The volunteers of the International Federation of Red Cross and Red Crescent Societies were specifically recognised in the June 2001 UNGASS on AIDS Declaration.
The global AIDS response needs to move beyond that to officially acknowledge that civil society is an integral part of - rather than an 'add on' to - a country's health and development system and, as such, is a vital and full stakeholder in all coordination initiatives in relation to HIV/AIDS prevention, care, and treatment.
Since 2001 the contribution of civil society, and especially volunteers and people living with HIV/AIDS have been underutilised in the response. This waste and neglect cannot continue.
Specific steps are needed to ensure broad civil society involvement in coordination efforts - that go beyond those who currently have a voice to involve smaller, newer and more 'controversial' NGOs and community groups such as those working with injecting drug users and sex workers, as well as people living with HIV/AIDS who are women, and young.
This means developing a working practice for coordination efforts that is based on genuine, two-way respect and transparency and whereby, for example, civil society can freely ask questions of government, donors, etc, and vice versa.
It is not just a matter of recognising and respecting the role and meaningful involvement of civil society in scaling up treatment access, but maximising this involvement - including people living with HIV/AIDS and other 'key populations'. We have to see these people in the coordination efforts, including programme planning and decision-making.
WHO's "treatment literacy" initiative with treatment activists is to be commended, but the investment needs to go much further than this, to routine investment in community level activists, carers and particularly PLWHA. The level of the health system that operates beyond the clinic door, in the home and community, should be prioritised for development as it is extremely cost effective.
3 x 5 offers a chance to redefine the health care process but it is not just a matter of shifting tasks from doctors to nurses and health workers, but also a matter of recognising that PLWHA themselves are a key human resource in their own care and treatment. Empower and educate PLWHA to be at the centre of their own care, and we will see long term motivation and compliance with the treatment.
3 x 5 will deliver to half those who need treatment. The International Federation advocates for the most vulnerable and we know that even 50% coverage means the poor and vulnerable are the ones who will die.
The International Federation wants to see universal coverage - we can no longer tolerate a world where people are left to die simply for the want of basic treatment.
Methadone is also a basic treatment, and must be included immediately on the WHO essential drugs list as an important component of harm reduction programming.