS

Roger England

BMJ, 10 May 2008, Volume 336, 1072

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Written by Anna Sophia McKenney