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Brazzaville, Congo 5-7 March 2014 5th Inter-Agency Meeting on Coordination and Harmonization of HIV/AIDS, TB and Malaria Strategies.

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Presentation on theme: "Brazzaville, Congo 5-7 March 2014 5th Inter-Agency Meeting on Coordination and Harmonization of HIV/AIDS, TB and Malaria Strategies."— Presentation transcript:

1 Brazzaville, Congo 5-7 March th Inter-Agency Meeting on Coordination and Harmonization of HIV/AIDS, TB and Malaria Strategies

2 Treatment 2015 launch

3 The agreed target…

4 .. and focusing on treatment is strategic

5 Treatment continues to expand

6 Gaps in global antiretroviral coverage under the 2010 and 2013 WHO HIV treatment guidelines Eligible but not receiving treatment Eligible and receiving treatment Total eligible: *Numbers of people receiving treatment in December 2012 versus (a) the numbers eligible in December 2012 under the 2010 WHO guidelines; (b) the numbers eligible in December 2013, under the 2013 WHO guidelines. 18,563,000 28,600, guidelines*2013 guidelines* 14,000,000 66% 39%

7 Source: UNAIDS estimates 2013 Gap in antiretroviral coverage varies within Africa

8 The agreed target is still ambitious… …and is a stepping stone towards treatment for all in need

9 UNAIDS PCB calls for new targets Encompass new science Drive progress Guide action beyond 2015 Ultimately aspire to end the AIDS epidemic

10 Challenges ahead: 1- Societal Lack of knowledge of HIV status Punitive policies and laws Stigma and discrimination

11 Cost of treatment per ART patient year by country US Dollars Challenges ahead: 2- diverse facility level costs *Republic of South Africa: costs include updated antiretroviral prices, which were renegotiated by the RSA government in early 2010 and are 53% lower than those observed during the costing period. US$ Average Maximum Minimum US$136 US$186 US$232 US$278 US$682 South Africa*

12 Challenges ahead: 3- treatment cascade Sources: 1. UNAIDS 2012 estimates; 2. Demographic and Health Surveys, 2007–2011 (; 3. Kranzer, K., van Schaik, N., et al. (2011), PLoS ONE; 4. GARPR 2012; 5. Barth R E, van der Loeff MR, et al. (2010), Lancet Infect Disease. Notes: No systematic data are available for the proportion of people living with HIV who are linked to care, although this is a vital step to ensuring viral suppression in the community.

13 Challenges ahead: 4- delivery systems Relative likelihood of HIV-positive adults (15-49 years) accessing antiretroviral therapy due to the distance from their nearest primary healthcare facility. Source: Location, Location: Connecting people faster to HIV services, UNAIDS; Geneva, 2013

14 Challenges ahead: 5- Key populations and partners a substantial share of new infections Nigeria 51% Kenya about 33% Mozambique more than 25% Morocco 80% Dominican Rep. 47% Peru 65%

15 Expected impact of HIV treatment in survival of a 20 years old person living with HIV in a high income setting (different periods) HIV treatment can normalize survival

16 What we can achieve Projected annual AIDS-related deaths, assuming scale up to 95% coverage by 2020

17 Expanding access to ART is a smart investment: Case of South Africa Source: Expanding ART for Treatment and Prevention of HIV in South Africa: Estimated Cost and Cost-Effectiveness PLoS ONE 7(2):e30216

18 With international support, universal access to ART is at reach in low- and middle income countries Malawi Lesotho Zimbabwe Mozambique Burundi Uganda Central African Rep. Tanzania Zambia Swaziland Kenya Liberia Togo Rwanda Sierra Leone Cameroon Chad Guinea-Bissau Côte d’Ivoire Botswana Haiti Guinea Namibia Djibouti Nigeria South Africa Burkina Faso Niger Benin Eritrea Ghana Mali Cambodia Belize Myanmar Senegal ART costs as a percentage of GDP % 2% – 5% 5% – 8% 0.1% – 1% 1% – 2% Source: Williams arXiv 2012:

19 The tasks ahead Source: Terhorst, D & Schmid, G., WHO 2006  Country consultations  Regional consultations  Dialogue with key strategic partners  Global consensus meeting Consultations (Countries, regions, ad hoc) Develop instruments (to support partners)  Modelling  Costing  Supply forecast  Testing campaign  Demand  Resources  Progress Monitoring and evaluation

20 Making it work: The African Union Roadmap Sustainable financing models Access to medicines – Local production and regulatory harmonization Leadership, governance and oversight

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