Progress on the Implementation of DFID's HIV/AIDS Strategy - International Development Committee Contents


1  INTRODUCTION

1. HIV/AIDS remains a significant global health challenge. While the percentage of adults living with HIV worldwide has been stable since 2000, there were an estimated 2.7 million new infections in 2007. The annual number of new infections remains high and continues to outpace the annual increase in the number of people receiving treatment.[1] The total number of people living with HIV (PLWH) is now 33 million. In its latest report on the global AIDS epidemic, UNAIDS (the Joint UN Programme on HIV/AIDS) estimated that 2 million people died due to AIDS in 2007. This was an increase on the 2001 estimate of 1.7 million.[2] Moreover, the number of deaths is increasing in parts of Africa, particularly eastern and southern Africa.[3]

2. Some progress in providing treatment is being made and the use of anti-retroviral (ARV) therapy has increased: of the estimated 9.5 million people in need of treatment in 2008 in developing countries, 42% had access, up from 33% in 2007. The greatest increase in access has been in sub-Saharan Africa, where two-thirds of HIV infections occur.[4]

The inquiry

3. At the beginning of this Parliament, we made a commitment to undertake an annual inquiry into HIV/AIDS. In 2005 we examined the provision of anti-retroviral treatment; in 2006 we looked at marginalised groups; in 2007 we combined our work on HIV/AIDS with our inquiry into Maternal Health; and last year we assessed the Department for International Development's (DFID) recently published HIV/AIDS Strategy.[5]

4. Our 2008 Report welcomed many of the initiatives and commitments announced in DFID's new HIV/AIDS Strategy.[6] However, we expressed concern about a number of issues. In particular, we had been unable to examine the process which DFID planned to use to monitor and evaluate the Strategy's implementation because its Monitoring and Evaluation Framework was not published until after our inquiry had been completed. Our Report also identified significant deficiencies in detail in the Strategy which the Government Response did not adequately address, despite a number of requests for specific information.[7] In this year's inquiry, we therefore decided to follow up some of the issues which we felt had not been resolved in the Government's Response, as well as examining recent developments in the implementation of the Strategy.

5. In the course of this inquiry we received written submissions from 19 organisations. We held one oral evidence session in two parts: the first with non-governmental organisations and the second with Mr Michael Foster MP, Parliamentary Under-Secretary of State for International Development and DFID officials. We would like to thank all those who contributed to our inquiry.

Structure of our Report

6. In Chapter 2 we examine how DFID's Strategy will be monitored and evaluated. In Chapter 3 we look at DFID's funding for strengthening health systems and its likely impact on HIV/AIDS programmes. Chapter 4 analyses how effectively HIV/AIDS programmes are integrated with strategies for tackling other related diseases. The extent to which social protection programmes will help those made vulnerable by HIV/AIDS, particularly children, is discussed in Chapter 5. Chapter 6 examines the Strategy's approach to marginalised groups. Chapter 7 looks at access to anti-retroviral treatment. We then examine overall funding for HIV/AIDS programmes and DFID's co-operation with other multilateral and bilateral donors (Chapter 8). The final chapter looks at the effectiveness of cross-Whitehall working and, in particular, the role of the Foreign and Commonwealth Office in taking forward HIV/AIDS work in middle-income countries.


1   World Health Organisation, Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector, Progress Report 2009, September 2009, p 4 Back

2   UNAIDS, 2008 Report on the global AIDS epidemic, July 2008, p 32. The estimate range was 1.8-2.3 million in 2007 and 1.5-2.3 million in 2001 Back

3   World Health Organisation, Progress on health-related Millennium Development Goals, May 2009 Back

4   World Health Organisation, Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector, Progress Report 2009, September 2009, p 5 Back

5   International Development Committee, First Report of Session 2005-06, Delivering the goods: HIV/AIDS and the provision of anti-retrovirals, HC 708-I; Second Report of Session 2006-07, HIV/AIDS: Marginalised groups and emerging epidemics, HC 46-I; Fifth Report of Session 2007-08, Maternal Health, HC 66-I; Twelfth Report of Session 2007-08, HIV/AIDS: DFID's New Strategy, HC 1068-I Back

6   DFID, Achieving Universal Access: the UK's strategy for halting and reversing the spread of HIV in the developing world, June 2008 Back

7   International Development Committee, First Special Report of Session 2008-09, HIV/AIDS: DFID's New Strategy: Government Response to the Committee's Twelfth Report of Session 2007-08, HC 235 Back


 
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Prepared 1 December 2009