What is Universal Access?

Universal access has been most commonly spoken of as access to antiretroviral treatment. However, that is only one part of the equation. Achieving universal access requires focus on poverty-related issues and injustices. This means attention to more than just medicines. Other essential aspects are adequate and accessible quality primary health care including voluntary test and counselling; income, food, water and sanitation security; and sexual and reproductive health rights. There is no way to achieve the goal of universal access by merely focusing on one aspect. How did this become the catchphrase in international policy-speak? ( see annex )

UNGASS
The General Assembly’s 2006 High Level Meeting on AIDS, held at UN headquarters from 31 May – 2 June 2006, assessed the international community's response to the epidemic as laid out in the 2001 Declaration of Commitment (the product of the 2001 UNGASS meeting). The meeting focused more on scaling up toward Universal Access by 2010, than on progress achieved toward fulfilling the commitments made in 2001. While international targets were not adopted in 2006, the UNGASS +5 Political Declaration from this meeting is the reference document for Universal Access. The Political Declaration includes a commitment to setting ambitious national targets for 2010, with interim targets for 2008 1 , and is essential in supporting countries to prioritise efforts, mobilise resources, monitor and evaluate results, and promote understanding regarding accountability. Despite the pledge to include civil society in the determination and discussion of those national targets, until now there has not been a clearly defined, inclusive process for doing so.

So what?
The majority of the world is affected by HIV and AIDS and yet remains unaware of this political commitment and the processes taking place around reaching Universal Access by 2010. Governments were asked to set targets by year-end 2006, and some are still in the process of establishing targets to submit to UNAIDS. Even in countries where targets have been set, civil society is supposed to be involved in ensuring that the targets are achieved. You can and should be involved in these processes. That is why we are hoping you will share this information with as many persons as you can.

Why?
IF WE DO NOT ALL SUPPORT UNIVERSAL ACCESS, WE CANNOT ACHIEVE IT .
Most people infected and affected by HIV and working in HIV understand the realities of the pandemic. Sharing that knowledge will make the response better and help spend money in ways that get results.
Universal access is your right - demand it.

Issues

• Integration of civil society participation has not been adequate. The time frame and process must provide for accountability. Without this, success in implementation is impossible.
• The definition of Universal Access risks becoming extremely inclusive and broad, and therefore meaningless without limited, focused measurement indicators. National targets and indicators are being set, but civil society perspectives need to be included.
• Access alone is insufficient without sustainable systems. Some economic resources are spent to increase numbers of people accessing services in the short run, but the short-term project approach is not developing, and at times undermines, long-term systems

Get involved

• Read the political declaration
• Read 2006 and 2008 UNGASS progress reports your countries prepared
• Read the guidelines for the Universal Access process produced by UNAIDS - see pages 11-12
• Talk to you civil society networks; National AIDS Council and national UNAIDS office about universal access and how you can participate
• Get more information about the National Plan your government is implementing to fight AIDS
• Insist on a broader participation of the most affected populations by UNAIDS
• Join national and regional forums taking place on this issue and present evidence at country level
• Better prepare your civil society participation in the next UNGASS review in 2008
• Ask your government to have representatives from the most affected population and civil society at the official delegation to the UN review in 2008
• Explore the ua2010.org website to find out more information about universal access and why it is important

Annex: International political commitment to UA

G8 (United States of America, France, Russian Federation, United Kingdom, Germany, Japan, Italy, Canada, and European Union representatives): At the 8 July 2005 Gleneagles Summit of G8 countries, G8 leaders pledged to increase official development assistance by around US$ 50 billion a year by 2010, committed to applying the Three Ones principles 2 in all countries, and called on UNAIDS, World Heath Organization and other multilateral bodies “to develop and implement a package for HIV prevention, treatment and care, with the aim of as close as possible to universal access to treatment for all those who need it by 2010.”

World Summit The G8 pledge was broadened at the 2005 World Summit and in the outcome document, Member States committed themselves to:
• Developing and implementing a package for HIV prevention, treatment and care with the aim of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it, including through increased resources, and working towards the elimination of stigma and discrimination, enhanced access to affordable medicines and the reduction of vulnerability of persons affected by HIV/AIDS and other health issues, in particular orphaned and vulnerable children and older persons

UN General Assembly: In December 2005, the UN GA passed a resolution entitled "Preparations for and organization of the 2006 follow-up meeting on the outcome of the twenty-sixth special session: implementation of the Declaration of Commitment on HIV/AIDS" (A/60/L.43). This resolution requested the UNAIDS Secretariat and its Cosponsors to assist in facilitating inclusive, country-driven processes, including consultations with relevant stakeholders, for scaling up HIV prevention, treatment, care and support, with the aim of coming as close as possible to the goal of universal access to treatment by 2010, for all those who need it.

At the United Nations General Assembly Special Session on HIV/AIDS May 31 – June 2, 2006, all 189 UN member-states unanimously adopted the political declaration that is associated with universal access and committed to setting national targets with civil society engagement.

UNAIDS , the Joint United Nations Programme on HIV/AIDS, was formed in 1996 and seeks to bring together the efforts and resources of ten UN organizations to the global AIDS response and endeavors to coordinate them with governments, civil society, donors, the private sector and others. UNAIDS has five focus areas: leadership and advocacy, strategic information and technical support, tracking monitoring and evaluation, and, since 2004, civil society engagement and mobilization of resources. UNAIDS cosponsors are UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO and the World Bank. Based in Geneva, the UNAIDS secretariat works on the ground in more than 75 countries world wide. UNAIDS has worked to lead the process of universal access, developing guidelines for scaling up, as well as for civil society participation. Please see www.unaids.org for more information.

1 Article 49. Commit ourselves to setting, in 2006, through inclusive, transparent processes, ambitious national targets, including interim targets for 2008 in accordance with the core indicators recommended by the Joint United Nations Programme on HIV/AIDS, that reflect the commitment of the present Declaration and the urgent need to scale up significantly towards the goal of universal access to comprehensive prevention programmes, treatment, care and support buy 2010, and to setting up and maintaining sound and rigorous monitoring and evaluation frameworks within their HIV/AIDS strategies.

2 One agreed HIV/AIDS Action Framework that provides the basis for coordinating the work of all partners. • One National AIDS Coordinating Authority, with a broad-based multisectoral mandate. • One agreed country-level Monitoring and Evaluation System