2. Moving from a commodity approach: “Fund some of everything” or “Fund what is comfortable” to An Investment approach: “Fund evidenced-based activities specific to the needs of your epidemic to get better long term results at lower costs.”

4.  Six basic programmatic activities  Critical interventions that create an enabling environment for achieving maximum impact; and  Programmatic efforts in wider health and development sectors related to AIDS.  Rights-based approach to all services and policies

5.  Activities that have a direct impact on reducing HIV transmission, morbidity and mortality to be scaled up according to size of relevant affected population  Interventions that directly affect incidence, morbidity and mortality (eg. ART, MC, NSP)  Complex interventions for which there is plausible evidence (eg. behaviour change programmes)

6. Based on high level evidence of effectiveness.  Treatment, care and support  Vertical Transmission prevention  Condom procurement and distribution  Key populations programs (MSM, IDU, Sex Workers)  Male circumcision  Behavior Change programs

7. Social Enablers - make possible environments conducive for sound AIDS responses:  outreach for HIV testing  treatment literacy,  stigma reduction,  advocacy to protect human rights  monitoring of the equity and quality of programme access and results

8. Program Enablers - create demand for and help improve the performance of key interventions:  incentives for engagement in health services  methods to improve retention on ART  capacity building for community-based organizational development  strategic planning  communications infrastructure  information dissemination  efforts to improve service integration and linkages from testing to care.

9.  Health systems and multiple health issues  Gender equality efforts  Education and justice sectors  Social protection and welfare  Food security  Community systems

10.  Community-driven outreach and engagement activities that connect people facing similar issues and engage them in HIV-related interventions  Support activities to enhance quality, adherence and impact in a range of settings such as people on treatment, engaged in harm reduction or drug treatment services, or who are using sexual and reproductive health services  Advocacy, transparency and accountability efforts at country and local levels to ensure that high-quality health services are available and accessible to vulnerable populations.

12. What can we achieve? Universal Access by 2015

13.  Resource needs and returns on investment were estimated for 139 low- and middle-income countries  Estimates based on the cost of increasing from current levels of coverage in 2011 to achieve universal access target coverage levels by 2015 and maintain them thereafter. (Includes 1 st and 2 nd line treatment.)  Each of the basic programme activities in the framework was applied to relevant populations according to their demographic and epidemiological situation including the distribution of new HIV infections by mode of transmission as detailed in the literature.

14. Coverage PMTCT90% Condoms (discordant couples)60% Condoms (high risk pop)50% Sex work60% MSM programmes60% IDU programmes60% Million HIV testing320 ART (CD4 350, T4P)14

17. Outcomes Total infections averted12.2 million Infant infections averted1.9 million Life years gained29.4 million Deaths averted7.4 million

18.  Elimination of new infections in children  Sexual transmission down by half  TB deaths down by half  AIDS related maternal mortality down by half  14 million PLHIV on treatment

20. 201120152020 Basic Programs7.012.910.6 Critical Enablers5.93.43.7 Synergies with Development Sectors3.65.85.4 Total16.622.019.8

22. Cost/Returns Total additional investment (over 10 years) USD 46.5 Billion Future treatment need averted USD 40 Billion Life years gained $1,060 per life year gained