Joint UN Programme on HIV/AIDS (UNAIDS) Executive Director, Peter Piot, is attending the World Summit on Sustainable Development in Johannesburg to deliver a simple message: until HIV/AIDS is brought under control, "you can forget about sustainable development". He spoke to IRIN about the need for political leadership, and the progress being made by African countries in dealing with the epidemic. Q: The NEPAD [New Partnership for Africa's Development] and Earth Summit documents have been criticised for sidelining HIV/AIDS, it's seemingly been an uphill battle to place it on the global political agenda. Is this perhaps not an indication that UNAIDS is falling short of its goals? Why has there not been a more powerful lobby to get AIDS at the forefront? A: Yes it is, it is a weakness. For example, as far as NEPAD is concerned, we are now working with the NEPAD secretariat to see how the AIDS part can be expanded, and not only in the health section, but it must be everywhere in the document. I always give that example because it is so striking that a recovery plan for the continent makes such little mention about HIV/AIDS. So yes, we are working on it, but still we are not effective enough or not successful enough. But in this kind of context [of the summit], hopefully the text that will be coming from governments will be a better reflection of the impact of HIV/AIDS. But the African governments are doing quite well in being outspoken about HIV/AIDS, but of course they are not the most powerful ones - that is the problem. Q: You've mentioned that African and Caribbean leaders are now at the forefront of putting AIDS on the agenda, and they are more aware of the epidemic than their Western colleagues. How has this happened? A: First of all, the reality of HIV/AIDS becomes more and more striking in Africa - people are dying, there are not too many families who have not been touched by it. But I would say that secondly, the fact that we have put a lot of emphasis on the economic and developmental impacts, this is what the leaders are very concerned about. Thirdly, a number of initiatives like the OAU [Organisation of African Unity] summit in Abuja have helped. I strongly believe in what I call peer education, not only for teenagers but governments - it is far more effective when they meet together and discuss HIV/AIDS. When I come there they know what I'm going to say - so we have to identify a number of champions, such as [Nigerian President Olesegun] Obasanjo to address them. I think that the example of the [UN] Secretary-General is also a good one. When I got there [as head of UNAIDS] six years ago, there were only two African presidents speaking about it. But today almost everybody is talking, so we shouldn't focus on all the bad news, there has been some progress. For example, in this country [South Africa], we can say that the silence has been broken. We can't keep looking at all the bad news, but we have to look at global achievements as well. Q: There's still a lot of confusion about the effectiveness of prevention programmes - particularly youth campaigns. What do you think makes a successful programme? A: Well, lets focus on youth. One needs to use the culture of youth, the language, the role models and so on. The best way of getting the message across is by using the young people themselves, that's why I think within the planning phase of these campaigns, young people should be at the forefront and should have hands on involvement. Peer education, pop music, these are all very important in campaigns. But in terms of the culture, these things vary, you can't use the same campaign in Uganda and South Africa. Lovelife [an HIV/AIDS youth education campaign that encourages young South Africans to talk freely about sexual issues] is trying very hard to do that, they are getting the youth involved. But we also have to be realistic - these things don't happen overnight. Q: There have been doubts raised about the validity of Uganda having successfully lowered the rates of HIV/AIDS as much as has been claimed. Are these valid accusations? A: I think it has been critically investigated. There are two aspects to it. One is when we ask ourselves: is this real, has there been true decline in the number of people infected with HIV/AIDS? I think there is no doubt about it. Over a 10-year period in sites in Uganda, the figures have shown this - and not only sites testing pregnant women. The second question is, how has this happened? Answering this would be very useful for other communities so they can use some of the Ugandan examples. But this is more difficult to answer than the first one, but I am deeply convinced [on the success]. Q: You've said that you're looking forward to a time when political leaders will win elections based on their track record on AIDS - will this really happen? A: Well, I think it will happen. I believe that AIDS will increasingly become a major issue for people's lives. Therefore, what will people accept from politicians, from me, and from leaders? They will want to see us doing something about it. When I speak of leaders, its not only political leaders, its business, church leaders and so on, they all have responsibilities. So I think [the political impact of] AIDS is going to grow and grow. I remember a few years ago I was in Thailand, and there was a person living with HIV/AIDS addressing a conference of medical people. He said that in Thailand, if all people living with AIDS united and formed a political party, it would become the biggest political party in the country. That really made me think. So I think anything in society that is a matter of survival - like AIDS - that's what political leaders should be assessed on. It's also a responsibility for us [UNAIDS], international organisations like ours also have to be held accountable. But we shouldn't just focus on presidents and governments, all of us have to contribute. So hopefully our presence here will be about that.