Multisectoral HIV/AIDS Approaches in Africa: How Are They Evolving?

Introduction The response to HIV/AIDS in Africa has evolved considerably since the first cases were reported on the continent in the early 1980s. After the initial medical and public health responses through the mid-1990s, there was an enormous expansion in the scope of the strategic approaches and level of political and financial commitment to fight the disease. In the absence of a vaccine or cure, the global response expanded far beyond the traditional confines of the health sector. Perceiving strong links between AIDS and the greater development processes, national and international organs reached out to a wide array of stakeholders to implement a broad multi-sectoral agenda. This expansion in vision was accompanied by a corresponding development of institutional structures and coordination mechanisms. Efforts to extend, harmonize, and improve the management of the multisectoral response are very much continuing today. Early in the new millennium, a very powerful new intervention was introduced into the arsenal against global HIV/AIDS. Already available in the developed countries, antiretroviral treatment (ART) was shown to effectively delay the progression of the disease in low-resource developing country conditions. A combination of medical advances, research, advocacy, and a very substantial upswing in donor funding allowed the global community to commit to universal access to these life-saving medications by 2010. The myriad of challenges to such a huge campaign, once seen as entirely insurmountable, is now seen as merely daunting. These major trends have resulted in an HIV/AIDS landscape characterized by high-level international commitment to combating HIV/AIDS in a coordinated,