Before the G8 summit in 2005, I joined a delegation to 10 Downing Street. I came with a simple message from my daughter, Smilie: "Tell Tony Blair that I saw Dr David who gave me medicine. I am now feeling better and I can go back to school. I am very happy."
Smilie is HIV positive. She was able to go back to school and enjoy her life because she got the antiretroviral drugs she needed. My message to world leaders was that by ensuring HIV treatment for all who need it, they could make a real difference to millions of men, women and children like my daughter.
A week later G8 leaders pledged HIV treatment for all by 2010. At the end of 2005 the UN committed to universal access to HIV prevention, treatment and care by 2010. These were momentous developments, and felt like a huge victory.
But the following May, the international community began passing the buck. At a UN special session on Aids they focussed on national Aids targets instead of the previously agreed global ones. By arguing that responsibility for an effective Aids response lay with national governments, rich countries were let off the funding hook.
Since this meeting the global momentum for fighting Aids seems to have been lost. The arrival of new debates, which falsely pitch health and Aids against each other, and argue that the world should be investing in health systems as opposed to diseases like Aids, hasn't helped.
The truth is few in the Aids movement would deny that strong health systems are needed to tackle HIV and other health issues. For ActionAid it is not a case of either/or. Increased funding is needed for both. Investing in HIV services brings relief to countries where most of the disease burden is due to Aids.
We are also seeing the compartmentalisation of Aids. Instead of following a long-term holistic approach, Aids has become projectised into three-year chunks that often address specific areas, such as behaviour change around abstinence approaches, that are not tested and often do not face the reality of Aids in a particular community. And these projects are frequently overseen by careerist consultants whose sole aim appears to be the crushing of innovation.
What's more, with projects have come a plethora of acronyms. There are national control programmes and national Aids commissions, international and national partnerships, national forums, theme groups, networks and umbrellas of networks, donor coordination groups, ministerial committees, country coordination mechanisms, interagency technical working groups, state, district, village and family Aids control committees, and on, and on.
In the meantime, things are not getting much better. The Global Fund for Aids, Tuberculosis and Malaria does not have enough money and global thinktanks are questioning the future of Unaids.
In this new world of multiple crises – food, climate, terrorism and now the global financial crisis – it may not seem the best time to start discussing the hopes of the 33 million people living with HIV who are still counting on rich countries to keep their promises. But if not now, when?
