New targets post 2015: Leave No One Behind Jacqueline Makokha

1. New targets post 2015: Leave No One Behind Jacqueline Makokha UNAIDS, Regional Support Team, Eastern and Southern Africa 20 August 2014

2. HIV epidemic in the ESA region (2013) Number of people living with HIV 18.5 million Number of children living with HIV 2.0 million Number of new HIV infections 1.1 million Number of new HIV infections among children 120,000 Number of AIDS deaths 730,000 Number of people receiving ART 7.7 million Source: UNAIDS 2014

3. Overview of the HIV epidemic in the ESA region (2013) Source: UNAIDS 2014

4. Overview of the HIV epidemic in the ESA region (2013) Source: UNAIDS 2014

5. The importance of location and population

6. HIV prevalence among young women and men aged 15-24 years in East and Southern Africa in 2013 Source: UNAIDS 2014

7. HIV prevalence among South African boys and girls in grades 9 and 10 in a rural district Source: Kharsany, A. B., M. Mlotshwa, et al. (2012). BMC Public Health 12: 231.

8. Challenges: Key populations (PHID, MSM, FSW)a substantial share of new infections • Swaziland ≈ 12% • Mozambique ≈ 20% • South Africa ≈ 25% • Kenya (incl. prison pop) ≈ 30% Source: Gouws E, Cuchi P. Sex Transm Infect 2012;88:i76–i85

9. HIV prevalence among MSM in Africa Ranging from: 6% in Cairo to 31% in Cape Town Source: Griensven et al. Current Opinion in HIV and AIDS 2009

10. Global HIV prevalence among adult female sex workers, 2013 Source: Beyrer, et al, The Lancet, 2014.

11. Percentage of adults (aged 15+) and children (aged 0-14) living with HIV who were receiving ART in 2013, in 21 priority countries Source: UNAIDS 2014

12. HIV treatment cascade for adults in sub-Saharan Africa aged 15 years or more, 2013

13. Source: UNAIDS / UNICEF / WHO

14. Summary of the epidemic in ESA Remarkable progress has been made in the region • Significant increase in ART and PMTCT coverage • Significant decline in AIDS deaths and in TB/HIV deaths • Important declines in new adult and child HIV infections • Funding support for the HIV response has been extraordinary and has enabled countries to significantly expand their responses • Increased focus on improving effectiveness and efficiency of the response

15. Population groups left behind

16. 12 population groups left behind • Adolescent girls • Prison populations • Immigrants • People who inject drugs • Older people who are HIV+ • Older people who do not think they are at risk • Sex workers • Transgender women • Children left behind on treatment • Women of reproductive age • HIV+ displaced persons • People with disabilities

17. Source: Human Sciences Research Council / Centers for Disease Control and Prevention / Human Rights Watch / Ukrainian Institute for Social Research after Olexander Yaremenko and United Nations Office on Drugs and Crime

18. Source: UNAIDS / UNODC

21. New targets post 2015

22. Why new targets are needed New targets are needed for four reasons: 1) Targets drive progress 2) New scientific evidence has emerged  3) New targets are needed to guide action 4) Bold new targets to end the epidemic demonstrates that AIDS is a winnable fight

23. HIV Treatment access gap

27. Ending AIDS, leaving no one behind • Too many people are left behind today – a challenge • 12 populations left behind by AIDS response (Sex workers, men who have sex with men; bisexual, transgender and intersex people; prisoners; people who inject drugs; migrant workers, people with disabilities; and women and girls) • Need to address stigma and discrimination • Close the gap between people who are reached with HIV services and people who are not • Require research and innovation combined with protective laws

28. Thank you