Living with our Bibi: A qualitative study of children living with grandmothers in the Nshamba area of north western Tanzania

Living with our Bibi: A qualitative study of children living with grandmothers in the Nshamba area of north western Tanzania

The present report provides an update on progress in the global AIDS response since the 2001 special session, identifies critical challenges that must be addressed and makes urgent recommendations to strengthen efforts at the global, regional and country levels.

The report is based on data supplied by countries on the complete set of core indicators developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS) to monitor implementation of the Declaration of Commitment on HIV/AIDS. Nearly 120 country progress reports have been submitted that update the data provided by countries in 2003. These have been supplemented by over 30 reports from civil society, as well as by national and global surveys and coverage estimates for specific programmatic interventions.

Five years after the 2001 special session, the available evidence underscores the great diversity among countries and regions in implementing the response envisioned in the Declaration of Commitment on HIV/AIDS. While certain countries have reached key targets and milestones for 2005 as set out in the Declaration, many countries have failed to fulfil the pledges. The central message of the present report is that a quarter of a century into the epidemic, the global AIDS response stands at a crossroads. The important progress made against AIDS since the special session — particularly in terms of greater resources, stronger national policy frameworks, wider access to treatment and prevention services and broad consensus on the principles of effective country-level action — provides a solid foundation on which to build a comprehensive full-scale response. In effect, for the first time ever the world possesses the means to begin to reverse the global epidemic. But success will require unprecedented willingness on the part of all actors in the global response to fulfil their potential, embrace new ways of working with each other and be committed to sustaining the response over the long term.

Failure to urgently strengthen the AIDS response will mean that the world will achieve neither the 2010 targets of the Declaration of Commitment nor Millennium Development Goal 6. And without major progress in tackling AIDS, global efforts to achieve the Millennium Development Goals of reducing poverty, hunger and childhood mortality will similarly fall short of agreed targets. Countries whose development is already flagging because of AIDS will continue to weaken, potentially threatening social stability and national security.