Plenary Sessions ICASA 2011 Summary December 8, 2011

1. Plenary SessionsICASA 2011 SummaryDecember 8, 2011 Mikael Hailu, Abraham Gebre-Amlak, Saba Lambert, Misrak Makonnen, Katie Morris & Abiola Tielley-Gyado

2. Thirty Years Perspective • Tracing the historical perspective of interventions for setting and implementing HIV/AIDS programs • A world of stigma and discrimination • A decade of “denial and silence” to “silence to action” • From civil societies advocacy to African government commitments and international donor responses • Highlights of the successes during the 30 years journey • Prevention interventions • ART roll-out (5 million on ART) • Scientific efforts for vaccine research • Mobilization of financial resources

3. Thirty Years Perspective • Setbacks • Continuous problem of stigma and discrimination • Significant number of PLHIV still in need of ART • Low enrollment of children on ART • More than 50% of African countries lagging behind in ARV coverage for MTCT • Less toxic, more effective and combination drugs are not available in resource limited countries • Limitation in financial resources - commitment of African leaders (Abuja Declaration) & International donors (Global Fund Round 11) • Ineffective and inefficient use of scarce resources

4. Thirty Years Perspective • From challenges to opportunities for change • Need for a “ smarter strategic response” • Evidence based interventions with more emphasis on practical and realistic approaches • Importance of reassessing past interventions, and following up on key intervention areas • Adherence • Prevention of new infections • Provision of treatment for those in need

5. Thirty Years Perspective • From challenges to opportunities for change • A change in funding paradigm • Greater responsibility of African leaders in their commitment against HIV/AIDS • A level of accountability of international donors • A need for strong capacity building to ensure deliverables from and ownership by Africans • Synergies with other health programs

6. Focus Areas • Ensuring Key populations, Youth & women’s rights in HIV/AIDS response • Lack of representation • Limited access to information and services • Limited financial support for targeted interventions • Way forward • Providing targeted programming focusing on the needs and rights of youth, women and key population • Ensuring social justice for all

7. Focus Areas • PMTCT – new target and new momentum • Long way to reach current status that required strong commitment from scientists, leaders and implementers • Zero transmission from mother to child by 2015; new PMTCT guidelines (HAART); • Way forward: • Building linkages and effective integration with the MCH services and communities • Addressing health and social systems bottlenecks • Pursuing high level advocacy to ensure shared accountability among leaders • Ensuring allocation of needed resources

8. Focus Area • Treatment 2.0 • Treatment to be more effective, affordable and accessible • Strategies developed in order to meet the goal of treating 15M people by 2015 • TB and HIV • Starting TB patients on ART within two weeks regardless of the CD4 count will reduce TB mortality and new cases

9. Focus Areas • Treatment as prevention • Transmission is reduced by 35 to 52% when VL < 400 • Early ART start will reduce HIV transmission by 96% • Primary prevention (PEP) – Reduction of HIV transmission • Gel: by 39%; TDF/FTC: by 73% • Test and treat studies are underway

10. Focus Area • Health System Strengthening • Laboratory technologies need functional systems to be successful • Using improvement of laboratory services for HIV care delivery as an entry point for greater public health impact • Various strategies to build up the capacities of health facilities – infrastructure, laboratory services including quality assurance, and human resources

11. Efforts undertaken in the last 30 years need to be continued and strengthened Own, Scale-up and Sustain!