29 January 2013: The UN Development Programme (UNDP) has published a report, titled ‘A Post-2015 Development Agenda: Lessons from the Governance of HIV Responses in Asia and the Pacific,’ which highlights how lessons learned from integrating governance principles into the health sector can accelerate global efforts to achieve the Millennium Development Goals (MDGs), and inform and shape discussions on the post-2015 development agenda.
In Asia and the Pacific, the HIV response produced “a new paradigm in the governance of disease responses” that led to one of the greatest MDG successes in the region, according to the report. By shifting from an individual, mono-sectoral, reactive, top-down approach, towards a collective, multi-sectoral, bottom-up, rights-based approach, it finds, the number of people with HIV declined an average of 20% over the last decade, and by over 50% in India, Myanmar/Burma, Nepal, Papua New Guinea and Thailand, the countries with the highest number of people living with HIV in the region.
The report argues that progress on achieving HIV targets under the MDGs provides insight for tackling other development challenges, such as environmental degradation, child and maternal health and non-communicable diseases (NCDs). It highlights democratic governance elements that characterize effective HIV responses, including strong national political leadership, decentralization, enabling legal and policy environments, and universal access and social justice principles.
The report recommends that the post-2015 framework: reference specific populations, including the disabled, elderly, and indigenous people, people with HIV, prisoners, sex workers and slum dwellers, whose needs and rights are often ignored by development efforts; and address factors that contribute to social exclusion of marginalized populations. It recommends amending the UN High-level Panel on the Post-2015 Development Agenda’s (HLP) proposed governance targets to include: stronger emphasis on marginalized populations, rather than the general public; and an access to justice target that focuses on peoples’ empowerment, rather than only legal institutions.
The report recommends that post-2015 health targets: commit to universal health care; link action to remove harmful laws and policies with positive health outcomes for poor and marginalized populations; promote strategic investment approaches that target those most affected and at risk of priority diseases; include HIV-specific targets on reducing deaths, new infections and discrimination; and promote research and development of new tools, including drugs, diagnostics and vaccines.
The report makes further recommendations on gender targets and indicators and the links between HIV and violence against women. [UNDP Press Release] [Publication: A Post-2015 Development Agenda: Lessons from the Governance of HIV Responses in Asia and the Pacific]