Findings

- UNGASS galvanised political action for the HIV response and resulted in:

• 130 countries developed roadmaps to achieve the UNGASS targets;
• 105 countries have set national targets to achieve Universal Access by 2010;
• considerable progress on increasing access to services including PMTCT and treatment;
• in places with conducive policies and legislation, access to services for marginalised groups is increasing

- However, if we continue with the current rate of implementation, by 2010:

• 4.6 million on treatment instead of 8.6 million in need;
• 21 million positive pregnant women receiving comprehensive ART instead of 78 million in need.

- Shadow reports highlight lack of commitment to ensure human rights and legal protections

- Official reports do not give sufficient indication whether service scale-up is translating into access for those most in need

- UNGASS presents a framework to reinforce public accountability

Challenges/Controversies

- A wide range of challenges remain at country level to achieving UNGASS and Universal Access targets

- Based on the specific example of Brazil these challenges include the social and political context to ensure human rights; access to affordable medicines; comprehensive services for PLHIV and addressing stigma and discrimination

- Country examples show that shadow reports highlight the discrepancy between official reports and the realities faced by communities

- Challenges remain to adequately reflect these additional findings in reviews and UNAIDS publications

- Despite UNGASS’ strong potential and current role in increasing accountability, challenges remain due to

• Lack of courage to openly identify shortcomings
• Current reviews do not include any analysis of the accuracy of official reports
• Current accountability mechanisms do not translate into concrete actions and consequences
• Lack of a strong accountability mechanism and shortcomings in UNAIDS’ ability to hold national governments to account