Finding
Paper
Abstract
At the end of the year, Peter Piot will step down as Executive Director of UNAIDS, the Joint UN Programme on HIV/AIDS and the largest organisation devoted to a single disease. He has been in the post since UNAIDS’ inception in 1995, and has raised the profi le of HIV/AIDS so successfully that the epidemic has remained a high priority on health, political, and security agendas. His achievements are substantial. After Piot announced his resignation, UNAIDS set up a Search Committee, which interviewed seven candidates from 117 applicants. According to the Committee the “paucity of highly-qualifi ed candidates” meant that the deadline had to be extended. On Oct 2, its Program Coordinating Board released details of the selection process and the four candidates it recom mended. Tim Barnett, originally from the UK, is very much a politician, having been a Labour Party member of parliament in New Zealand since 1996. He is currently a senior government whip. Previously, he worked for non-governmental organisations (NGOs) in the UK and elsewhere. His particular strengths lie in participative democracy, citizens’ access, partnerships with NGOs, and innovative law reform. He is a fan of HIV/AIDS exceptionalism, in terms of it needing a separate UN agency and spending stream, and as being a catalyst for wider change in, for example, human rights law. Stefano Bertozzi, born in Italy, is an AIDS researcher, and founding director of the Division of Health Economics & Policy at Mexico’s National Institute of Public Health. He is also a member of the Technical Evaluation Reference Group of the Global Fund to Fight AIDS, Tuberculosis and Malaria. In September in The Lancet, he wrote with others that HIV-prevention programmes are still largely defi cient, managers of national programmes need to improve targeting, selection, and delivery of preventions, and that funding should be optimised by making more eff ective use of current knowledge about prevention. Michel Sidibé, from Mali, has worked at the UN for over 20 years, and is currently Deputy Executive Director of UNAIDS. His record in working with international and local organisations at all levels is impressive, as is his commitment to human rights, especially for women and girls, and to GIPA (greater involvement of people living with or aff ected by HIV/AIDS). Sidibé also wants UNAIDS to help countries apply research results in science and technology. His worry for the future is about a risk of complacency and adherence to the status quo. Debrework Zewdie, from Ethiopia, is the director of the Global HIV/AIDS Program at the World Bank. Originally an immunologist, Zewdie has a strong history, particularly in Africa, of research, management, and advocacy, especially in women’s health. She helped to form the Multi-Country HIV/AIDS Program, which has funded over 40 projects with a total budget of US$1·5 billion. Her application is supported by the NGO Delegation to UNAIDS and the Global Fund. The recommendations of the Program Coordinating Board record the Search Committee’s acknowledgment of two candidates, naming Sidibé in particular. The other preference is believed to have been Zewdie. A UNAIDS Committee of Cosponsoring Organizations, which includes WHO and the World Bank, has now interviewed the four candidates, and will recommend three names to the UN Secretary-General, Ban Ki-moon, on Oct 24. The Secretary-General, who will make the fi nal decision, had asked for three names, one of whom was to be a woman. It will be interesting to see if he will be as transparent as the Program Coordinating Board and make public the criteria used in his decision making. We urge him to do so. Since UNAIDS was formed, thinking about HIV/AIDS has evolved. Our recent series on HIV prevention indicates that UNAIDS needs to place science at the centre of its policies and be evidence-driven. It is time to unwind the rhetoric, and reposition the response to HIV/AIDS as one of several important health challenges. A view beyond HIV/AIDS will reinforce plurality and justice, protecting minorities and thus wider majorities. UNAIDS needs to abandon AIDS exceptionalism. Horizontal pro grammes are now equally as important as vertical ones. The new Executive Director will need to work with others from the non-HIV world, and be big on prevention and access to all essential medicines, including antiretrovirals. As soon as the ink has dried on the door-plaque for the new Executive Director, The Lancet will present him or her with one of their fi rst opportunities: to write about their vision and plans for their new role. That public manifesto can become a declared commitment and purpose to which we can return again and again as this new era for UNAIDS and the epidemic itself unfolds. ■ The Lancet For the recommendations of the Program Coordinating Board see http://data.unaids. org/pub/InformationNote/ 2008/20080902_pcb_em_ report_fi nal_en.pdf
Authors
T. Lancet
Journal
The Lancet