Innovative Financing : Exceptionality of AIDS

1. Innovative Financing:Exceptionality of AIDS Brookings Institution and the Health Financing Task Force Washington D.C. 25 July 2006 Dr Peter Piot, UNAIDS Executive Director

5. AIDS Resource Needs

7. Global AIDS Funding • World Bank Multi-Country AIDS Program • The Global Fund to fight AIDS, Tuberculosis and Malaria • President’s Emergency Plan for AIDS Relief

12. Funding • US$ 20-23 billion needed by 2010 • Who will pay? (Domestically, internationally) • Predictability and sustainability of financing

13. Expenditure by source of funding Expenditure by allocation of funding

14. Expenditure by source in 13 LAC countries, 2002. Total expenditure = USD$ 588,550,000 Brazil is not included in the sample. 4.6% is for administration and infrastructure

15. Expenditure by Source in West African countries, 2003 Total expenditure = USD$ 51,858,000 11.1% is for administration and infrastructure

16. Innovative Mechanisms • International Financing Facility • Solidarity Contribution on Airline Tickets • Red Campaign • National AIDS Levy (Zimbabwe)

17. Making the money work • Reduce unit costs • Specific AIDS services as part of health system • Invest in human, institutional and community capacity • Use money for results and impact • “3 Ones”: Ownership, coherence and accountability-OECD / DAC

19. Making the money work • Reduce unit costs • Specific AIDS services as part of health system • Invest in human, institutional and community capacity • Use money for results and impact • “3 Ones”: Ownership, coherence and accountability-OECD / DAC

20. Specific HIV treatment services as part of health system • Ryan White Act • Brazil: Federal programme on antiretroviral therapy • Mexico: Universal access to antiretroviral therapy • Thailand: 30-baht scheme includes antiretroviral therapy • South Africa

21. Making the money work • Reduce unit costs • Specific AIDS services as part of health system • Invest in human, institutional and community capacity • Use money for results and impact • “3 Ones”: Ownership, coherence and accountability-OECD / DAC

24. Making the money work • Reduce unit costs • Specific AIDS services as part of health system • Invest in human, institutional and community capacity • Use money for results and impact • “3 Ones”: Ownership, coherence and accountability-OECD / DAC

25. Funding of health services will not stop AIDS • HIV prevention largely outside health services • Tackle drivers of epidemic

26. Social change: Tackle the structural drivers of the epidemic • Gender • HIV related stigma and discrimination • Sexuality, including homosexuality • Social and economic inequalities directly related to AIDS

27. Southern Africa:Need for an AIDS “Marshall” plan? • Enormous impact of AIDS epidemic • Even major intensification of current efforts may not be enough • Exceptional financing and policy measures needed

28. Maintaining the exceptionality of AIDS – but at the core of development & health agendas, not outside

29. AIDS has rewritten the rules; to prevail we too must continually rewrite the rules.

30. Thank you