Presentation on theme: "Towards an AIDS-Free Generation Women & Girls and HIV in PEPFAR"— Presentation transcript:
1 Towards an AIDS-Free Generation Women & Girls and HIV in PEPFAR Opening:Thank you for that gracious introduction.I am pleased to be here today with all of you as we begin what I hope will be a productive three days together.I want to thank Ambassador Gaspard, Counselors General Taylor Ruggles and Erica Barks Ruggles, DCM Virginia Palmer, PEPFAR Coordinator James Maloney and the entire South African PEPFAR Country Team for their incredible hospitality. I know this meeting was delayed, but I am delighted that we’re all here!!My goal for this meeting is to begin a dialogue that continues throughout my tenure as Global AIDS Coordinator….31 months and 19 days…but who is counting?!Ambassador Deborah BirxGlobal AIDS CoordinatorUS Department of StateSeptember 9, 2014
2 History of the Epidemic & Response 1Where We Were:This morning, I’d like to talk about the history of our response to the epidemic (which we touched on a bit in some of the agency meetings yesterday) and the challenges and opportunities as we move toward an AIDS Free generation…. and then share some thoughts about my vision for PEPFAR.Like some of you in this room, I’ve been on the frontlines of the fight against HIV/AIDS since the early days of the epidemic—when I was treating young soldiers at Walter Reed Army Hospital who had an illness we didn’t have a name for at the time. Being on the frontlines has its highs and lows.In the U.S., we managed our way through the first decade of AIDS without effective treatment as we struggled to contain the spread of the disease in our own communities.After more than a decade of tireless work by scientists, activists and people from all walks of life working together to provide prevention, care and treatment we forged our way to the advent of the lifesaving medicines that changed the course of the disease in America and other countries around the world that could afford the cost of care.At the same time, we were facing the enormity of the AIDS crisis as it raced around the globe and wrought then untold devastation on Africa and much of the developing world. Facing the stark reality of death and despair faced by those in the wake of this disease citizens around the world had to make a choice—the same choice faced by countless individuals and communities before us—to either rally or be overwhelmed.History of the Epidemic & ResponseCelebrating success and a call to action
3 Where we were before PEPFAR… 1991 – 2001:Peakof thePandemic2001: Nearly 10,000 new HIV infections daily2002: 50,000 on treatment in sub-Saharan AfricaHealth systems overwhelmed by the epidemicLife expectancy declines of over 20 years in some countriesLoss of working age population – reversing decades of development progress
4 Delivering an AIDS-Free Generation Unwavering Leadership from Congress Demonstrated Commitment to Ending the AIDS Pandemic2003US Leadership Against AIDS, TB, & Malaria Act2008Hyde-Lantos Reauthorization of PEPFAR2013PEPFAR Stewardship & Accountability ActDelivering an AIDS-Free GenerationAccountabilityTransparencyImpact
5 Trends in New HIV Infections, 1990-2013 PEPFAR Has Saved Millions of Lives New Infections Halved since Peak of EpidemicTrends in New HIV Infections,But we can’t become complacent now. The road ahead to an AIDS-free generation remains long….. and complicated. And all of you know that because you’re paving the road!
6 2Leaving no one behindWomen face disproportionally high burden of HIV/AIDS
7 Key Populations Face a Significantly Higher Risk of Acquiring HIV/AIDS Young womenSex workPeople who inject drugsMen who have sex with menTransgenderMigrantsPrisonersDisplacedPregnant women50+DisabledAfrican American womenIntimate partnersYoung women in Sub-Saharan Africa are by far the largest group with a disparately high risk of acquiring HIVSource: UNAIDS, 2014
8 New HIV Infections in Sub-Saharan Africa by Age & Sex, 2013 Disparately High HIV Prevalence among Young Women Compared to Young MenNew HIV Infections in Sub-Saharan Africa by Age & Sex, 2013Source: UNAIDS 2014
9 HIV Leading Cause of Death among Adolescent Girls in SSA In Eastern and Southern Africa, HIV is the leading cause of death in girls aged 15-1916.9Source: Global Burden of Disease 2010
10 PEPFAR: Improving Outcomes for Women & Girls 3PEPFAR: Improving Outcomes for Women & Girls
12 ACT: Accelerating Children’s HIV/AIDS Treatment PEPFAR & CIFF(the Children’s Investment Fund Foundation)launched apublic-private partnershipto keepChildren & Adolescentsalive and healthyThis $200 million initiative aims to double the number of children on treatment in at least 10 countries in sub-Saharan AfricaWith this initiative, we could avert an additional 250,000 HIV-related deaths of children under the age of fiveAdditional HIV-related deaths will be averted in the 5-15 year old age group.
13 800 mothers die attributable to HIV Maternal Deaths & HIV 18% Maternal mortality ratio, 2010Every day800 mothers diedue to pregnancy & childbirthWHO estimates that18%of all maternal deaths areattributable to HIVPeople Living with HIV by Region, 2011Source: WHO, 2011/2012
14 PMTCT: HIV Testing for Pregnant Women Over half of HIV+ pregnant women in the world are tested and identified with PEPFAR support6.9%
15 PMTCT: Getting Lifesaving ART to HIV+ Pregnant Women to Protect Maternal & Infant Health In 2013, 56% of women received lifelong ART, up from 23% in 2011.
16 Saving Mothers Giving Life An Innovative Public-Private Partnership SMGL is bringing together key partners…To address the 3 delays that contribute to maternal mortality:Delay in decision to seek careDelay in reaching careDelay in receiving quality health careApproximately half of all women in sub-Saharan Africa deliver at home without skilled care and timely access to emergency services; this puts them and their newborns at increased risk of dying from pregnancy-related complications should they arise.Saving Mothers, Giving Life focuses on reducing maternal deaths when these emergencies occur, by addressing the three delays:-Delays in deciding to seek appropriate care-Delays in reaching care-Delays in receiving timely, quality care at the facilityThe partnership works to address these issues in a number of ways:--Raising awareness and mobilizing communities to encourage more women to seek facility births.--Facilitating access to facilities, through enhanced communications, transportation and referral networks.--Improving quality of care through supporting the training of health providers, community midwives and other health workers, by improving facility infrastructure, and by procuring needed supplies.
17 SMGL Outcomes Evaluation January 9, 2014 SMGL Phase 1 Results: Institutional Maternal Mortality Declined in both Uganda & Zambia- 35%- 35%- 36%- 35%Percentage declines noted are statistically significant
18 significantly higher risk Pink Ribbon Red Ribbon Public-Private Partnership to Combat HIV & Cervical and Breast Cancers in AfricaHIV-infected womenhave asignificantly higher riskof acquiringcervical cancerCervical cancer – one of most common cancers among women in developing world275,000 deaths each year>85% global burden in developing countries$85 million over 5 years currently committedZambia and Botswana are initial PRRR countriesMajor expansion of “screen and treat” programsPilot programs for HPV vaccinationTraining for breast cancer awareness and CBEFounding PRRR members include:PEPFARThe George W. Bush InstituteSusan G. Komen for the CureUNAIDSMultiple private sector partners
19 PEPFAR Gender Strategy in the past four years, PEPFAR reached over 114,000 survivors of sexual violence with post-exposure prophylaxis to prevent HIVIncreasing gender equity in HIV/AIDS programs and services, including reproductive health servicesPreventing and responding to gender-based violenceEngaging men and boys to address norms and behaviors around masculinity and sexualityIncreasing gender-related policies and laws that increase legal protectionIncreasing gender equitable access to income and productive resources, including education
20 Mitigation as Prevention: OVC Programs Impacts of social protection on girls’ past-year incidence of transactional sex
21 Together for Girls A Unique Public-Private Partnership Daniela starts here
22 Our work is not done. This week alone… Over 3600 children died this week from HIVOver 25,000 adults died this week from HIVOver 4,600 babies were infected with HIVOver 36,500 adults were infected of which more than 7000 were young women
23 As I reflect on my new role as Global AIDS Coordinator, I am humbled to play my small part in the worldwide effort to bring and end to AIDS as we know it.I cannot emphasize enough that we are all in this together. That’s why coordination and collaboration is so important. Each and every one of us is doing our part in delivering an AIDS-free generation through impact, transparency and accountability.And each and every one of us is making a difference in the lives of others. That’s a pretty remarkable feat. A feat, which should make us all proud. …….Again, thank you for all of your hard work and thank you for your continued commitment to PEPFAR’s promise. The next few days will give us an opportunity for open dialogue about how we move forward together—the interagency, donors, multilateral organizations, civil society, people living with and affected by HIV, indigenous organizations, and host-country governments. We all have a critical role to play. The responsibility and success of PEPFAR is dependent on all of us.I look forward to answering your questions.