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Figure 2008 Report on the global AIDS epidemic Selected events in the global response to the epidemicUniversalAccessTargets 2001 2006 20082015 MillenniumDevelopmentGoals.

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Presentation on theme: "Figure 2008 Report on the global AIDS epidemic Selected events in the global response to the epidemicUniversalAccessTargets 2001 2006 20082015 MillenniumDevelopmentGoals."— Presentation transcript:

1 Figure 2008 Report on the global AIDS epidemic Selected events in the global response to the epidemicUniversalAccessTargets MillenniumDevelopmentGoals Member States submit UNGASS Country Progress Reports Millennium Declaration and launch of the Millennium development goals UN General Assembly Political declaration on Universal Access to Prevention, Treatment, Care and Support G8 commitment to Universal Access to Treatment UN General Assembly Special Session on HIV/AIDS (UNGASS) Member States signed the Declaration of Commitment Core indicators for monitoring the Declaration of Commitment on HIV/AIDS developed First International AIDS Conference held in Atlanta, United States Global Programme on AIDS launched by WHO Midway to Millennium Development Goals 1.1

2 Table 2008 Report on the global AIDS epidemic National indicators for the implementation of the Declaration of Commitment on HIV/AIDS 1a National Indicators National Commitment and Action 1Domestic and international AIDS spending by categories and financing sources 2National Composite Policy Index (Areas covered: gender, workplace programmes, stigma and discrimination, prevention, care and support, human rights, civil society involvement, and monitoring and evaluation) National Programmes (Blood safety, antiretroviral therapy coverage, prevention of mother-to-child transmission, co-management of TB and HIV treatment, HIV testing, prevention programmes, services for orphans and vulnerable children, and education) 3Percentage of donated blood units screened for HIV in a quality assured manner 4Percentage of adults and children with advanced HIV infection receiving antiretroviral therapy 5Percentage of HIV-positive pregnant women who received antiretrovirals to reduce the risk of mother-to-child transmission 6Percentage of estimated HIV-positive incident TB cases that received treatment for TB and HIV 7Percentage of women and men aged who received an HIV test in the last 12 months and who know their results 8Percentage of most-at-risk populations that have received an HIV test in the last 12 months and who know their results 9Percentage of most-at-risk populations reached with HIV prevention programmes 10Percentage of orphaned and vulnerable children aged 0–17 whose households received free basic external support in caring for the child 11Percentage of schools that provided life skills-based HIV education in the last academic year FIRST OF 2 PARTS:

3 Table 2008 Report on the global AIDS epidemic National indicators for the implementation of the Declaration of Commitment on HIV/AIDS 1b National Indicators Knowledge and Behaviour 12Current school attendance among orphans and among non-orphans aged 10–14* 13Percentage of young women and men aged 15–24 who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission* 14Percentage of most-at-risk populations who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission 15Percentage of young women and men aged 15–24 who have had sexual intercourse before the age of 15 16Percentage of women and men aged 15–49 who have had sexual intercourse with more than one partner in the last 12 months 17Percentage of women and men aged 15–49 who had more than one sexual partner in the past 12 months reporting the use of a condom during their last sexual intercourse* 18Percentage of female and male sex workers reporting the use of a condom with their most recent client 19Percentage of men reporting the use of a condom the last time they had anal sex with a male partner 20Percentage of injecting drug users reporting the use of a condom the last time they had sexual intercourse 21Percentage of injecting drug users reporting the use of sterile injecting equipment the last time they injected Impact 22Percentage of young women and men aged 15–24 who are HIV infected* 23Percentage of most-at-risk populations who are HIV infected 24Percentage of adults and children with HIV known to be on treatment 12 months after initiation of antiretroviral therapy 25Percentage of infants born to HIV-infected mothers who are infected * Millennium Development Goals indicator LAST OF 2 PARTS:

4 Figure 2008 Report on the global AIDS epidemic Percentage of UN member states reporting by region, 2004– (total number of UN Member States in the region) 2004 (102/189) 2006 (122/191) 2008 (147/192) Year of reporting (UN Member States reporting/total number of UN Member States) Caribbean (13) East Asia (5) Eastern Europe and Central Asia (19) Latin America (20) North Africa and Middle East (20) North America (2) Oceania (14) South and South- East Asia (20) Sub- Saharan Africa (47) Western and Central Europe (32) % Source: UNGASS Country Progress Reports 2008.

5 Figure 2008 Report on the global AIDS epidemic Percentage of countries with Monitoring and Evaluation components in place, 2005 and One national Monitoring and Evaluation plan is available The Monitoring and Evaluation plan is endorsed by key partners The Monitoring and Evaluation plan has associated budget Funding of Monitoring and Evaluation is secured A functional National Monitoring and Evaluation unit is present A central HIV database is present Percentage of countries (%) Source: UNGASS Country Progress Reports

6 Figure 2008 Report on the global AIDS epidemic Global trends in monitoring and evaluation system strengthening, 2005 and basic elements* in place one or more basic elements* missing no trend data available * One national monitoring and evaluation plan including budgetary requirements and with funding secured; a functional national monitoring and evaluation unit and/or monitoring and evaluation working group; a central national HIV database. Source: UNGASS Country Reports 2006, 2008.

7 Figure 2008 Report on the global AIDS epidemic Selected events in tracking the epidemic Midway to Millennium Development Goals First Reference Group on Estimates, Modelling and Projections meeting First global series of regional training workshops on estimation methods for national epidemics Guidelines on second generation HIV surveillance As of 2007, 31 countries have conducted population-based surveys with HIV prevalence measurement The first HIV antibody test becomes available UN General Assembly Special Session on HIV/AIDS June 2001/ 189 Member States signed the Declaration of Commitment First Demographic and Health Surveys with HIV prevalence measurement in Mali and Zambia Global Programme on AIDS launched by WHO 1987 UniversalAccessTargets MillenniumDevelopmentGoals

8 Figure 2008 Report on the global AIDS epidemic A global view of HIV infection 33 million people [30–36 million] living with HIV,

9 Table 2008 Report on the global AIDS epidemic 2a COUNTRY Time period for which prevalence data were available Prevalence trend a Percent of young people (15–19 years) having had sex before age 15 b Proportion having sex with more than one partner in the last 12 months c Condom use during last sex among those with more than one partner in the last 12 months d FemalesMalesFemalesMalesFemalesMalesFemalesMales ANGOLA a ID BAHAMAS BENIN b 2000–2006 * * * BOTSWANA 2001–2006 * * BURKINA FASO 2000–2006 * * * * * * BURUNDI 1999–2004 * CAMEROON a ID * * * * * * CENTRAL AFRICAN REPUBLIC b CHAD a ID * * CONGO a ID CÔTE dIVOIRE 2000–2004 * ID * * * * DEMOCRATIC REPUBLIC OF THE CONGO a ID Analysis of trends among 15–24-year-olds in high prevalence countries (all countries with national prevalence that exceeded 3% and 4 additional countries in Africa with notable prevalence levels): HIV prevalence among pregnant women (2000–2007) in sentinel surveillance systems, and selected sexual behaviours among women and men (1990 – 2007) from national surveys NOTES: [1] Highlighted cells indicate positive trends in prevalence or behaviour. [2]* Consistent sites only were used in the analysis of change in HIV prevalence over time, for a minimum of three years. Significance test based on H 0 : slope =0 LEGEND: [ a ] Prevalence obtained from pregnant women attending antenatal clinics in selected. [ b ] Among 15–19 years olds, proportion reported having had sex by age 15. Analyses based on DHS, MICS or national surveys conducted between 1990 and [ c ] Among 15–24 years olds, proportion reported having had sex with more than one partner in the last 12 months. Analyses based on data from repeat DHS or national surveys conducted between 1990 and [ d ] Among 15–24 years olds, proportion of those with more than one partner reporting having used a condom the last time they had sex. Analyses based on data from repeat DHS or national surveys conducted between 1990 and [ ] Observed increase in HIV prevalence or behaviour. [ ] Observed decrease in HIV prevalence or behaviour. [ * ] Statistically significant decrease in HIV prevalence of more than 25% or significant decrease in measured behavioural indicator. Analysis of prevalence based on regression analysis; analysis of behaviour based on Chi-square or Chi-square test for trend. [ * ] Statistically significant increase in measured behavioural indicator. Analysis of behaviour based on Chi-square or Chi-square test for trend. [] No evidence of change. [ID] Insufficient data, i.e. less than three years of data received. FIRST OF 3 PARTS:

10 Table 2008 Report on the global AIDS epidemic 2b COUNTRY Time period for which prevalence data were available Prevalence trend a Percent of young people (15–19 years) having had sex before age 15 b Proportion having sex with more than one partner in the last 12 months c Condom use during last sex among those with more than one partner in the last 12 months d FemalesMalesFemalesMalesFemalesMalesFemalesMales DJIBOUTI b ETHIOPIA b * * * * GABON b GAMBIA b GHANA b * * * HAITI b * * * KENYA 2000–2005 * * * * * LESOTHO a 2003–2007 LIBERIA b MALAWI e 1999–2005 * * * * MOZAMBIQUE f 2000–2007 * NAMIBIA 2002–2006 * * * Analysis of trends among 15–24-year-olds in high prevalence countries (all countries with national prevalence that exceeded 3% and 4 additional countries in Africa with notable prevalence levels): HIV prevalence among pregnant women (2000–2007) in sentinel surveillance systems, and selected sexual behaviours among women and men (1990 – 2007) from national surveys NOTES: [1] Highlighted cells indicate positive trends in prevalence or behaviour. [2]* Consistent sites only were used in the analysis of change in HIV prevalence over time, for a minimum of three years. Significance test based on H 0 : slope =0 LEGEND: [ a ] Prevalence obtained from pregnant women attending antenatal clinics in selected. [ b ] Among 15–19 years olds, proportion reported having had sex by age 15. Analyses based on DHS, MICS or national surveys conducted between 1990 and [ c ] Among 15–24 years olds, proportion reported having had sex with more than one partner in the last 12 months. Analyses based on data from repeat DHS or national surveys conducted between 1990 and [ d ] Among 15–24 years olds, proportion of those with more than one partner reporting having used a condom the last time they had sex. Analyses based on data from repeat DHS or national surveys conducted between 1990 and [ ] Observed increase in HIV prevalence or behaviour. [ ] Observed decrease in HIV prevalence or behaviour. [ * ] Statistically significant decrease in HIV prevalence of more than 25% or significant decrease in measured behavioural indicator. Analysis of prevalence based on regression analysis; analysis of behaviour based on Chi-square or Chi-square test for trend. [ * ] Statistically significant increase in measured behavioural indicator. Analysis of behaviour based on Chi-square or Chi-square test for trend. [] No evidence of change. [ e ] Semi-urban and urban areas were combined in analysis of urban data. [ f ] Analysis in Mozambique combined for South, North and Central. SECOND OF 3 PARTS:

11 Table 2008 Report on the global AIDS epidemic 2c COUNTRY Time period for which prevalence data were available Prevalence trend a Percent of young people (15–19 years) having had sex before age 15 b Proportion having sex with more than one partner in the last 12 months c Condom use during last sex among those with more than one partner in the last 12 months d FemalesMalesFemalesMalesFemalesMalesFemalesMales NIGERIA a RWANDA 1998–2003 ND * * * SIERRA LEONE a ID SOUTH AFRICA g 2000–2006 * SUDAN a SWAZILAND 2002–2006 TOGO a UGANDA b * * * UNITED REPUBLIC OF TANZANIA 2000–2006 * * * * * ZAMBIA h 1998–2004 * * * * ZIMBABWE 2000–2004 * * * * Analysis of trends among 15–24-year-olds in high prevalence countries (all countries with national prevalence that exceeded 3% and 4 additional countries in Africa with notable prevalence levels): HIV prevalence among pregnant women (2000–2007) in sentinel surveillance systems, and selected sexual behaviours among women and men (1990 – 2007) from national surveys NOTES: [1] Highlighted cells indicate positive trends in prevalence or behaviour. [2]* Consistent sites only were used in the analysis of change in HIV prevalence over time, for a minimum of three years. Significance test based on H 0 : slope =0 LEGEND: [ a ] Prevalence obtained from pregnant women attending antenatal clinics in selected. [ b ] Among 15–19 years olds, proportion reported having had sex by age 15. Analyses based on DHS, MICS or national surveys conducted between 1990 and [ c ] Among 15–24 years olds, proportion reported having had sex with more than one partner in the last 12 months. Analyses based on data from repeat DHS or national surveys conducted between 1990 and [ d ] Among 15–24 years olds, proportion of those with more than one partner reporting having used a condom the last time they had sex. Analyses based on data from repeat DHS or national surveys conducted between 1990 and [ ] Observed increase in HIV prevalence or behaviour. [ ] Observed decrease in HIV prevalence or behaviour. [ * ] Statistically significant decrease in HIV prevalence of more than 25% or significant decrease in measured behavioural indicator. Analysis of prevalence based on regression analysis; analysis of behaviour based on Chi-square or Chi-square test for trend. [ * ] Statistically significant increase in measured behavioural indicator. Analysis of behaviour based on Chi-square or Chi-square test for trend. [] No evidence of change. [ID] Insufficient data, i.e. less than three years of data received. [ND] Data not received. [ g ] No data received in response to working group process; analyses based on data in South Africa surveillance report. [ h ] No data received in response to working group process; analyses based on data reported in Zambia 2005 surveillance report. Analysis based on urban and rural data combined. LAST OF 3 PARTS:

12 Figure 2008 Report on the global AIDS epidemic

13 Figure 2008 Report on the global AIDS epidemic Percent of adults (15+) living with HIV who are female 1990–

14 Figure 2008 Report on the global AIDS epidemic Children living with HIV globally, 1990–

15 Figure 2008 Report on the global AIDS epidemic New HIV infections among children, 1990–

16 Figure 2008 Report on the global AIDS epidemic Child deaths due to AIDS, 1990–

17 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in Africa,

18 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) among pregnant women attending antenatal clinics in sub-Saharan Africa, 1997–2007 NOTE: Analysis restricted to consistent surveillance sites for all countries except South Africa (by province) and Swaziland (by region) Southern Africa Median HIV prevalence (%) 50 Botswana Lesotho Mozambique Namibia South Africa Swaziland Zimbabwe 1997– – West Africa Median HIV prevalence (%) Median HIV prevalence (%) Eastern Africa 1997– – – – Ethiopia Kenya Burkina Faso Côte d'Ivoire Ghana Senegal 2.9 Source: National surveillance reports and UNAIDS/WHO/UNICEF, Epidemiological Fact Sheets on HIV and AIDS. July 2008.

19 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) among 15–24 years old, by sex, selected countries, 2005– % HIV prevalence Swaziland South Africa Zimbabwe Central African Republic Côte d'Ivoire Sierra Leone Rwanda Haiti Guinea Ethiopia Benin DR Congo Niger Senegal Cambodia India Uganda Chad Dominican Republic Mali Female Male 2.10 Source: Demographic and Health Surveys and other national population-based surveys with HIV testing.

20 Figure 2008 Report on the global AIDS epidemic Life expectancy at birth, selected regions, 1950–1955 to 2005– Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision,

21 Figure 2008 Report on the global AIDS epidemic Changes in population structure: Ghana and Lesotho 2.12 Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision,

22 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in Asia,

23 Figure 2008 Report on the global AIDS epidemic HIV prevalence among injecting drug users, men having sex with men, and female sex workers in Pakistan, 2004– a Injecting drug users % Karachi SukkerHyderabad Faisalabad Sargodha RawalpindiLarkana Lahore Quetta Peshawar Source: Ministry of Health Pakistan. HIV Second Generation Surveillance in Pakistan, National Report Rounds I and II. FIRST OF 3 PARTS:

24 Figure 2008 Report on the global AIDS epidemic HIV prevalence among injecting drug users, men having sex with men, and female sex workers in Pakistan, 2004– b Men having sex with men % 20 Karachi Sukker Larkana Hyderabad FaislabadSargodhaLahoreQuettaPeshawar Male sex workersHijras *Cities with single or multiple years 0% HIV prevalence: Sukker (MSW: 2005, 2006); Hyderabad (MSW: 2005); Rawalpindi (MSW & Hijras: 2004, 2005, 2006); Lahore (MSW: 2004, 2005, 2006); and, Quetta (MSW: 2004, 2005, 2006) Source: Ministry of Health Pakistan. HIV Second Generation Surveillance in Pakistan, National Report Rounds I and II. SECOND OF 3 PARTS:

25 Figure 2008 Report on the global AIDS epidemic HIV prevalence among injecting drug users, men having sex with men, and female sex workers in Pakistan, 2004– c Female sex workers % 5 KarachiQuettaLahoreSukkerHyderabad *Cities with single or multiple years 0% HIV prevalence: Larkana (2006); Faisalabad (2005, 2006); Sargodha (2005, 2006); Rawalpindi (2004, 2005, 2006); and Peshawar (2005, 2006) Source: Ministry of Health Pakistan. HIV Second Generation Surveillance in Pakistan, National Report Rounds I and II. LAST OF 3 PARTS:

26 Figure 2008 Report on the global AIDS epidemic

27 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in Eastern Europe and Central Asia,

28 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in the Caribbean,

29 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in Latin America,

30 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in North America, Western and Central Europe,

31 Figure 2008 Report on the global AIDS epidemic

32 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in Middle East and North Africa,

33 Figure 2008 Report on the global AIDS epidemic HIV prevalence (%) in adults (15–49) in Oceania,

34 Figure 2008 Report on the global AIDS epidemic Annual diagnoses of HIV infection and AIDS in Australia 1981– AIDS diagnosesHIV diagnoses Year Number of diagnoses Source: National Centre in HIV Epidemiology and Clinical Research, Data available at

35 Figure 2008 Report on the global AIDS epidemic Selected events related to social determinants of the HIV epidemic Establishment of UN Secretary Generals Task Force on Women, Girls and AIDS Creation of the Global Coalition on Women and AIDS 3rd international consultation on HIV and Human Rights makes first call for universal access to prevention, treatment care and support UN General Assembly Declaration of Commitment on HIV/AIDS recognises human rights as essential element in the global response Over 100 country and regional consultations identified stigma, discrimination and gender inequality as major barriers to universal access 1st Global Parliamentary Meeting on AIDS calls for rights-based response to the epidemic and end to HIV- related travel restrictions Paris meeting establishing the Greater Involvement of People with AIDS (GIPA) principle 1994 UniversalAccessTargets MillenniumDevelopmentGoals Midway to Millennium Development Goals UN General Assembly Special Session on HIV/AIDS June 2001/ 189 Member States signed the Declaration of Commitment Tools for measuring gender inequitable norms and HIV related stigma established 3.1

36 Figure 2008 Report on the global AIDS epidemic Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) Middle East (4) North America (1) Oceania (7) South and South- East Asia (13) Sub- Saharan Africa (41) Western and Central Europe (14) Percentage of countries (%) Women are addressed as a specific component of multisectoral HIV strategy Women are addressed as a specific component of multisectoral HIV strategy with a budget Percentage of countries in regions reporting that women are addressed as a specific component of their multisectoral HIV strategy with a specific HIV budget for their activities 3.2 Source: UNGASS Country Progress Reports (Number of countries reporting)

37 Figure 2008 Report on the global AIDS epidemic Percentage of countries (by region) reporting policies in place to ensure equal access to HIV prevention, treatment, care, and support for women and men 3.3 Caribbean (12) East Asia (3) Europe (30) Latin America (19) Middle East (4) Oceania (7) South Asia (13) Sub- Saharan Africa (41) Percentage of countries (%) Source: UNGASS Country Progress Reports (Number of countries reporting)

38 Figure 2008 Report on the global AIDS epidemic Index of policies related to womens vulnerability to HIV Eastern Europe and Central Asia Latin America Oceania Middle East Caribbean South and South-East Asia East Asia Sub-Saharan Africa Scale of (0–14) Source: UNGASS Country Progress Reports 2008.

39 Figure 2008 Report on the global AIDS epidemic Percentage of countries (by region) reporting programmes designed to change societal attitudes of stigmatization associated with HIV and/or using indicators for reduction of HIV-related stigma and discrimination 3.5 Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) Middle East (4) North America (1) Oceania (7) South and South- East Asia (13) Sub- Saharan Africa (41) Western and Central Europe (13) Percentage of countries (%) Countries reporting programmes designed to change societal attitudes of stigmatization associated with HIV and AIDS Countries reporting using performance indicators or benchmarks for reduction of HV-related stigma and discrimination Source: UNGASS Country Progress Reports (Number of countries reporting)

40 Figure 2008 Report on the global AIDS epidemic Percentage of countries (by region) reporting legal protections against discrimination and relevant mechanisms 3.6 Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) Middle East (4) North America (1) Oceania (7) South and South- East Asia (13) Sub- Saharan Africa (41) Western and Central Europe (13) Percentage of countries (%) Report laws or regulations protecting people living with HIV against discrimination Report mechanisms to report, document and address cases of discrimination against people living with HIV and/or most-at- risk populations Source: UNGASS Country Progress Reports (Number of countries reporting)

41 Figure 2008 Report on the global AIDS epidemic Median percentage of population reached with HIV prevention services within the specified legal environment Sex workers (N=42) Injecting drug users (N=17) Men having sex with men (N=28) Median percentage of population reached with HIV prevention services (UNGASS indicator 9) Countries reporting having non- discrimination laws/regulations with protection for this population Countries reporting NOT having non- discrimination laws/regulations with protection for this population Source: UNGASS Country Progress Reports

42 Figure 2008 Report on the global AIDS epidemic HIV Prevalence by wealth status: men 3.8 Burkina Faso LesothoKenyaMalawiGhanaCameroonUR Tanzania Uganda HIV prevalence (%) WEALTH QUINTILE Source: Mishra V, Bignami-Van Assche S, Greener R, Vaessen M, Hong R, Ghys P, Boerma T, Van Assche A,Khan S, Rutstein S, HIV infection does not disproportionately affect the poorer in sub-Saharan Africa, 2007,AIDS, Vol 21 Supplement 7, November 2007.

43 Figure 2008 Report on the global AIDS epidemic Selected events related to HIV prevention UN General Assembly Declaration of Commitment: prevention is the mainstay of the AIDS response Prevention of Mother to Child Transmission (PMTCT) found to be effective in resource-poor settings and recommended for implementation globally First Male circumcision trial, Orange Farm, South Africa Global comprehensive prevention policy established Treatment Action Campaign in South Africa supports mass marches for prevention Universal Access to Prevention endorsed by UN General Assembly 1982– Gay community responses organized in many developed countries 34% of HIV-positive pregnant women are receiving antiretrovirals for PMTCT 40% of young males and 36% of young females have accurate knowledge about HIV prevention UniversalAccessTargets MillenniumDevelopmentGoals Midway to Millennium Development Goals UN General Assembly Special Session on HIV/AIDS June 2001/ 189 Member States signed the Declaration of Commitment Needle exchange programmes to reduce HIV transmission begin in Britain, Australia, Netherlands Thailand introduces 100% condom use programme nationally 4.1

44 Figure 2008 Report on the global AIDS epidemic Namibia:HIV related knowledge and behaviour in the general population, 2000– FemaleMaleFemaleMale Female Male (%) Tested for HIV in last 12 months (15–49 year olds) Condom use (15–49 year olds) Sex with >1 partner in last 12 months (15–49 year olds) Comprehensive knowledge (15–24 year olds) Sex before age 15 (15–24 year olds) Source: Namibia Country Progress Report 2008.

45 Figure 2008 Report on the global AIDS epidemic Comprehensive knowledge of HIV among young people (ages 15–24), 1999– – – % Year Male Female 2005 Target 2010 Target Source: MEASURE DHS (2008) 4.3

46 Figure 2008 Report on the global AIDS epidemic Comprehensive knowledge of HIV among young people, by type of question 4.4 MalesFemales (%) correct All 5 questions are correct Mosquitos do not transmit HIV A healthy looking person can have HIV Having only one faithful partner can protect against HIV Condoms can prevent HIV Sharing food does not transmit HIV Source: UNGASS Country Progress Reports QUESTION

47 Figure 2008 Report on the global AIDS epidemic Percentage of countries with AIDS education as part of the school curriculum 4.5 Sub- Saharan Africa (41) Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) North Africa and Middle East (4) North America (1) Oceania (7) South and South- East Asia (13) Western and Central Europe (14) Percentage of countries (%) Primary curriculum Secondary curriculumTeacher training Source: UNGASS Country Progress Reports (Number of countries reporting)

48 Figure 2008 Report on the global AIDS epidemic Percentage of young people who have first sex before age 15, by sex Year % MaleFemale Source: Measure DHS.

49 Figure 2008 Report on the global AIDS epidemic Annual investment in preventive HIV vaccine research and development by source between 2000 and Year US$ Millions 2006 Multilaterals Other Public Sector Europe US Source: HIV Vaccines and Microbicides Resource Tracking Working Group, 2007.

50 Figure 2008 Report on the global AIDS epidemic Country reporting on prevention services for populations most at risk, 2005 and Countries reporting on MSM Countries reporting on sex workers Countries reporting on IDUs Source: UNGASS Country Progress Reports 2008.

51 Figure 2008 Report on the global AIDS epidemic Percentage of countries reporting laws, regulations or policies that present obstacles to effective HIV services for most-at-risk populations 4.9 Sub- Saharan Africa (41) Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) North Africa and Middle East (4) North America (1) Oceania (7) South and South- East Asia (13) Western and Central Europe (13) Percentage of countries (%) Injecting drug users Men having sex with menSex workers Source: UNGASS Country Progress Reports (Number of countries reporting)

52 Figure 2008 Report on the global AIDS epidemic Percentage of most-at-risk populations reached with HIV prevention programmes, 2005–2007 Sex workers Injecting drug users Men having sex with men % Median 60.4%* (39 countries) 46.1%** (15 countries) 40.1%* (27 countries) * Percentage of sex workers and men having sex with men reported knowing where they can receive an HIV test and that they were given condoms. ** Percentage of injecting drug users who reported knowing where they could receive an HIV test and be provided with condoms and sterile injecting needles and syringes. Source: UNGASS Country Progress Reports

53 Figure 2008 Report on the global AIDS epidemic Percent change in condom use at last sex, among those with more than one partner in the last 12 months, by sex % 40% 30% 10% 0% -30% -10% -20% Cameroon Namibia Cote d'Ivoire Peru Uganda Rwanda Zambia Guinea Colombia Burkina Faso UR Tanzania Benin Zimbabwe Mali Kenya Haiti Dominican Republic Ghana Malawi Chad Ethiopia Niger Armenia Percent change from previous survey (%) FemaleMale Source: Measure DHS 2008.

54 Figure 2008 Report on the global AIDS epidemic Condom use at last sex, among those with more than one partner in the last 12 months, in three high-burden countries % 40% 30% 0% 20% 50% 1995– – –2007 Uganda Female Uganda Male Zambia Female Zambia Male UR Tanzania Female UR Tanzania Male Source: Measure DHS 2008.

55 Figure 2008 Report on the global AIDS epidemic Number and percentage of HIV-positive pregnant women receiving antiretroviral prophylaxis, 2004– Number of HIV-positive pregnant women receiving anti-retrovirals Year % of HIV-positive pregnant women receiving anti-retrovirals Source: UNAIDS, UNICEF & WHO, 2008; data provided by countries. 4.13

56 Figure 2008 Report on the global AIDS epidemic Percentage of HIV-positive pregnant women receiving antiretroviral prophylaxis, Source: UNAIDS, UNICEF & WHO, 2008; data provided by countries.

57 Figure 2008 Report on the global AIDS epidemic Selected events related to the treatment of AIDS Accelerating Access Initiative launched by UN/industry partnership 3 million people on treatment in developing countries UN General Assembly Political Declaration on Universal Access to Prevention, Treatment care and support 1996 Introduction of HAART World Bank MAP II includes ART in developing countries G8 Declaration for Universal Access to treatment First Global Fund Grants awarded for treatment WHO launches 3 x 5 initiative UniversalAccessTargets MillenniumDevelopmentGoals Midway to Millennium Development Goals UN General Assembly Special Session on HIV/AIDS June 2001/ 189 Member States signed the Declaration of Commitment

58 Figure 2008 Report on the global AIDS epidemic Number of people receiving antiretroviral drugs in low- and middle-income countries, Source: Data provided by UNAIDS & WHO, end end end end Millions Year end end North Africa and the Middle East Eastern Europe and Central Asia East, South and South-East Asia Latin America and the Caribbean Sub-Saharan Africa 5.2

59 Figure 2008 Report on the global AIDS epidemic

60 Figure 2008 Report on the global AIDS epidemic

61 Figure 2008 Report on the global AIDS epidemic

62 Figure 2008 Report on the global AIDS epidemic Relationship between tuberculosis notification rate and HIV prevalence in Zimbabwe, 1990– Source: WHO Global TB control report 2008 (WHO, 2008a); UNAIDS HIV prevalence estimates TB notification rate (per population) % HIV prevalence in all ages TB notification rate (new and relapse), rate per population HIV prevalence in all (%)

63 Figure 2008 Report on the global AIDS epidemic Percentage of incident tuberculosis cases in people living with HIV receiving both antiretroviral and anti-tuberculosis medications, Source: UNGASS data provided by countries, Oceania (2) (Number of countries reporting) Caribbean (10) East Asia (12) Eastern Europe and Central Asia (12) Latin America (14) North Africa and Middle East (3) GLOBAL (76) South and South- East Asia (8) Sub- Saharan Africa (22) Western and Central Europe (3) % ( Note: No data from North America )

64 Figure 2008 Report on the global AIDS epidemic

65 Figure 2008 Report on the global AIDS epidemic Treatment outcomes for HIV-positive and HIV-negative tuberculosis patients, 2005 cohort 5.9 Source: WHO Global tuberculosis control: surveillance, planning, financing. World Health Organization, Geneva HIV+ (6113) HIV- ( ) HIV+ (8100) HIV- ( ) HIV+ (2577) HIV- (34 863) Not evaluated Transferred Defaulted Failed Died Completed Cured Smear-positive (data from 47 countries) Smear-negative and extrapulmonary (data from 42 countries) Re-treatment (data from 25 countries)

66 Figure 2008 Report on the global AIDS epidemic HIV testing for tuberculosis patients, all countries, Source: WHO, 2008a. Number of TB cases tested (thousands) Percentage of notified TB cases tested 12% 8.5% 3.2% 4.0% 0.5% (9, 37%) 2004 (84, 61%) 2003 (92, 53%) Year 2005 (118, 83%) 2006 (112, 90%) Note: Numbers under bars represent the number of countries reporting data followed by the percentage of total estimated HIV-positive tuberculosis cases accounted for by reporting countries

67 Figure 2008 Report on the global AIDS epidemic Percentage of countries reporting laws, regulations or policies that present obstacles to services for injecting drug users 5.11 Source: UNGASS Country Progress Reports Oceania (7) Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) Middle East (4) North America (1) South and South- East Asia (13) Sub- Saharan Africa (41) Western and Central Europe (13) Percentage of countries (%) (Number of countries reporting)

68 Figure 2008 Report on the global AIDS epidemic Percentage of countries by income status reporting a policy of free services for antiretroviral treatment 5.12 Source: UNGASS Country Progress Reports Low income (42) Lower middle income (39) Upper middle income (31) High income (16) Percentage of countries (%)

69 Figure 2008 Report on the global AIDS epidemic Selected events related to mitigating the impact of AIDS UNICEF first International Conference on AIDS orphans Children on the Brink: Strategies to Support HIV/AIDS," published by USAID includes the most comprehensive global estimates of the effects of HIV/AIDS on the world's children Unite for Children, Unite Against AIDS campaign launched by UNICEF and partners Anglo American introduces policy to make antiretroviral therapy available for HIV positive employees In Mexico, the Universal Antiretroviral Therapy access was guaranteed by the newly implemented Seguro Popular for the informal sector along with the social insurance schemes for the formal sector UniversalAccessTargets MillenniumDevelopmentGoals Midway to Millennium Development Goals UN General Assembly Special Session on HIV/AIDS June 2001/ 189 Member States signed the Declaration of Commitment

70 Figure 2008 Report on the global AIDS epidemic Estimated number of children under 18 orphaned by AIDS in sub-Saharan Africa (1990–2007) 6.2 Source: UNAIDS/WHO, 2008 Millions

71 Figure 2008 Report on the global AIDS epidemic Ratio of school attendance among orphans to non-orphans in countries with HIV prevalence greater than 5% 6.3 Source: UNGASS Country Progress Reports Mozambique South Africa Gabon Cameroon Kenya Lesotho Zimbabwe Uganda Malawi Swaziland Central African Republic Namibia Zambia UR Tanzania Côte d'Ivoire Proportion of school attendance, orphans/non-orphans UNGASS 2007 UNGASS 2005 UNGASS 2003

72 Table 2008 Report on the global AIDS epidemic 6.1 Support to orphans and vulnerable children as reported by countries with adult HIV prevalence 5 % (2005 estimates) Source: UNGASS Country Progress Reports COUNTRYOVC SUPPORTEDOVC TOTAL 1 COVERAGE in 2007 (n=10) Population based survey data BotswanaNot reported Cameroon4124,4319% Central African RepublicNot reported 7% Gabon2592,63710% KenyaNot reported 17% 2 LesothoNot reported MalawiNot reported 19% Namibia8825,34317% Swaziland1,4723,57641% Uganda5695,32111% Zambia5783,67116% Zimbabwe1,9726,32231% Population adjusted average34,1614,97015% Programme based data Côte d'Ivoire37,250420,9439% South Africa1,057,9001,577,20067% United Republic of Tanzania471,315930,00051% Population adjusted average2,928,1431,566,46553% 1 Total number of OVC as reported by countries. 2 Information based on survey implemented by PEPFAR in Kenya on OVC support in 2007, source: Kenya UNGASS country report 2008.

73 Figure 2008 Report on the global AIDS epidemic Orphans due to AIDS in Sub-Saharan Africa, from 2006 projected to Source: UNICEF, UNAIDS, WHO, Millions AIDS orphans_base AIDS orphans scaled phase-up AIDS orphans UA2010

74 Table 2008 Report on the global AIDS epidemic 6.2 HIV-Related Labour Costs Source: Piot P et al. (2007). Squaring the Circle: AIDS, Poverty, and Human Development. SECTORCOUNTRYNUMBER OF WORKERS IN SECTOR ESTIMATED HIV PREVALENCE (% of Adult Population) COST PER AIDS DEATHS OR RETIREMENT (Multiple of Annual Compensation) AGGREGATE ANNUAL COSTS (% of Labour Cost) Retail South Africa Agribusiness South Africa Uganda Kenya22, Zambia1, Manufacturing South Africa1, Uganda Ethiopia1, Ethiopia1, Media South Africa 3, Utility South Africa>25, Mining South Africa Botswana Tourism Zambia

75 Figure 2008 Report on the global AIDS epidemic Percentage of countries with sectors included in the national AIDS strategy and earmarked budgets 6.5 Source: UNGASS Country Progress Reports Public works Tourism Trade and industry Minerals and energy Agriculture Transportation Health Labour Military/police Sector included Earmarked budget present Percentage of countries (%), N=126

76 Figure 2008 Report on the global AIDS epidemic Estimated total annual resources available for HIV, 2000–2007, and projected financial resources required by 2010 if current scale up continues (US$ billion)* * This represents the projected trend in resource needs if the current rate of scale- up of services is maintained constant A US$ Billion Resources available for HIV services Current trend

77 Figure 2008 Report on the global AIDS epidemic Spending in programmes specifically directed to the populations most at risk for HIV as a percentage of total prevention spending by type of epidemicpublic and international Funds, 2006 B Source: UNGASS Country Progress Reports % 0.5% 2.8% 0.1% 8.6% 4.7% 0.0% 0% 5% 10% 15% 20% 25% LowConcentratedGeneralized TYPE OF EPIDEMIC 3.3% 1.8% Harm reduction programs and IDUs Programs for men having sex with men Programs for sex workers and their clients

78 Figure 2008 Report on the global AIDS epidemic Per capita HIV expenditures from domestic public sources in low- and middle-income countries, 2004–2007 Year US$ Sub-Saharan Africa Upper middle income countries Rest of the world Upper middle income countries Rest of the world Low and lower middle income countries Sub-Saharan Africa Low and lower middle income countries (9.89) (1.17) (0.63) (0.14) (12.01) (2.04) (1.15) (0.20) C Source: UNGASS Country Progress Reports 2008.

79 Figure 2008 Report on the global AIDS epidemic Public domestic expenditures, Malawi (US$ millions) D US$ Million 0

80 Figure 2008 Report on the global AIDS epidemic Annual domestic spending: top 20 countries (US$ 2.73 billion) UNGASS reports, latest data available (US$ million) E Brazil* South Africa Russian Federation Mexico Thailand Argentina UR Tanzania China Botswana Australia Colombia Japan Zimbabwe Turkey Chile Poland Iran Cuba Angola Ukraine DOMESTIC PUBLIC EXPENDITURE (US$ Millions)DOMESTIC PUBLIC EXPENDITURE PER CAPITA (US$) * Partial data

81 Figure 2008 Report on the global AIDS epidemic HIV expenditures by finance sources and income level 2007, or latest data available F Per capita (US$): $3.32$2.54$8.31$0.26 International Public Low income Lower middle income Upper middle income High income: non-OECD %

82 Figure 2008 Report on the global AIDS epidemic Resources available to HIV-related programmes by source and bilateral disbursements, 2006 G Sources: UNAIDS analysis based on OECD/DAC online database (last visited on May 6, 2008), Resource availability UNAIDS 2005, Funders Concerned About AIDS (FCAA), European HIV/AIDS Funders Group (EFG) for Philanthropic sector Bilateral disbursements to HIV-related programmes in 2006 Total Resource availability for HIV-related programmes in 2006 (US$ Billions) UN (2%) GFATM (7%) Foundations (11%) Bilaterals (33%) Domestic Public and Private (46%) EC (0.5%) Canada 2% Belgium 1% Netherlands 3% Other DAC country members 1% Sweden 3% Spain 1% Norway 2% Australia 2% Germany 2% Ireland 3% United Kingdom 9% United States 71% (US$ Billions) Total resources available: US$8.9 BillionPercentage out of the total bilateral disbursements Total Bilateral disbursements 2006: US$ 2.9 Billion The organizational disbursements are different than commitments or obligations, as well as different from in-country expenditures

83 Figure 2008 Report on the global AIDS epidemic Disbursements for HIV per US$ 1 Million GDP, 2006 H Sources: UNAIDS and Kaiser Family Foundation analysis, June 2007; Global Fund to Fight AIDS, Tuberculosis and Malaria online data query May 2007; International Monetary Fund, World Economic Outlook Database, April Italy 4 Japan 24 Canada 50 Germany 60 France 93 United States 120 United Kingdom 328 Ireland 408 Sweden 462 Netherlands US$

84 Figure 2008 Report on the global AIDS epidemic Annual resources available 2000–2007 and funding gap between projected financial resources if current scale-up continues and a phased scale-up scenario to reach universal access between 2010 and 2015 (US$ billion) I US$ Billion Resources available for HIV services Resource Needs: if current scale-up continues Resource Needs for phased scale-up to Universal Access

85 Figure 2008 Report on the global AIDS epidemic

86 Figure 2008 Report on the global AIDS epidemic Comparison of 2005 and 2007 percentage coverage of antiretroviral therapy for people with advanced HIV and percentage coverage of antiretroviral drugs for HIV positive pregnant women by region 7.2 Source: UNAIDS/UNICEF/WHO. GLOBALEasternEurope and Central Asia Latin America and the Caribbean North Africa and the Middle East East, South and South-East Asia Sub-Saharan Africa Percent (%) Antiretroviral Therapy Prevention of Mother to Child Transmission

87 Table 2008 Report on the global AIDS epidemic 7.1 Percent Coverage of Antiretrovirals for Prevention of Mother-to-Child Transmission Breakdown by Quartiles (N=63) Less than 25% Coverage (36 Countries): Angola, Burkina Faso, Burundi, Cameroon, Chad, China, Colombia, Congo (Republic of the), Côte d'Ivoire, Democratic Republic of the Congo, El Salvador, Eritrea, Ethiopia, Gabon, Ghana, Guatemala, Guinea, Guinea-Bissau, Haiti, India, Indonesia, Iran (Islamic Republic of), Liberia, Madagascar, Malaysia, Mali, Nepal, Nigeria, Pakistan, Papua New Guinea, Senegal, Sierra Leone, Somalia, Togo, Venezuela, Viet Nam 25% to 49% Coverage (16 Countries): Benin, Cambodia, Central African Republic, Dominican Republic, Gambia, Honduras, Lesotho, Malawi, Mozambique, Myanmar, Niger, Peru, Uganda, United Republic of Tanzania, Zambia, Zimbabwe 50% to 75% Coverage (7 Countries): Brazil, Kenya, Namibia, Rwanda, South Africa, Swaziland, Ukraine Greater than 75% Coverage (4 Countries): Argentina, Botswana, Russian Federation, Thailand All values are based on need estimates using UNAIDS/WHO methodology. Includes all countries for which number of HIV pregnant women receiving ARVs was reported for 2007, except countries for which UNAIDS/WHO need estimates are not available, or with need estimates less than 500.

88 Table 2008 Report on the global AIDS epidemic Less than 25% Coverage (45 Countries): Algeria, Armenia, Azerbaijan, Bangladesh, Belarus, Bolivia, Burundi, Central African Republic, Chad, China, Congo (Republic of the). Democratic Republic of the Congo, Djibouti, Egypt, Eritrea, Gambia, Ghana, Guinea-Bissau, Hungary, Indonesia, Iran (Islamic Republic of), Kazakhstan, Kyrgyzstan, Liberia, Lithuania, Madagascar, Mauritania, Mauritius, Mozambique, Myanmar, Nepal, Niger, Pakistan, Paraguay, Russian Federation, Serbia, Sierra Leone, Somalia, Sri Lanka, Sudan, Tajikistan, Togo, Ukraine, Uzbekistan, Zimbabwe 25% to 49% Coverage (40 Countries): Angola, Bahamas, Belize, Benin, Burkina Faso, Cameroon, Cote d'Ivoire, Dominican Republic, Ecuador, Equatorial Guinea, Estonia, Ethiopia, Gabon, Guatemala, Guinea, Guyana, Haiti, Honduras, Jamaica, Kenya, Lebanon, Lesotho, Malawi, Malaysia, Mali, Morocco, Nicaragua, Nigeria, Papua New Guinea, Peru, Philippines, Poland, South Africa, Suriname, Swaziland, Uganda, United Republic of Tanzania, Venezuela, Viet Nam, Zambia 50% to 75% Coverage (14 Countries): Argentina, Barbados, Cambodia, Czech Republic, El Salvador, Moldova, Netherlands, Panama, Romania, Rwanda, Senegal, Thailand, Trinidad and Tobago, Uruguay Greater than 75% Coverage (7 Countries): Botswana, Brazil, Chile, Costa Rica, Cuba, Lao People's Democratic Republic, Namibia Percent Coverage of Antiretroviral Therapy for Adults and Children with Advanced HIV Breakdown by Quartiles (N=106) 7.2 All values are based on need estimates using UNAIDS/WHO methodology. Includes all countries for which number of adults and children on ART was reported for 2007, except countries for which UNAIDS/WHO need estimates are not available, or with need estimates less than 500.

89 Figure 2008 Report on the global AIDS epidemic Annual AIDS deaths comparing projected current rate of scale up and the phased scale-up strategy to reach universal access between 2010 and Source: UNAIDS, Number of AIDS deaths (Millions) Current Scale-Up Phased Scale-Up

90 Figure 2008 Report on the global AIDS epidemic HIV spending on prevention, treatment, and care, Mexico, 1995–2005 (US$ millions) 7.4 Source: Personal communication with Centro Nacional para la Prevención y control del SIDA (CENSIDA), Ministry of Health, Mexico (2008). US$ Millions Programs for sex workers and their clients Programs for men having sex with men Blood safety Prevention – selected components PreventionTreatment and Care US$ Millions

91 Figure 2008 Report on the global AIDS epidemic Resources needed in 2010 using a phased scale-up strategy towards universal access* 7.5 Source: UNAIDS, * Estimates in 138 low- and middle-income countries for implementing the most effective programmatic services as determined by data derived from national efforts to know and act on your epidemic Program Support Orphans and Vulnerable Children Treatment and Care Prevention Low Level (50) Concentrated (44) Generalized and Hyperendemic (44) US$ Billions TYPE OF EPIDEMIC

92 Figure 2008 Report on the global AIDS epidemic Prevention, care and treatment expenditures from public and international funding sources Mozambique, 2004–2006, US$ millions 7.6 Source: UNGASS Country Progress Reports Care and Treatment Prevention Year US$ Millions

93 Figure 2008 Report on the global AIDS epidemic Countries reporting quality implementation of the national AIDS strategy 7.7 Source: UNGASS Country Progress Reports * One national multisectoral strategy and operational plan with goals, targets, costing, and identified funding per programmatic area, and a monitoring and evaluation framework. (Number of countries reporting) (N=130) Caribbean (12) East Asia (3) Eastern Europe and Central Asia (16) Latin America (19) Middle East And North Africa (4) North America (1) Oceania (7) South and South- East Asia (13) Sub- Saharan Africa (41) Western and Central Europe (14) Percentage of countries (%) Quality national strategy*

94 Figure 2008 Report on the global AIDS epidemic Country progress in improving the implementation quality of the Three Ones: one national strategic framework, one national AIDS authority, and one national monitoring and evaluation system* 7.8 Source: UNGASS Country Progress Reports * Quality implementation refers to: 1 One national multisectoral strategy and operational plan with goals, targets, costing, and identified funding per programmatic area, and a monitoring and evaluation framework; 2 One national coordinating body with terms of reference, a defined membership, an action plan, a functional secretariat, and regular meetings; 3 One national M&E plan which is costed and for which funding is secured, a functional national monitoring and evaluation unit or technical working group, and central national database with AIDS data. ** Only countries that have all three or two of the three components in place are displayed; other countries have only one or none of the components in place, or did not report. Number of countries (N=94)**2007 (N=129)** quality implementation of 2 components quality implementation of all 3 components


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