This is the text of an opinion piece about where the negotiations are at and how we believe they can be salvaged, namely through an affirmation of the 2001 Declaration and an agreement by the international community to reconvene later this year to create a plan for making good on its universal access promise.

5 years after the UN General Assembly met to decide on how to respond to the global AIDS crisis world leaders are meeting again in New York this week to review progress and renew commitment to fighting the disease.

Despite some advances since 2001, including substantially increased funding and expanded access to HIV treatment, everyone agrees that continued success requires a new and revitalised willingness on the part of governments to fulfil their promises.

The biggest and most important test of the success or failure of this week’s meeting will be a simple one, namely whether or not the UN can agree to sustain the effort to prevent more people from being infected with HIV and treat more people living with AIDS.

At last year’s G8 meeting in Scotland and World Summit in New York leaders from across the globe committed to a massive scaling up of HIV prevention, treatment and care with the aim of achieving universal access to these services by 2010.

Since then the United Nations, governments and civil society have been working on a plan to make that happen. However, despite agreeing that the proposed plan would be discussed this week at the High Level Meeting on AIDS at UN headquarters, there has been no sign of it.

The plan for achievcing universal access included six vital steps:

-          setting and supporting national priorities;

-          providing predictable funding;

-          adopting largescale measures to strengthen human resources;

-          removing barriers to affordable prevention commodities, drugs and diagnostics;

-          protecting and promoting the rights of vulnerable groups; and

-          a commitment to monitoring progress on all these fronts at the national level.

These recommendations represent a solid platform for progress in the fight against AIDS and deserve widespread support.

However, a lack of leadership, direction and forsight among member states has conspired to rob the plan of any opportunity to gather that support at the UN this week.

The G8 and World Summit, where we agreed on universal access, were global processes that secured the endorsement of the international community as a whole, both rich and poor countries, those heavily affected by HIV and AIDS and those with relatively contained HIV epidemics.

Despite these differences, governments were able to reach agreement on the urgent need to provide people living with and affected by HIV access to prevention and treatment services, wherever they live.

The outcomes of both the G8 and World Summits illustrate the potential of international cooperation. But equally the failure by the UN this week to agree on how to deliver on the promise of universal access demonstrates the inability of the international system to turn its rhetoric into reality.

It is therefore vital, both for the future fight against AIDS and to rescue any residual faith in the international system, that we turn this situation around.

Making universal access real for people living with and affected by HIV/AIDS will require an implementation plan that is unlikely to be agreed before the meeting finishes on Friday. But what the international community can agree to is the development of that plan wth essential international and national targets later this year.

The gains we have made in the global fight against AIDS have been achieved with international leadership and determination and there is no reason whatsoever that the necessary leadership and determination can not be mounted again.

In the event that the UN doesn’t make a commitment to convene again to make good on its promise of universal access to HIV prevention, treatment and care, then like minded countries, many of whom have been working for a decent outcome this week, must take the lead and deliver what was agreed at the World Summit last year.

Writing from the High Level Meeting on AIDS in New York Joseph O’Reilly argues that the UN is failing to deliver a strategy for realising universal access: the next vital step in the global fight against AIDS.