AIDS: Ushering in a new era of shared responsibility for global health

For the first time since AIDS erupted as worldwide emergency, global leaders, the scientific community, activists and people living with HIV are venturing to speak about the end to the pandemic. Signs of hope abound: over 8 million people are receiving life-saving treatment, the number of new infections is on significant decline, the remarkable evidence of treatment’s impact on preventing new infections and the aspiration of zero new HIV infections among children is firmly within grasp. This progress, won by people living with HIV and countries with support from partners such as the US programme PEPFAR, the Clinton Health Access Initiative and untold more, embodies global solidarity to bring about an AIDS-free generation.Yet, despite efforts made by countries, donor agencies and countless other global health initiatives as well as a series of ambitious commitments made by the international community in the 2011 Political Declaration on HIV/AIDS to be met by 2015 [1] – including among others to: (1) reduce sexual transmission by 50%; (2) eliminate new infections among children and reduce AIDS-related maternal deaths; (3) reach 15 million people with life-saving antiretroviral treatment; (4) reduce TB deaths among people living with HIV by 50 %; and (4)mobilise resources to meet the estimated annual investment need of US$ 22–24 billion-much remains to be done. The number of new infections continues to outpace the number of people newly accessing treatment [2]. The availability of appropriate formulations of medicines to treat children living with HIV is sorely lacking. Added to this, international financing for HIV has not increased since 2008. In part, this reflects the emergence of a new set of global challenges and priorities and in part, concerns held by those in the global North and South about how best to finance AIDS on a more sustainable basis (many national responses, particularly in Africa, are overwhelmingly dependent on external resources). This paradox of