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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