This briefing paper highlights the challenges in harmonising efforts to provide universal HIV/AIDS care. The 'Three Ones' principles, set in place to make the global fight against HIV/AIDS more efficient, advocate one action framework to coordinate all partners, one national AIDS authority and one country-level monitoring and evaluation system.

But, as the report points out, limited capacity in developing countries and a lack of incentives for donors to revise their practices are barriers to implementing these principles. There are also tensions between national ownership and accountability to donors.

By looking at countries that have been most successful in fighting the disease, such as Botswana and Malawi, the report outlines the keys to improving access to HIV/AIDS care.

Empowering national leadership is vital: what is needed are national HIV/AIDS strategies that have explicit priorities, are evidence-based, and link to other development plans. The multilateral donor community also needs to improve its delivery of technical support.

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