The "AIDS and MDGs" approach: what is it, why does it matter, and how do we take it forward?

Progress towards the Millennium Development Goals (MDGs) has been mixed, and many observers have noted the tendency for development actors to address individual MDGs largely in isolation from one another. This in turn has resulted in missed opportunities to catalyse greater interdisciplinary collaboration and innovation towards MDG achievement. The term 'AIDS and MDGs' is gaining currency as an approach that aims to explore, strengthen and leverage the links between AIDS and other health and development issues. Drawing from academic literature and from MDG country reports, this article sets out three important pillars to an AIDS and MDGs approach: 1) understanding how AIDS and the other MDGs affect one another; 2) documenting and exchanging lessons learned across MDGs; and 3) creating cross- MDG synergy. We propose broader policy level implications for this approach and how UNDP and other partners can take this agenda forward. Because the MDGs explicitly locate HIV within a broader international commitment to human development targets, they provide a critical platform for development partners to galvanise resources, political will and momentum behind a broader, systematic and structural approach to HIV, health and development.

The history and challenge of HIV prevention.

The HIV/AIDS pandemic has become part of the contemporary global landscape. Few predicted its effect on mortality and morbidity or its devastating social and economic consequences, particularly in sub-Saharan Africa. Successful responses have addressed sensitive social factors surrounding HIV prevention, such as sexual behaviour, drug use, and gender equalities, countered stigma and discrimination, and mobilised affected communities; but such responses have been few and far between. Only in recent years has the international response to HIV prevention gathered momentum, mainly due to the availability of treatment with antiretroviral drugs, the recognition that the pandemic has both development and security implications, and a substantial increase in financial resources brought about by new funders and funding mechanisms. We now require an urgent and revitalised global movement for HIV prevention that supports a combination of behavioural, structural, and biomedical approaches and is based on scientifically derived evidence and the wisdom and ownership of communities.

Ensuring sexual and reproductive health for people living with HIV: an overview of key human rights, policy and health systems issues.

Despite rhetorical attention there is little programmatic guidance as to how best to ensure that women and men living with HIV have access to sexual and reproductive health services that help them realise their reproductive goals, while ensuring their human rights. A dynamic relationship exists between the manner in which health services and programmes are delivered, and the individuals who seek these services. A review of the literature shows clear gaps and highlights areas of concern not yet sufficiently addressed. The delivery and use of health services and programmes is shaped by the underlying determinants of people's access to and use of these services, the health systems in place at community and country level, and the legal and policy environment these systems operate in. Few governments can provide the full range of services that might be required by their populations. In most places, people access health services from a variety of formal and informal providers, and health-related behaviour is influenced from many directions. The synergistic roles of health systems, law and policy and underlying social determinants in helping or hindering the development and delivery of adequate programmes and services for HIV positive people must be addressed.