HIV/AIDS The times they are a changing Roxana Rogers David Stanton Office of HIV/AIDS

OVERVIEW Changes in… Changes in… resources resources accountability accountability partners partners the epidemic the epidemic Office of HIV/AIDS Office of HIV/AIDS More changes over The Next Five Years? More changes over The Next Five Years?

Change: More Funding

HIV/AIDS & Infectious Disease Funding FY ($ millions)

Congressional & Executive Expectations High interest (thru directives, earmarks & communication) about certain activities, e.g. MTCT & OVC High interest (thru directives, earmarks & communication) about certain activities, e.g. MTCT & OVC Congress wants more information for evidence based decision making Congress wants more information for evidence based decision making President also has high expectations and sees HIV/AIDS as priority President also has high expectations and sees HIV/AIDS as priority

Reporting Requirements in year global strategy 5 year global strategy Annual report Annual report Empowering women Empowering women Brain drain Brain drain Enhanced HIPC Enhanced HIPC Provision of AIDS treatment Provision of AIDS treatment Mother to child transmission Mother to child transmission TB TB Health Corps Health Corps Orphans and vulnerable children Orphans and vulnerable children

Change: More accountability!!!!!

The Expanded Response: Global Targets-2007 Reduce HIV prevalence by 50% in y.o. in high prevalence countries Reduce HIV prevalence by 50% in y.o. in high prevalence countries Maintain prevalence at <1% in y.o. in low prevalence countries Maintain prevalence at <1% in y.o. in low prevalence countries Access to basic care to 25% of HIV infected Access to basic care to 25% of HIV infected Access to MTCT services to 25% HIV infected women Access to MTCT services to 25% HIV infected women Access to basic services to 25% OVC Access to basic services to 25% OVC

Accountability What USAID needs Selected process data (e.g. service statistics, numbers of people trained in X countries) that adds up to impressive numbers (relative to the investment) Selected process data (e.g. service statistics, numbers of people trained in X countries) that adds up to impressive numbers (relative to the investment) Impact data (standardized, aggregrated data, baselines, trendlines, cross country comparisons) Impact data (standardized, aggregrated data, baselines, trendlines, cross country comparisons)

Change: More Partners

USG Resources for HIV/AIDS

Global AIDS Program (GAP) Centers for Disease Control

CDC GAP Funding History * Note: Projected in President’s Budget. *

GAP Status as of June countries: 19 now staffed; Others by 12/02 24 countries: 19 now staffed; Others by 12/ direct hire staff positions – > 100% increase over 12 months ago: 128 direct hire staff positions – > 100% increase over 12 months ago: 74 in field 74 in field 54 at headquarters 54 at headquarters Locally employed staff increased from 160 in 2001 over last 12 months Locally employed staff increased from 160 in 2001 over last 12 months

The Global Fund for AIDS, TB and Malaria

GFATM

GFATM

GFATM

GFATM: Potential Partnerships

USAID Cooperating Agencies

USAID 38% 46%52%

USAID FY 02 CSH/HIV field support total allocation: $83.1 million FY 02 CSH/HIV field support total allocation: $83.1 million Number of central programs receiving HIV funds: 50 Number of central programs receiving HIV funds: 50

In sum: Changing times More funding  expanded, scaled up response More funding  expanded, scaled up response More stakeholder interest  more reporting More stakeholder interest  more reporting More stakeholder interest  more directives More stakeholder interest  more directives More partners  more coordination More partners  more coordination