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Track E Report

Track E Report. François DABIS (France) On behalf of Track E Rapporteur Team Benjamin CHI (USA & Zambia) Donn COLBY (USA & Vietnam) Anna MILLER (UK & Zimbabwe) Joanna ORNE-GLIEMANN (France) Freddy PEREZ (USA & Ecuador).

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Track E Report

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  1. Track E Report François DABIS (France) On behalf of Track E Rapporteur Team Benjamin CHI (USA & Zambia) Donn COLBY (USA & Vietnam) Anna MILLER (UK & Zimbabwe) Joanna ORNE-GLIEMANN (France) Freddy PEREZ (USA & Ecuador)

  2. Scope of Track EImplementation Science, Health systemsand Economics • 7 plenary sessions • 35 concurrent sessions, special sessions, symposia and oral poster discussions • 504 posters

  3. Implementation science and health systems • eMTCT • Male circumcision • Care and retention • Vulnerable populations Economics • Social protection • Country ownership – HIV and beyond • Global financing

  4. Implementation science and health systems • eMTCT • Male circumcision • Care and retention • Vulnerable populations Economics • Social protection • Country ownership – HIV and beyond • Global financing

  5. eMTCT: Option B+ BenefitsA business case (Luo, Wednesday Plenary)

  6. Malawi: “Option B+” Scale UpChirwa, SUSA40 Six-fold increase in number of pregnant & breastfeeding women starting ART (from 1200 in Q2 to 15,000 in Q4) Source: Courtesy of Dr Erik Schouten, unpublished data, Malawi

  7. The use of cell phones, as part of an active community tracking program has benefited the Haiti early infant diagnosis program and increased adherence (Segaren, WEAE03)

  8. Roll-out of male circumcision: substantial country differences (Mugo, Tuesday Plenary) % of target achieved

  9. Effectiveness Swaziland, Reed, MOPDE01 Reported male circumcision was 16% in 2011, double that of 2007 estimates (8%) Circumcised men were more likely to have accessed HIV testing and prevention services and less likely to be infected (14% vs. 24% prevalence) Health work force issues in implementation Kenya, South Africa, Tanzania, Zimbabwe, Rech, MOPDE01 Occupational burnout can reach 70% for MDs

  10. HIV care and treatment cascadein sub-Saharan Africa % N = 58,779 persons • Mugglin C &IeDEA (in press), c/o Hirnschall, Thursday plenary

  11. mHealth and community-based data reporting: Tanzania (Regan, WEAE03) After 2 months After 6 months 37% of patients had usable monthly report 43% of patients had usable monthly report Only 6% of monthly reports collected Received 85.5% of monthly reports (but with more information missing) Paper

  12. Efficiency: Dramatic gains in life expectancy in rural South Africa at population level (Bor & Bärnighausen, TULBE) Public Sector ART Rollout 60.6 years in 2011 52.4 years in 2003

  13. Ukraine - Pharmacies provide free of charge services to injecting drug users and sex workers (Naduta, WEPDE02)

  14. Population-based studies of combination prevention(Hankins, MOBS01) Titel

  15. Implementation science and health systems • eMTCT • Male circumcision • Care and retention • Vulnerable populations Economics: how to be “smart” • Social protection • Country ownership – HIV and beyond • Global financing

  16. … However more than money needed for sustained impact on adolescent HIV risk (Watts, TUPDE01) Conditional cash transfers improve birth registration and school attendance amongst orphans and vulnerable children in Manicaland, Zimbabwe (Robertson, TUPDE01)

  17. Rwanda: Health Insurance and ART coverage rise in tandem ART Coverage (%) Nsanzimana, session MOSY03

  18. Non Communicable Diseases and HIV Overlapping epidemics but funded separately How to integrate? (Rabkin, MOAE01)

  19. EffectsoftheCompulsoryLicense in Brazil Nationalproduction CL ViegasNevesda Silva, WEAE01

  20. Trends in ARV drug price and their determinants in developing countries (SagaonTeyssier & Moatti, WEAE01) • Genericcompetitionisthe driving force for ARV pricedecreases • Getting close to marginal cost for first-linedrugs • ARV priceremains a major barrier for switching to 2nd and 3rd lines • Middle-income countries face new difficulties in negotiatingdrugprices and thusreachinguniversalaccess • (Bhardwaj, WEAE01)

  21. Smart investmentsThe 2012 toolboxBinagwaho, Goosby, Kim, Schwartländer, Sidibé, … • Country ownership: domestic efforts > international contribution • Equity: basic social protection everywhere • Evidence-best approach: focus on what works and deliver prevention and ART more efficiently • Community participation • Strong partnerships: North-South, South-South, public-private • Sustainability: new innovative mechanisms of domestic and international financing

  22. Pay now - or pay forever (Schwärtlander, Tuesday plenary) 2015 gap with current policy scenario: US$ 7 billion HIV investment US$ (billions) New HIV infections (millions)

  23. Track EImplementation Science, Health systemsand Economics At the fork to Zero AIDS • Implementation research helps us to learn what works and how it can be replicated • Reaching targets at scale requires strong health systems including communities in order to deliver • Investing in HIV is also investing in health systems • Invest now in this epidemic and we will save lives The 7 billion (minimum) gap is killing people and reduces our chances to reach an HIV-free generation

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