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Health expert calls for end to UN HIV programme

09/05/2008

The joint United Nations programme on HIV and Aids should be "closed down rapidly", according to a health management expert.

Roger England, chairman of Health Systems Workshop - an independent advisory group on health management in poor countries - says UNAids should be disbanded as its mandate is "wrong and harmful".

Launched in 1996, UNAids is based in Switzerland and works in more than 80 countries worldwide against the spread of HIV and Aids.

Writing in the British Medical Journal (BMJ), Mr England says the agency was set up on the argument that HIV and its impact are exceptional.

But he writes that this argument is no longer valid and says the claims HIV needs its own body as it can tip households into poverty would also apply to all serious diseases and disasters.

"HIV is a major disease in southern Africa, but it is not a global catastrophe, and language from a top UNAids official that describes it as 'one of the make-or-break forces of this century' and a 'potential threat to the survival and well-being of people worldwide' is sensationalist," Mr England said.

"Worldwide the number of deaths from HIV each year is about the same as that among children aged under five years in India."

He argues that "far too much is spent on HIV relative to other needs and that this is damaging health systems".

His estimates claim HIV causes 3.7 per cent of mortality but receives a quarter of international healthcare aid and a "big chunk" of domestic expenditure.

"HIV exceptionalism is dead - and the writing is on the wall for UNAIDS," Mr England said.

"Why a UN agency for HIV and not for pneumonia or diabetes, which both kill more people?"

He added: "UNAids should be closed down rapidly, not because it has performed badly given its mandate, which it has not, but because its mandate is wrong and harmful.

"Its technical functions should be refitted into [the World Health Organisation], to be balanced with those for other diseases."