Who should be the new head of UNAIDS?
Earlier this week it was reported that a short list of five people is still in the running for the Joint United Nations Programme on HIV/AIDS (UNAIDS) top job. They are South African Professor Salim Abdool Karim, Winnie Byanyima, Professor Chris Beyrer, Dr Bernard Haufiku, and Dr Sani Aliyu.
The appointment of a new Executive Director comes at a difficult time for UNAIDS. In December last year an independent inquiry was deeply critical of leadership at the UN agency, and particularly of the way in which allegations of sexual harassment was handled. As a result, the previous head of UNAIDS Michel Sidibé had to step down. Currently Gunilla Carlsson is acting in the role.
Questions have also increasingly been asked about whether we still need a UN agency focussed on HIV and AIDS. Spotlight previously reported on alleged covert plans to collapse the agency into the World Health Organisation. Whatever may or may not have become of those plans, real questions can and should be asked about what role UNAIDS should play in future, if any. The answer to this question should then inform the choice of the Executive Director, UNAIDS’ third one (excluding the acting ED). Professor Peter Piot was the first UNAIDS Executive Director, followed by Sidibé.
At a most fundamental level, UNAIDS should be an internationalist entity aimed at ensuring that HIV is eliminated as a public health threat as soon as possible. This implies a role in coordination, fundraising and diplomacy, but maybe most fundamentally in the framing of the global AIDS response.
One of the biggest blunders of the Sidibé years was the premature rhetoric about the “end of AIDS” – at a time when even UNAIDS’s own modelling suggested that we were not nearly on a trajectory to end AIDS by 2030. It seems plausible that the over-optimistic rhetoric contributed to a sense of complacency and a general perception that HIV no longer requires urgent action. The “end of AIDS” rhetoric was eventually scaled down, but not before significant damage was done.
One of the most important tasks for the new UNAIDS Executive Director would be to reframe the discourse on AIDS. This does not mean we need new spin – it means that we need a new sense of realism and seriousness. It means building a new narrative around AIDS that is firmly rooted in scientific evidence, human rights, and common decency and understanding. This will require an Executive Director who knows and understands both the dynamics of the epidemic and that of the AIDS community.
At last year’s international AIDS conference in Amsterdam much was said about what it would take to reinvigorate AIDS activism, something most seem to agree is needed. One lesson from the global AIDS response around the turn of the century is that doctors, researchers, lawyers and policymakers were all part of the AIDS movement. UNAIDS itself started as a uniquely activist UN agency – but over the years the urgency and animation has waned. For UNAIDS to justify its continued existence, as opposed to being collapsed into the WHO, it has to again become an activist agency.
Ideally, the new UNAIDS Executive Director will be someone who can bring the urgency and shared sense of activism back to the HIV response. While it is easy for candidates to say they will do this – actually doing it is another matter. While the head of UNAIDS has to be politically astute, he or she also has to be willing to step on toes when needed and to once again make HIV and AIDS a political crisis (it never stopped being a humanitarian crisis).
The new Executive Director would also have to address the very serious leadership and organisational culture problems identified in the inquiry into how allegations of sexual harassment were handled at the agency. It should go without saying that UNAIDS needs to ensure that all UNAIDS employees can safely report sexual harassment and have their allegations properly and fairly investigated by people who are independent and impartial. Given the links between gender-based violence and HIV, UNAIDS should be setting the example in this regard.
We are not in a position to definitively say which of the five candidates best meet the above criteria – and being based in South Africa we obviously know Karim better than we know the other candidates. That said, we have asked various experts and members of the AIDS community from around the world about their views on the five candidates. We have by no means conducted a scientific survey, but we have at least some sense of sentiment in the AIDS community. With those caveats out of the way, here are some observations on the five candidates:
- Winnie Byanyima, an aeronautical engineer, diplomat, freedom fighter and human rights activist, is currently heading up Oxfam and worked previously with the United Nations Development Programme. She is the only woman on the short list. She handled sexual harassment allegations at Oxfam much better than Sidibé did at UNAIDS. She has no high-level experience in HIV, and is not that well-known in the AIDS world, especially among researchers and scientists. She could potentially be a hard sell to some in the AIDS world, but is a popular choice among activists who feels she is just the person for the job – and in the current atmosphere that makes her a front-runner alongside Karim.
- Professor Salim Abdool Karim is internationally recognised to be a leading HIV researcher and clearly knows the epidemic and the HIV community well. Less well known is the role he played in strengthening and dramatically increasing funding for the South African Medical Research Council when he headed it from 2012 to 2014. Karim’s work has not focused specifically on human rights, but much of the research conducted at CAPRISA, the research organisation he heads in KwaZulu-Natal, is aimed at finding ways to help young women stay HIV negative. He was also an outspoken voice during the government’s denialist era. Based on the various conversations we’ve had, he seems to be one of the front-runners for the position.
- Professor Chris Beyrer comes with excellent HIV pedigree having previously headed up the International AIDS Society and he has both a strong biomedical and human rights background. He is a Professor of Epidemiology and like Karim, he knows and understands the HIV epidemic and AIDS community very well. Beyrer is openly gay, well-liked among most people we spoke to – but fairly or unfairly (unfairly in our view) it will probably count against him that he is North American (he was born in Switzerland to American parents, but grew up in the US). Had it not been for that, his chances would have been very good.
- Dr Bernard Haufiku, a medical doctor, is a former Minister of Health and Social Services of Namibia. He is currently the health advisor to Namibia’s deputy president. He does not have the international HIV experience and profile that Karim and Beyrer has, but is well-spoken of by those who know him. They specifically mention his record in promoting human rights and is viewed as someone who understands the need for a community-led response to HIV. His lack of experience on an international platform makes him an outsider for the position.
- Dr Sani Aliyu, a medical doctor and microbiologist, is the director general of Nigeria’s National Agency for the Control of AIDS (NACA). NACA is the country’s agency which leads and co-ordinates the response to HIV. There are estimated to be about 1,9-million people living with HIV in Nigeria. The epidemic is most prevalent among women in Nigeria. Like Bernard Haufiku, he is an outsider for the UNAIDS top job given his relative lack of international HIV experience and his limited profile in the AIDS world.
3 Responses to “Who should be the new head of UNAIDS?”
Roger Paul Kamugasha
As a global digital reporter and public health advocate, who has reported for global health with a special focus on infectious and non communicable diseases, it goes without saying that Winnie Byanyima is the sole match for this job which requires cross cutting experience given the ups & downs UNAIDS has faced in the recent months, the organization needs people like Winnie who recently dealt diligently with the Oxfam scandals and managed to put the organization back on track. Our choice in the health media fraternity is “Winnie Byanyima.”
Jeff Tshabalala
The primary attention of the new ED should be on changing the organizational culture that has promoted single, self-interest driven agendas, processes and ideas. It is important that the leadership at headquarters inspires and rewards collective contribution to the global health development vision and the repositioning of the global HIV response to that vision.
Strengthening regional support teams as facilitators and interlocutors of the global HIV response from a regional perspectives, partnerships and collaboration. Create clarity of strategic contribution, collaboration and regional connectedness to other UN agencies, RECs , other development partners and regional CSOs. Provide oversight and technical support to country offices.
Reconfigure country offices and do away with a one hat fits all structure. Restructure country offices based on national priorities, burden of disease, capacity and expertise resident in other UN agencies, USG and other partners. Ensure that postings are not rewards for “good behavior” or punishment.
Generally, strengthen the way UNAIDS works with regional partners, national governments, communities and CSOs. Make UNAIDS a learning and collaborative organization that provides strategic activism grounded on evidence from the countries and regions.
Boingotlo Gupta
UNAIDS 44TH PCB MEETING 26TH JUNE 2019 GENEVA, SWITZERLAND
Honorable Board Members and Colleagues
Please permit me to introduce myself, I am Boingotlo Gupta the Continental Chairperson of Pan African Positive Women Coalition (PAPWC) based in Botswana. Pan African Positive Women Coalition is a network of women and Adolescent Girls and young women living with HIV/AIDS in Africa. We are in all the five regions of Africa, North, Southern, East, West and Central Africa.
On behalf of my organisation, we sincerely appreciate the opportunity the PCB and management of UNAIDS to effectively continue to sponsor organisations especially ours because since the inception of our organisation in 2012 , we had a Regional Director of UNAIDS as our patron and to this day we get most of our support from UNAIDS. Your work is clearly visible in the world and your vision clear and evident as your focus to fight and End AIDS by 2030.
On behalf of my organisation as the Chairperson we elect Winnie Byanyima based on the following reasons :
As a woman, she understands impact of gender imbalances, and effects of patriotism, in relation to impact of HIV/AIDS, and how much women and girls are affected, especially that the research still shows that women and girls, LBGTI communities are the hardest hit. It is also without doubt that she has a good record of handling Sexual Harrassment allegations that were in her organisation, and we know very well that most of the countries especially in Africa are experiencing high numbers of Gender Based Violence which is identified as one of the drivers of HIV/AIDS.
She is well vested with issues of HIV/AIDS and also brings with her knowledge of NGO world, she understands that without funding and recognition of civil societies through meaningful involvement there is no response.
She is also aware of need for research and science in HIV response as key, especially introduction of new methods of medication, to address the issue of low adherence to medication by young people. She will be able to push for more choices.
Another strength is the fact that she is a human rights activists, as women living with HIV we long said that the best solution to respond to HIV is Human Rights based, that is why we are doing advocacy for Sexual Reproductive Health and Rights, and the need for Justice.