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Universal Access and Other HIV, TB, and TB/HIV Targets. What will be covered. Why are Declarations/ Targets useful? What are some Declarations/ Targets relevant for TB, HIV, TB/HIV and are we achieving them? -Millenium Development Goal, -Universal Access
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What will be covered • Why are Declarations/ Targets useful? • What are some Declarations/ Targets relevant for TB, HIV, TB/HIV and are we achieving them? -Millenium Development Goal, -Universal Access -Global Plan to Stop TB (2006-2015) -Abuja • Activist uses of targets
Why are Declarations and Targets Important? • Declarations are reflections of political commitment and concern • They reflect on what actions to be undertaken to address the issue • When they contain targets, these can be used to mobilize resources, initiate and speed up action, monitor and evaluate progress
Some Declarations/ Targets Relevant for TB/HIV • Millenium Development Goals • Universal Access Goals • Global Plan to Stop TB • Abuja Declaration and Maputo
Millenium Development Goals (HIV) www.dfid.gov.uk/Pubs/files/ mdg-factsheets/hivandaidsfactsheet.pdf
UNAIDS related Declarations relevant Universal Access for HIV/AIDS • United Nations General Assembly Special Session on AIDS (UNGASS) Declaration of Commitment (01) and UNGASS+5 Review Political Declaration (06): • 2001 DOC- No treatment tgts (has prevention tgts), No TB mention, Language about involvement of CSO in review • 2006 PC- Emphasizes scale up of TB/HIV Collaborative Services in line with Global Plan to Stop TB (06-15). • National UA HIV/AIDS targets
Are we achieving UA for HIV? • UA is often defined as 80% of all those in need get access to services • For ART 2007: est PWH 33.2 M, 9.7 M need ART, 3 M put on treatment • It is anticipated that most countries will not reach their UA targets by 2010
Millenium Development Goals (TB) www.dfid.gov.uk/Pubs/files/ mdg-factsheets/tuberculosisfactsheet.pdf Has led to the WHO TB target of identifying 70% of new pulmonary TB cases and successfully treating 85% of them
Global Plan to Stop TB (2006-2015) • Launched at the World Economic Forum in Jan 2006 • In 2005, World Health Assembly supported it • Targets: - Halt and reverse incidence by 2015 - Halve prevalence and death rates by 2015 compared to 1990 levels - Target at least 80% of all cases will be detected by 2015 and cure rates will be 85% of cases by 2010 (DOTS Exp WG)
Progress towards GP2 Targets • 2006 case detection of SS+ cases in DOTS programs, estimated 61% • Treatment success rates in DOTS programs globally 84.7% • African region, India, and China have 69% of the undetected cases • European region has lowest treatment success rate (71%)
Progress towards GP2 Targets (Contd) • Target of halving the TB incidence compared to 1990 levels will be met before 2015 • TB prevalence and death are falling: but targets will not be met in Africa and Europe
Are we reaching the TB/HIV GP 2 Targets? • 12% of TB cases tested for HIV • 78% of TB/HIV cases given CPT • 67,000 TB/HIV cases given ART, target 220,000 • Only 0.1% of HIV+ cases w/out TB given IPT • Only 2032 of 23353 MDR-TB cases treated according to WHO guidelines
Abuja Declaration & Targets • Abuja Declaration on HIV, TB, and Other Related Infectious Diseases (2001) • Signed by African Union Heads of State • Commited 15% of annual budget to health • Zambia met the target, Namibia, South Africa, Uganda, and Malawi are all @11 % among South and East Africa in 2003
Uses of Targets • Activist Case Study • Other uses of targets? -Advocating for targets to be created/ changed -Shadow reports, -Participation in global monitoring and evaluation process, -Based on monitoring and evaluation outcomes, advocating for actions and resources to achieve targets.