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Towards an improved investment approach for an effective response to HIV. Dr Bernhard Schwartländer UNAIDS. We have done a lot …. Unprecedented scale up of services Decline in rate of new HIV infections in many countries More than 6.5 M on ART But we can do better
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Towards an improved investment approach for an effective response to HIV Dr Bernhard Schwartländer UNAIDS
We have done a lot … • Unprecedented scale up of services • Decline in rate of new HIV infections in many countries • More than 6.5 M on ART But we can do better Scale up to date guided by “commodity approach” • Unsystematic prioritisation and investment • Resources spread thinly across many parallel interventions • Focus on discrete interventions rather than overall results leading to a fragmented response
A shift in paradigmStrategic investment based on prioritisation and driven by latest evidence
100% 100% 90% 90% 80% 80% 70% 70% 60% 60% Coverage Coverage 50% 50% 40% 40% 30% 30% 20% 20% 10% 10% 0% 0% >500 >500 350-499 350-499 250-349 250-349 200-249 200-249 100-199 100-199 50-99 50-99 <50 <50 CD4 Count (cells/ml) CD4 Count (cells/ml) ART coverage in 2015 by CD4 count CD4 350 15 million (T4P) 13.1 million (health)
Return on investment:More than 12 million infections averted
Annual number of AIDS deaths: 2011-2020 9
Conclusions • Through a focused and committed approach we can turn this epidemic around • With an upfront investment over the coming 5 years, we will be able to turn cost around • Time to overcome the false dichotomy between prevention and treatment • In line with the commitments and targets included in the Declaration of the HLM AIDS The Lancet Vol 377 June 11, 2011 - Available online at www.thelancet.com