The United States and several other wealthy nations on Sunday agreed to measures aimed at streamlining HIV/AIDS programs in developing nations so that the money they donate can be spent "efficiently and more effectively," the New York Times reports (Becker, New York Times, 4/26). Many AIDS programs have been developed "in isolation" by donors, non-governmental organizations and others, thereby subjecting governments in affected countries to "confusing and duplicative demands" to demonstrate success in each program, according to a UNAIDS release (UNAIDS release, 4/25). Officials six months ago began developing the accord to address the increasing inability of developing nations to meet donor demands. Officials from UNAIDS, the United States and other nations met on Sunday in Washington, D.C., "to take advantage of the presence of" finance and development officials who were in town for the annual meeting of the World Bank and International Monetary Fund, according to the Times (New York Times, 4/26). Donor nations and developing countries agreed to three principles, known as the "Three Ones," to help streamline the international community's response to AIDS. The principles include: one HIV/AIDS action framework to coordinate the work of all involved parties; one national AIDS authority with a "broad based multi-sector mandate"; and one country-level system to monitor and evaluate programs, according to the UNAIDS release (UNAIDS release, 4/25). The United States, Britain, Australia, Belgium, Canada, Denmark, Finland, France, Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, Norway and Sweden signed the agreement, which should be implemented within a year, according to the Times.

Reaction
"We know some of these countries are screaming for help to streamline the process and free up valuable health workers who are busy satisfying donors instead of taking care of patients. Otherwise, it is chaos," Robin Gorna, head of the HIV/AIDS policy division of Britain's aid agency, said. "What is really new is this is an agreement between the people who have the money saying that they will leave their flags and affiliations at the door and make sure the resources are spent wisely," UNAIDS Executive Director Peter Piot said. "AIDS is an emergency that requires urgent action and a new way of doing business," U.S. Global AIDS Coordinator Randall Tobias said (New York Times, 4/26). AIDS Healthcare Foundation President Michael Weinstein said that the agreement "can only speed up the dismal progress that is currently not being made in saving lives worldwide," adding, "Anything and everything that can be done to cut through the bureaucracy must be done" (AHF release, 4/26).

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