By Dr.Marie-Goretti HARAKEYE, Head of Division-HIV/AIDS, TB, Malaria & OID Department of Social Affairs

1. CONTEXT 2. Mandate AUC/DSA 3. Abuja Declaration-Translating commitments into actions 4. AWA and the AU Roadmap 5. AU Roadmap: Three Actions Pillars 6. Progress on the Pillars of the AU Roadmap 7. Key Messages 8. Roles and Responsibilities

In fact while Africa accounts for only 13% of the global population it is home to 57% of global maternal and 50% of child deaths respectively. AIDS and malaria are the greatest contributors to the disease burden in Africa with 70% HIV cases and 90% of the deaths due to malaria. It is noteworthy that AIDS has been the fastest growing cause of disease burden globally in the last 20 years. Communicable and non-communicable diseases including neglected tropical diseases are also increasingly becoming prominent across the continent.

 Coordinate and Ensure Coherence of Heath related policies and programmes in the continent;  To work with relevant international partners in the eradication of preventable diseases and the promotion of good health on the continent. ◦ The continental response is targeting: the health system strengthening, scaling up Health interventions with accélération of access to Health services especially those aiming to control HIV and AIDS, TB and Malaria

6 COMMISSIONER DIRECTOR ACALANCELHTOACERWC Secretariat Division of HIV/AIDS, Malaria and TB Division of Labour, Employment and Migration Division of Social Welfare and Drug Control Division of Culture Division of Sports Division of Health Population and Nutrition AWA Secretariat DSA Organizational Structure

 The last decade :moment for health and development, with compelling vision for the future and strong political commitment to control the three diseases.  Recognising that the successes of the last decade, a decision was taken by the 18th Session of the African Union assembly in January 2012 to revitalise and in July 2012:. and endorsment of the AU Raodmap.  The mandate of AWA was broadened to cover the three diseases Building on the experience in responding to the AIDS epidemic with mobilisation of substantial global resources flowing in rapid scale from contributions by donors.

 Through joint advocacy efforts by African leaders and various stakeholders the Global Fund to Fight AIDS, TB and Malaria (GFATM) was established in  This initiative has now grown to be the most significant source of financing for programmes on AIDS, TB and malaria in most affected countries.  President’s Emergency Plan for AIDS Relief (PEPFAR), which has also become one of the biggest contributors to the AIDS response.

 African High Level Advocacy and accountability Platform to combat HIV/AIDS, TB and Malaria  The roadmap provides a blueprint for fast tracking implementation of the priority areas of the “Abuja Declarations and Abuja Call” following three action pillars which are health governance, diversified financing and access to medicines. The roadmap  2013: Special Summit AIDS TB and Malaria in Abuja

 Re-mobilize & sustain high level leadership  Promote national ownership and ensure self- sufficiency  Mobilize local & international resources  Facilitate accountability on commitments  Keep ATM high on national, continental & international agendas; plus galvanize action (MDG goal)

Heads of State and Government (Africa-wide) AWA Champions AWA Consultative Experts Committee (MS) AWA Secretariat AU-AWA Chairperson (Mauritania) –AWA Vice Chairperson - East Africa Tanzania North Africa Tunisia Southern Africa Malawi West Africa Cote d’lvoire Central Africa Gabon

5. The Roadmap: three action pillars 1 More diversified, balanced and sustainable financing models  Develop financial sustainability plans with clear targets  Ensure development partners meet commitments and align with Africa’s priorities  Maximise opportunities to diversify funding sources and increase domestic resource allocation  Invest in leading medicines manufacturers – focusing on AIDS, TB and malaria  Lay foundations for a single African regulatory agency  Acquire essential skills through technology transfers and south-south cooperation  Incorporate TRIPS flexibilities and avoid "TRIPS-plus" measures in trade agreements  Use strategic investment approaches for scale-up of basic programmes  Support communities to claim their rights and participate in governance of the responses  Ensure investments contribute to health system strengthening  Mobilise leadership at all levels to implement the Roadmap 3 Leadership, governance and oversight for sustainability 2 Access to medicines – local production and regulatory harmonisation Priority actions 12

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Innovative financing examples that countries have developed so far to boost financing for their health sector and three disease responses include:  Rwanda and Uganda are charging levies on mobile phone usage;  Airline levies are charged by the governments of Benin, Congo, Madagascar, Mali, Mauritius and Niger;  The governments of Cape Verde and Comoros are charging alcohol excise taxes.  SA has modify procedures and transparency with a result of 53% reduction of the ARVs cost. 14

 Progress has been made to enable countries to scale up pharmaceutical manufacturing, especially in ARVs and ACTs, as well as other malaria commodities (e.g. ITNs).  Pharmaceutical Manufacturing Plan for Africa (PMPA) Business Plan, an African-wide framework supported through a PMPA Business Plan Consortium.  At least two PMPA Business Plan pilots (Ghana and Uganda)  Other countries, including South Africa, Kenya, Uganda, Nigeria, Tanzania and Tunisia, have negotiated public- private partnerships that will allow for more rapid pre- qualification for manufacturing of essential drugs by WHO as well as other, Bednets and other commodities 15

Progress is also being made in improving regulatory harmonisation across the continent:  The NEPAD Planning and Coordination Agency began work in 2012 on the development of a Model Law for Medicines Regulation Harmonisation in Africa. The Model Law aims to address legislative gaps that hamper medicines and commodities regulatory harmonization  African Medicines Regulation Harmonisation (AMRH) Initiative is promoting the establishment of Regional Centres of Regulatory Excellence through the existing REC structures, supported by the NEPAD Agency  African Medicine Regulatory Agency Project 16

The AUC, Regional Economic Communities, AU Member States and Development Partners have already risen to the challenge of leading the changes:  Countries working on more robust, results focused national strategies and related investment cases,  Streamlining disease coordination and governance to make best use of limited national human and financial resources in some countries.  AIDS Watch Africa (AWA) has been reinvigorated as African leaders recognized the need for accelerated momentum towards meeting MDG 6 targets by 2015 and the 5 Reginal champions  APRM, Members of the Pan African Parliament (PAP) and Regional CSOs have committed themselves to playing a key leadership role and monitoring the implementation of the AU Roadmap, March  African Leaders for Malaria Alliance (ALMA) taking the lead on holding governments to account through quarterly scorecards. 17

Pillar I Diversified, balanced and sustainable financing models Member States encouraged to develop financial investment plans for health, including AIDS, TB and Malaria, showing how national programme costs will be covered with domestic and external funding and annual increases in share of domestic funding Member States and regional Economic Communities encouraged to produce case studies that report different country's progress in diversifying sources of financing and increasing domestic funding AUC to commission a mapping of Innovative Financing Mechanisms and Modalities that catalogues what options are possible in different contexts and promote the best practices from the MS. 18

Pillar II Access to medicines through local production and regulatory harmonization AU member states are urged to ensure that the PMPA-BP Consortium is fully functional and resourced The AU to seek partnership with BRICS partners on investing in African pharmaceutical manufacturing capacity, especially of generic essential drugs. AU Member states are encouraged to create an enabling regulatory environment within country in order to reduce import tariffs and harmonize regulatory requirements with other countries in the region Trips Flexibilities 19

Pillar III Leadership, governance and oversight for sustainability Heads of States and Government are called upon to champion the AU Roadmap at national, continental and global levels and to oversee its implementation in their countries in collaboration with main stakeholders Heads of States and Government are urged to use the AIDS Watch Africa platform to share lessons learnt with each other AU member states to develop a comprehensive plan) to modernize the Health System Governance bodies to improve leadership, coherence, efficiency and performance of the health sector generally and the three diseases specifically 20

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One Africa One Voice!! – Shared Responsibility and Global Solidarity