Brazzaville, Congo 5-7 March 2014
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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
description
5th Inter-Agency Meeting on Coordination and Harmonization of HIV/AIDS, TB a nd Malaria Strategies. Brazzaville, Congo 5-7 March 2014. Treatment 2015 launch. The agreed target…. .. a nd focusing on treatment is strategic. Treatment continues to expand. 2003. 2015. - PowerPoint PPT Presentation
Transcript of Brazzaville, Congo 5-7 March 2014
Brazzaville, Congo5-7 March 2014
5th Inter-Agency Meeting on Coordination and Harmonizationof HIV/AIDS, TB and Malaria Strategies
Treatment 2015 launch
The agreed target…
.. and focusing on treatment is strategic
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150
15,000,000
2012 20152003
Treatment continues to expand
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
0%
50%
100%28,600,000
2010 guidelines* 2013 guidelines*
14,000,000
66%39%
Source: UNAIDS estimates 2013
Gap in antiretroviral coverage varies within Africa
The agreed target is still ambitious…
…and is a stepping stone towards treatment for all in need
UNAIDS PCB calls for new targets
• Encompass new science• Drive progress• Guide action beyond 2015• Ultimately aspire to end the AIDS epidemic
Challenges ahead: 1- Societal
• Lack of knowledge of HIV status• Punitive policies and laws• Stigma and discrimination
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$136US$186
US$232US$278
US$682
Malawi Ethiopia Rwanda Zambia RSA$0
$100
$200
$300
$400
$500
$600
$700
$800
$900
South Africa*
Challenges ahead: 3- 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: 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
Challenges ahead: 5- Key populations and partnersa substantial share of new infections
Nigeria 51%Kenya
about 33%Mozambique more than
25% Morocco 80% Dominican Rep. 47% Peru 65%
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
What we can achieve
Projected annual AIDS-related deaths, assuming scale up to 95% coverage by 2020
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 2011-2050. PLoS ONE 7(2):e30216
With international support, universal access to ART is at reach in low- and middle income countries
MalawiLesotho
ZimbabweMozambique
BurundiUganda
Central African Rep.Tanzania
ZambiaSwaziland
KenyaLiberia
TogoRwanda
Sierra LeoneCameroon
ChadGuinea-Bissau
Côte d’IvoireBotswana
HaitiGuinea
NamibiaDjiboutiNigeria
South AfricaBurkina Faso
NigerBenin
EritreaGhana
MaliCambodia
BelizeMyanmarSenegal
AR
T c
osts
as
a pe
rcen
tage
of
GD
P
0 1 2 3 4 5 6 7 8%
2% – 5%
5% – 8%
0.1% – 1%
1% – 2%
Source: Williams arXiv 2012: http://arxiv.org/abs/1206.6774
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
Making it work: The African Union Roadmap
• Sustainable financing models
• Access to medicines – Local production and regulatory harmonization
• Leadership, governance and oversight
