1. UNIVERSAL ACCESS A Perspective From Rwanda
Dr. Agnès Binagwaho,
Executive Secretary
National AIDS Control Commission (CNLS) Rwanda
XVII International AIDS Conference, 6 August 2008, Mexico City

3. Achievements in the past decade
Malaria
HIV
On ART: 70% ,
55,000
survival/one year > 90 %.

4. Government - led decisions MOH / CNLS
Country-led processes (at central and district levels) ensure that development partners contributions fit into the national plan

5. Efficiency in coordination
Economies of scale
Simplified and harmonized planning and reporting (standardized format)
Understanding of real cost to determine cost/efficiency
Comparison of intervention models (improve our policies and choice of strategies and interventions)

6. Health sector Sustainability
TB/HIV/STI/malaria/IGA
(Integrated VCT)
Performance-based financing
Reinforcement of education in
the community
Focus on prevention
Community-based health
insurance (Mutuelle)
ARV
PMTCT
VCT
Basic care

7. Strengthening the overall system by using HIV/AIDS as an Entry point

8. Evolution of Community Health Insurance Membership

9. Evolution of Utilization of Curative Health Care in Rwanda

12. 12
Current sites (June2004)
New Sites (by June 2005)

13. How?
Improve the population financial access to the health care services
To Improve health state of the population To capacity of the health structures
To Strengthen community participation in health care management
Create the demand and quality of care

14. Largely externally financed
country driven and community need oriented
sector wide approach (SWAP)
Multisectoral perspective
Integration in a national plan with a consensus-driven approach
Transparency among partners
Alignment of donors

15. Challenges contd. Human resources Critical interventions underfunded
Short term commitment of partners
Sustainability , autonomy, exit strategies
ARV , testing kits)
Development partners must be results-oriented and not timeline-driven

16. Opportunities Clear political and technical vision
Strong government leadership/Coordination
Broad-based community and civil society participation
Good will of all partners, global solidarity
Strong program on which to build Full integration
Skilled, motivated teams
zero tolerance for corruption

17. Conclusions NO easy, short time solutions
Rollback diseases by fighting poverty and vice versa
Coordination of stakeholders and improvement of laws and regulations are necessary steps to ensure the basic human right to healthcare
NO easy, short time solutions

18. Rwanda is a country of hope Africa is a continent of hope
Thank you