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Official resigns from UNAIDS to "tell the truth"
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     Dr Jean-Louis Lamboray, one of the founders of UNAIDS, the joint United Nations programme on HIV/AIDS, announced his resignation from the secretariat this week because he "can't continue with an institution that doesn't make a difference."

    Dr Lamboray, a Belgian doctor, represented the World Bank in 1987 during the conception and design of UNAIDS, which is cosponsored by 10 UN organisations including the World Health Organization and the United Nations Children's Fund (Unicef). He intends to leave the organisation on 31 August.

    Although he praised some of UNAIDS work, Dr Lamboray, who has been the principal coordinator of the competence programme of UNAIDS and UNITAR (United Nations Institute for Training and Research), said that it was not doing all it should and he felt the need to leave so that he could "tell the truth." Dr Lamboray also questioned the authority and accountability of the organisation.

    Dr Lamboray told the BMJ: "UNAIDS is making efforts to coordinate work, but people at local level are out of the loop, and we're not doing all we can. We're missing out the grassroots level where people live and work, and we need to learn more from them. UNAIDS is continuing to focus on the national and global processes, and this isn't enough. I too made a mistake—I focused on commodities and money. We are more comfortable in this role."

    Dr Lamboray drew on his experiences in Phayao, northern Thailand, which saw a dramatic reduction in the proportion of young people with HIV. "What I learned was that you do need the distribution of condoms and drugs and tests, nothing substitutes for what people decide to do by themselves for themselves. They have to have a feeling of `ownership,' that they are in charge of the response from the bottom up. Being told from the top what to do and what not to do is not good enough," he said.

    Dr Peter Piot, UNAIDS Executive Director, rejected the criticism. He said that it was the first time he had heard such an accusation and described grassroots organisations as "our bread and butter." He said: "In our offices, we actually have special staff members whose job it is to bring together grass roots organisations with the government in many countries."(Deborah Cohen)