What will it take to turn the tide?

1. What will it take to turn the tide? Bernhard Schwartländer Yogan Pillay Till Baernighausen

2. Doing it better

3. Business as usual will lead to stagnation Investment New HIV infections (millions) HIV investment US$ (billions) Schwartländer et al. Lancet 2011

4. Business as usual will lead to stagnation Investment HIV investment US$ (billions) New HIV Infections New HIV infections (millions) Schwartländer et al. Lancet 2011

5. Better investments can achieve large gains HIV investment US$ (billions) New HIV infections (millions) Schwartländer et al. Lancet 2011

6. Pay now - or pay forever 2015 gap: US$ 7 billion HIV investment US$ (billions) New HIV infections (millions) Schwartländer et al. Lancet 2011

7. Value for money: doing the right things 300 000 Russian Federation Number of new HIV infections Brazil - 1980 1990 2000 2010 Source: UNAIDS

8. Value for money: doing things right AIDS Resources and Treatment scale-up Africa 2002 – 2011: 16 14 12 10 8 6 4 2 - 7 6 5 4 3 2 1 - AIDS Resources (US$ billion) Millions of people on ART AIDS investment Antiretroviral treatment 2002 2003 2004 2005 2006 2007 2008 20092010 2011 Source: UNAIDS, WHO 2012

9. Value for money: price reductions Median price of selected first-line regimens in low-income countries 700 2008 2011 - 60% US$/ppy - 57% - 53% - 41% - 15% 0 TDF+FTC+NVP TDF+3TC+EFV 3TC+NVP+ZDV ZDV+3TC+EFV TDF+FTC+EFV Source: Global Price Reporting Mechanism, WHO 2012

10. New World

11. Economic growth is rapidly changing the world order 2000 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

12. Economic growth is rapidly changing the world order 2001 2000 2003 2002 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

13. Economic growth is rapidly changing the world order 2001 2000 2003 2002 2005 2004 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

14. Economic growth is rapidly changing the world order 2001 2000 2003 2002 2005 2004 2007 2006 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

15. Economic growth is rapidly changing the world order 2001 2000 2003 2002 2005 2004 2007 2006 2009 2008 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

16. Economic growth is rapidly changing the world order 2004 2001 2000 2003 2005 2002 2007 2009 2008 2011 2010 2006 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

17. Economic growth is rapidly changing the world order 2007 2001 2000 2003 2002 2004 2005 2006 2008 2011 2010 2013 2012 2009 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

18. Economic growth is rapidly changing the world order 2006 2001 2000 2003 2002 2005 2007 2004 2009 2011 2010 2013 2012 2015 2014 2008 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

19. Economic growth is rapidly changing the world order 2009 2001 2000 2003 2002 2005 2004 2006 2007 2008 2010 2013 2012 2015 2014 2017 2016 2011 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

20. Economic growth is rapidly changing the world order 2008 2001 2000 2003 2002 2005 2004 2007 2009 2006 2011 2013 2012 2015 2014 2017 2016 2019 2018 2010 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

21. Economic growth is rapidly changing the world order 2008 2001 2000 2003 2002 2005 2004 2007 2009 2013 2006 2010 2012 2015 2014 2017 2016 2019 2018 2020 2011 High income Upper middle income Lower middle income Low income Source: IMF data, extrapolated 2017-2020

22. The vast majority of people living with HIV will be in middle income countries Proportion of people living with HIV by country income category, 2000 - 2020 Source: UNAIDS, IMF 2012

23. Inequality persists despite strong income growth South Africa: GDP per capita1996-2011 Per capita GDP Richest 20%of population Poorest 20% 1996 2011 Source: IMF

24. Inequality persists despite strong income growth South Africa: GDP per capita and income distribution1996-2011 Per capita GDP Share of national income held by: Richest 20% Poorest 20% 1996 2011 Source: IMF, World Bank

25. Most people living with HIV will live where the wealth is concentrated 600 big cities in the world in 2025: 25% of the population 60% of the global wealth 2 of every 3 people living with HIV will be living in urban areas by 2030 Source: McKinsey Institute, UNAIDS 2012

26. New Resources

27. Wealth for health: economic growth will benefit health budgets in low- and middle-income countries Grow to 15% of Gov Budget: plus US$ 640 billion US$ 2 020 bn Economic growth: plus US$ 670 billion by 2020 US$ 1 380 bn Health spending in 2012: US$ 710 billion US$ 710 bn Source: UNAIDS, WHO 2012

28. Options for domestic HIV financing in Africa US$ US$ US$ US$ US$ US$ 2.4 3.1 2.0 1.7 3.9 2.4 billion billion billion billion billion billion 1% income tax levy earmarked for AIDS Airline levy by all African countries 2% of public sector budgets earmarked for AIDS Contributions from high-revenue enterprises 75% of an alcohol levy Mobile phone levy Source: Estimates for UNAIDS by Oxford Policy Management, 2012

29. US$ Options for global development financing 4 US$ US$ billion US$ US$ 3 11 Issue diaspora bonds (1% of developing-country migrants’ savings) 64 billion billion 150 billion billion Global portion of widely implemented tobacco taxes (WHO) Extending the annual airline levy to all OECD countries Global tax on shipping and aviation fuels Global financial transaction tax Sources: World Bank, UN, IMF, AfDB, WHO, International Food Policy Research Institute, Bill & Melinda Gates Foundation

30. Those that say it can’t be done should get out of the way of those doing it Chinese Proverb Together we will end AIDS