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People in the poorest places have access to life-prolonging medicines

No money, no results! New estimates of need Carlos Avila and Catherine Hankins Joint United Nations Programme on HIV/AIDS XVIII International AIDS Conference Vienna, Austria, 18-23 July 2010.

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People in the poorest places have access to life-prolonging medicines

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  1. No money, no results!New estimates of needCarlos Avila and Catherine HankinsJoint United Nations Programme on HIV/AIDSXVIII International AIDS Conference Vienna, Austria, 18-23 July 2010

  2. Collectively we’ve made remarkable progress in many aspects of the response to HIV… … antiretroviral treatment, incidence of new infections, human rights

  3. People in the poorest places have access to life-prolonging medicines

  4. Young people are leading the prevention revolution by taking definitive action toprotect themselves from HIV

  5. Some high-burden countries have achieved a 25% reduction in HIV prevalence among young people by 2010

  6. Know your epidemic and response synthesis process ANALYSIS OF EPIDEMIC Incidence data (modelled or otherwise) Epidemiological Review: Drivers/ country specificity SYNTHESIS Prevention policies, response and strategic info review Review of resources for prevention ANALYSIS OF RESPONSE

  7. Human rights issues and the AIDS movement • Recent advances include the decision of the Delhi high court to strike down an anti-sodomy law dating back to the early days of the British Raj • China’s launching of needle exchange and methadone programmes for people who inject drugs need to be multiplied “Gay couple freed by Malawi presidential pardon return to home villages” Human rights campaigner says men have not been reunited amid fears for their safety

  8. One of the biggest human rights issues facing the AIDS movement is funding

  9. TOTAL annual resources available for AIDS in low and middle income countries, 1996-2009

  10. Spending per capita for HIV > $10 per capita $1 - $10 per capita $0.10 - $1 per capita < $0.10 per capita Source: UNAIDS global report 2008, Annex 2

  11. International AIDS Assistance: Trends in G8/EC & Other Donor Government Assistance, 2002-2009 USD billions Disbursements Commitments(Enacted Amounts) Sources: KFF and UNAIDS, Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments in 2009, July 2010

  12. ____________ _________ ___ ________ ________ ___ _________ ____ International Assistance for HIV, domestic spending, and financing gaps Eastern Europe and Central Asia DONOR 2 BILLION DONOR 3.5 BILLION South East Asia and the Pacific DONOR 21 MILLION Latin America and the Caribbean DONOR 8 MILLION Sub-Saharan Africa

  13. Now is not the time to slow down the responseNow is the time to accelerate it!

  14. Worst case scenarios if funding decreases: Increased mortality and morbidity Greater transmission risks Treatment interruption Increased burden on health systems Reversal of economic and social gains 17

  15. Resources needed to provide ART under two CD4 eligibility criteria (New WHO ART guidelines) 12,000 10,000 8,000 6,000 4,000 CD4 <350 CD4 <200 2,000 Millions US$ 0 2010 2011 2012 2013 2014 2015 18

  16. A call for efficiency!

  17. Improve how money is spent: • Spending at efficient scale • Long-term view to programming • Making available money work harder: • Collaboration • Technical support • Bridge funding 20

  18. Efficiency is not a choice; it is a necessity Opportunity to improve efficiency of programming: • Choose interventions strategically • Focus them where they will have maximum benefit 21

  19. Tie funding to performance • Efficient mechanisms (e.g. World Bank, Global Fund, bilateral) • Efficient implementers • Efficient technical assistance

  20. Assessing Fair Share 2: Donor Rank by Disbursements for AIDS per US$1 Million GDP*, 2009 Sources: KFF and UNAIDS, Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments in 2009, July 2010

  21. Resource mobilization action! Financing options Increase domestic funding Fair share from bilaterals Corporate Partnerships Framework Agreement on Debt2Health Airline ticket tax BRIC governments becoming donors Huge accumulation of wealth (Sovereign Wealth Funds, HNI) Robin Hood Tax (take a look at the videos on http://robinhoodtax.org.uk/) 24

  22. Bilateral Aid for AIDS in 2008 Bonus paid to London Financial staff at Christmas 2006 Amounts spent on Valentine's day Cost of war in Iraq in 2008 - 25 50 75 100 125 150 175 200 US$ billion How much is too much?

  23. What will it take for you? What will it take for everyone of us……. …..to think strategically, raise our voices to advocate, and take action for the funding of a decent response to AIDS?

  24. THANK YOU!

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