The global fight against AIDS: how adequate are the national commissions?



This article examines the response of the international community to the HIV/AIDS crisis, focusing on efforts to promote a ‘multisectoral’ approach to fighting the epidemic. It critically assesses the evolution of an ‘organizational template’, which requires developing country governments to establish stand-alone National AIDS Commissions in order to receive funding for HIV/AIDS programmes. While the World Bank, based on interpretations generated by the United Nations Joint Programme on HIV/AIDS (UNAIDS) and bilateral donors, claims that the model is derived from successful experience, an examination of evidence particularly from Uganda, Senegal and Malawi, suggests that National Commissions have not worked well and may, in fact, have contributed to weakening health sectors attempting to cope with the crisis. Copyright © 2004 John Wiley & Sons, Ltd.