Source: Demographic and Health Surveys Men Women HIV+ population tested at least once
Access To Virologic HIV Testing (Early Infant Diagnosis) 2012 *Lesotho data represents 2011 coverage data Source: UNAIDS, UNICEF and WHO, 2013 Global AIDS Response Progress Reporting, and UNAIDS modeling2012 HIV and AIDS estimates.
90% of eligible people on treatment is possible
high coverage in several countries Brazil UNGASS Country Progress Report (2012) UNAIDS Situation Room
Proportion (95% CI) of patients with undetectable VL in a nationally representative sample of HIV-infected adults on ART in Rwanda Source: Basinga P et al. (2013) PLoS Site S Site T Total 100.00% 80.00% 60.00% 40.00% 20.00% Site A Site B Site C Site D Site E Site F Site G Site H Site I Site J Site K Site L Site M Site N Site O Site P Site Q Site R 83%
Challenges ahead: 1- Societal Lack of knowledge of HIV status Punitive policies and laws Stigma and discrimination
Challenges ahead: 2- delivery systems Source: Location, Location: Connecting people faster to HIV services, UNAIDS; Geneva, 2013 Relative likelihood of HIV-positive adults (15-49 years) accessing antiretroviral therapy due to the distance from their nearest primary healthcare facility.
Uptake of pediatric HIV services after introduction of family-based approach Luyirika et al. PLoS ONE, 2013
Cost of treatment per ART patient year by country US Dollars Challenges ahead: 3- 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*
Challenges ahead: 4- treatment cascade Sources: 1. UNAIDS 2012 estimates; 2. Demographic and Health Surveys, 2007–2011 (www.measuredhs.com); 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.
Challenges ahead: 5- Financing 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 012345678% 2% – 5% 5% – 8% 0.1% – 1% 1% – 2% Source: Williams arXiv 2012: http://arxiv.org/abs/1206.6774