During the beginning of the Pandemic, the response to HIV took a medical approach. It took a short period for the scientific community and the rest of the world to realize that the issues associated with HIV and AIDS go far beyond health. This realization led to a global agreement that HIV and AIDS must be looked at as a development issue, of course with health playing a role. Many experts argue that this was the moment that changed the trajectory of the Global HIV prevalence, as the response took a development and multi-sectoral approach the world started to see remarkable success and gains in the HIV response.
Following the Heads of State and Governments Special Summit on HIV and AIDS held in Abuja in 2001, consensus was reached for national structures to be formed and to make available the necessary resources for the improvement of the comprehensive multi-sectoral response and that an appropriate and adequate portion of this amount is put at the disposal of the National Commissions/Councils for the response against HIV and AIDS.
In all countries in Africa and beyond, the national commission, councils/secretariats on HIV and AIDS are under the highest political office, usually the Office of the President. For instance, in Senegal and Guinea Bissau, it is under the Office of the Prime Minister. In Ghana, Nigeria, Malawi and Uganda it is under the Office of the President. In the United States, the Office of the National AIDS Policy, under the White House Domestic Policy Council, coordinates the implementation of the national HIV and AIDS strategy. This approach to the HIV response does not only adopt a multi-sectoral approach, it also demonstrates the highest political will to combat the disease as agreed at the Abuja Declaration.
By an Act of Parliament, the National AIDS Secretariat (NAS) which is the administrative structure of the National AIDS Council (NAC) is given the mandate to coordinate the national response to HIV and AIDS since 2001. However, it was not until 2015 that the National Assembly enacted the NAS and NAC Bill, further cementing the mandate of the NAS as the National Coordinating Authority. The NAC provides overall strategic and policy leadership and oversight of the national response to HIV. NAC was formed in 2002 and comprises representatives of the Government, PLHIV, Civil Society, the Private Sector, development partners, and academic and research institutions. The President of the Republic of the Gambia is the Chairperson of the NAC. This shows a high level of political commitment to the effective coordination and implementation of the national response to HIV and AIDS. In addition, it demonstrates efforts to achieve universal access to HIV prevention, treatment, care and support services in line with the goals and targets stipulated in the 2006 and 2011 Political Declarations on HIV and AIDS ( 1 & 2) to which The Gambia is a signatory.