UNAIDS: Preparing for a New Phase

This is a joint posting with Danielle Kuczynski and Kristie Latulippe, co-authors of the Background Report for the UNAIDS Leadership Transition Working GroupTim Barnett, Stefano Bertozzi, Michel Sidibe, Debrework Zewdie -- who will be the next head of UNAIDS? As founding UNAIDS Executive Director Peter Piot prepares to step down at the end of the year and move on to a role as Director of the new Institute for Global Health at Imperial College London, a Search Committee is looking for his successor. The Program Coordinating Board, after interviews with seven candidates out of a pool of 117 applicants, recently released the names of these top four candidates for the position.

This week's lead editorial in The Lancet showcases the candidates and calls for transparency in the selection process through the release of criteria used in UN Secretary-General Ban Ki-moon's final decision on an appointee.What does a future leader need to consider? There is a lot for these candidates to keep in mind when taking the helm:

• Recent calls for a shift away from "AIDS exceptionalism" in development assistance for health, and a push toward ensuring that new spending focus on health systems rather than disease-specific interventions
• Increasing recognition that it's impossible to treat our way out of the epidemic, and that more and better HIV prevention is vital but few international champions for prevention have emerged
• Concern that UNAIDS, as a joint program coordinating the activities of 10 cosponsoring agencies at both the country and global level, has a curious mandate and an uneven track record

There are also questions about what UNAIDS means for other disease areas in which the death toll is enormous, multiple sectors and agencies must be mobilized and financial resources are scant compared to need: If UNAIDS makes sense, why not UNMalaria? Or UNTobacco? A rights-based approach to HIV/AIDS, which has been the underpinning of a considerable amount of the effective advocacy, may require equal treatment for other diseases.The Lancet states: "A view beyond HIV/AIDS will reinforce plurality and justice, protecting minorities and thus wider majorities. UNAIDS needs to abandon AIDS exceptionalism."If UNAIDS abandons exceptionalism, what does that mean for the existence of this quite exceptional program?A controversial piece by Roger England in the British Medical Journal asked whether the "writing was really on the wall for UNAIDS." Should the program be shut down? Or if it continues, in response to continued special needs related to the international response to HIV/AIDS, what functions make sense for it to retain?This week, the Center for Global Development and the Global Economic Governance Programme at Oxford launched a new Working Group focusing on these very questions. The UNAIDS Leadership Transition Working Group is made up of a core of 15 senior experts in global health and HIV/AIDS. During three consultations in Washington, DC, Oxford, UK, and Durban, South Africa, the Working Group will develop a set of practical and forward-looking recommendations on the future of the Joint Programme.To formulate recommendations, the working group will need to look at the key priorities for the international response to HIV/AIDS, and understand which of these UNAIDS has demonstrated unique potential to accomplish, at both international and national levels. As a springboard for these deliberations, a draft background paper has been prepared. We welcome comments are being invited from civil society organizations, the research community, funders and others who closely follow the work of UNAIDS.Please send comments on the paper or on the future of UNAIDS more broadly to Danielle Kuczynski. Or post your views as a comment on this blog for others to read. Have your say on the future of this unusual organization! We look forward to hearing from you.