World Bank and UNAIDS meeting on structural drivers of HIV and poverty

Social drivers to end AIDS and extreme poverty: High-level meeting

01 February 2014
Annie Holmes

The World Bank and UNAIDS convened a high-level meeting on structural action to prevent HIV and alleviate poverty.

Opened by World Bank President Jim Yong Kim, the 9 January 2014 meeting in Washington, DC included Michel Sidibe of UNAIDS, Helen Clark of UNDP, Tony Fauci of NIH (the US National Institutes of Health) and Darren Walker of the Ford Foundation. The gathering committed to a joint agenda to eliminate both extreme poverty and the HIV epidemic by 2030.


Despite unprecedented progress over the past decade in the global response to HIV, economic inequality, social marginalization and other structural factors have continued to fuel the HIV epidemic. The epidemic continues to undermine efforts to reduce poverty and marginalization. HIV deepens poverty, exacerbates social and economic inequalities, diminishes opportunities for economic and social advancement and causes profound human hardship.

The World Bank and UNAIDS Press Release, 15 January 2014

Several participants cited the series of papers produced by STRIVE and AIDSTAR-One on structural approaches to HIV prevention, and copies were distributed at the meeting. Michael Samson of EPRI (the Economic Policy Research Institute, South Africa) also drew on STRIVE's causal pathways model in his presentation on 'Structural drivers and interventions: State of the evidence and barriers to action'.

To address structural drivers including gender inequality, stigma and discrimination, lack of access to education and unstable livelihoods, the meeting advocated:

  • aligning health and development efforts around country-led time-bound goals towards ending extreme poverty and AIDS
  • urging the post-2015 development agenda to include targets towards ending AIDS alongside the goal of universal health coverage
  • promoting national and global monitoring and implementation research
  • convening two high-level meetings in 2014 with national policy leaders and experts on ending AIDS and extreme poverty

Social protection schemes and cash transfers have been the focus of much attention, particularly given the findings on a cash transfer programme in Malawi. Analysis by STRIVE researchers shows the potential of cash transfer schemes, such as the one in Zomba, to achieve a range of development outcomes. At the Washington meeting, as generally, opinions differed on the way such mechanisms can and should be interpreted:

  • as a means to incentivise particular behaviours, or
  • as a poverty-alleviation strategy, to reduce inequalities

This debate among others will be continued at the next meeting around the joint HIV/poverty agenda, planned for July 2014 during the International AIDS Conference in Melbourne. Meanwhile, the Washington meeting marked a significant point for the future of the HIV field. The intersection of HIV transmission and the social conditions of people's lives is now officially acknowledged.

Just as money alone is insufficient to end poverty, science is powerless to defeat AIDS unless we tackle the underlying social and structural factors.

Jim Yong Kim, President of the World Bank Group