The close of 2008 marked the end of Peter Piot’s service as the executive director of the Joint United Nations Programme on HIV/AIDS. His tenure saw the global toll of HIV infections and AIDS deaths rise, yet it included many important advances against the epidemic, progress he attributes to basing policy recommendations on scientific evidence.

Piot was the founding director of UNAIDS, an agency that was born out of widespread frustration with the lack of a coordinated U.N. effort to fight the disease. “When we started, AIDS was definitely not on the world’s political agenda, and now it is,” Piot told The New York Times. In 1996, when Piot was named to lead UNAIDS, about $250 million was spent to fight AIDS in developing nations. The current figure is about $10 billion.

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The launch of UNAIDS coincided with the introduction of powerful combination drug therapies that have extended the lives of many patients. But these drugs are very expensive, and at the time, “the development agencies and the traditional public health communities were dead set against making access to treatment available in poor countries,” Piot told the Times. The task of persuading manufacturers to cut their prices in poor countries was “largely UNAIDS work until the Clinton Foundation came in and shaved off the last bits to further lower the costs,” he said.

Piot was criticized because some early UNAIDS reports inflated estimates of HIV and AIDS cases. “We were wrong,” he acknowledged, but he added that while cases were overestimated in some countries, they were underestimated in others.

Piot is credited with helping the U.N. characterize AIDS as a global security issue and making it the focus of the first General Assembly session devoted to a single health issue. He has expressed confidence in the leadership abilities of his successor and former deputy, Michel Sidibe of Mali.