Recognizing that a global epidemic requires a global response, 5 European AIDS Ambassadors came to Washington this week to strengthen transatlantic cooperation in the global fight against HIV/AIDS. At a public event co-sponsored by CGD and CSIS, Ambassadors from Belgium, France, Norway, the Netherlands, and Sweden emphasized that European and American policymakers largely agreed on how AIDS programs should be designed and delivered.
Still, the Ambassadors did note a couple of areas of policy divergence: according to the Ambassadors, European countries place a greater emphasis on multilateralism, and would like to see the US direct a greater share of PEPFAR money towards multilateral institutions like the Global Fund (note though that the US is still by far the largest contributor to the Global Fund). In terms of prevention efforts, the Ambassadors stressed the importance of comprehensive sexual education, and expressed some skepticism about the abstinence-only programs that are part of the American-supported ABC approach. The Swedish Ambassador, for example, explained that abstinence-only education is inadequate in a context where "1/3 of new infections are non-voluntary" due to sexual violence or coercion.
A couple of other thoughts on the event:
The Ambassadors were all eager to discuss the issue of gender. Several of them referenced statistics demonstrating that girls in the 15-24 year old demographic worldwide are being infected at twice the rate of their male counterparts. They also noted that married women are at high-risk of infection by unfaithful husbands. The Dutch Ambassador cited a study from Nicaragua demonstrating that married women were twice as likely as sex workers to contract HIV. No new ideas were offered on how to tackle the problem, but maybe that's because weâ€™re still so far behind in implementing "old" ideas - expanding girls' education, ensuring service provision fits women's schedules, investing in microbicides, etc.
On donor coordination, the Norwegian Ambassador explained that global-level talk has produced too few results at the country level. Instead, we need to "get to work at implementing" the Three Ones principles on the ground in countries. The toughest of these principles to implement, of course, is the common Monitoring & Evaluation framework. The Ambassador herself noted the silliness of spending time attributing AIDS patients to PEPFAR or Norway or the Global Fund, especially when these counting exercises are all being conducted independently. She called for greater investment in national information systems that could gather comprehensive figures.
In plenary, there wasn't time to delve into many of the details on how to address the problems described above, but the Ambassadors did join the audience for more thorough breakout group discussions on gender, donor coordination, HIV prevention, and intellectual property and access to medicines. Notes from those sessions will be posted shortly and, in the meantime, you can check out the video footage from the event.