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After two decades of experience, a great deal has been learned about how to respond to the global HIV/AIDS crisis. The challenge is not in identifying how to respond, but rather how to marshall the political and financial commitments needed to implement effective responses.

In the poorest countries of the world, approximately $2 billion is spent annually on HIV/AIDS prevention, treatment and care. In preparation of the Special Session, the United Nations assembled experts to estimate global resource requirements needed to reverse the spread of the epidemic and mitigate its impact. According to these experts, annual expenditures of more than $9 billion are needed on a sustained basis. More than half of these resources are needed for prevention efforts, and half for treatment and care.

The UN Secretary-General, Kofi Annan, has proposed creation of a special international fund dedicated to HIV/AIDS and related health concerns. Negotiations leading up to the UN Special Session have pointed towards an independent fund, governed by a Board of Directors drawing from the public and private sectors. Resources dedicated to the fund would be used primarily for HIV/AIDS prevention efforts. In addition, as much as 25% of the fund would be used for prevention and treatment of malaria and tuberculosis, one of the opportunisitic infections that causes AIDS deaths. The United States and France have formally pledged initial contributions to the fund.

At the Special Session, the political and financial commitments made by world leaders, and the final arrangement regarding administration of the fund will be among the most closely watched issues.