Alan whitside - HEARD
Upcoming SlideShare
Loading in...5
×
 

Alan whitside - HEARD

on

  • 462 views

Title - What is going on HIV and AIDS in 2013 and beyond

Title - What is going on HIV and AIDS in 2013 and beyond
Presented at the HIV Capacity Summit. view program here - http://www.hivcapacityforum.org/index.php?sid=12

Statistics

Views

Total Views
462
Views on SlideShare
462
Embed Views
0

Actions

Likes
0
Downloads
3
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • This slide needs updating
  • By 2009-10, approximately one third of the total investment was from domestic public budgets, mostly in the middle-income countriesApproximately a further one third was in the form of technical assistance, and not directly spent in countries
  • In both prevalence among 18-49 is 31%. Decline in youth rates.

Alan whitside - HEARD Alan whitside - HEARD Presentation Transcript

  • WHAT IS GOING ON IN HIV AND AIDS IN 2013 AND BEYOND Prof Alan Whiteside RATN MEETING JOHANNESBURG March 2013
  • Outline 1. Context: Epidemiology • Where the epidemic is • Hyper-epidemic countries 2. What does this mean • For development (and MDGs) • Economic growth • Donors 3. Responding • Prevention (first prize) • Treatment • Impact mitigation 4. Conclusion • Understand your epidemic • Prioritize
  • 2009 Global HIV Infection33.3 million people [31.4–35.3 million] living with HIV2.2
  • Exceptional Epidemics: Prevalence in Africa2009 (Adults 15–49) Source: UNAIDS Global Report 2010 Geneva: UNAIDS (2009data)
  • HIV prevalence & no of HIV+ people countries with >1% of SSA HIV+ population. HIV prevalence and number of HIV positive people in countries with 1% or more of the total Sub-Saharan African HIV positive population. Data from: UNAIDS (http://www.unaids.org/en/dataanalysis/epi demiology/
  • DHS HIV Prevalence Swaziland 2006
  • HIV and AIDSCountry Number of adults HIV/AIDS living with HIV Prevalence rateSwaziland 190,000 26.1%South Africa 5,700,000 18.1%Botswana 300,000 23.9%
  • Comparison of Epidemics•Scale of the epidemic: Southern Africa unbelievablyhigh over 15%,•Numbers•Mode of transmission: SA - unprotectedheterosexual intercourse•Ability to respond: a function of wealth and politicalcommitment
  • What does this mean (more) • For development (and MDGs) • Economic growth • Donors
  • Demographics: Population Growth Rate
  • Beyond the MDGs
  • Responding • Prevention (first prize) • Treatment • Impact mitigation
  • Epidemic Curves: HIV, AIDS and Impact Numbers HIV prevalence Impact A2 A1 A AIDS - cumulative B B1 T1 T2 Time Epidem’gy& Lit. p. 27 27Aug01 -Report I:
  • Logic for Prevention 1. Growing case load • For every two people put on treatment there are five new infections 2. Stretched health systems • Lack of buy-in, time for adequate training, intervention that ‘speak to’ individuals 3. Strained human resources • 13 providers per 100,000 people in SSA • 5,100 new doctors per year in Africa (compared to 173,800 in Europe) 4. Money
  • AIDS Treatment without prevention is moppingthe floor while the tap is running
  • What Works in Prevention? Currently: PMTCT Male circumcision Male and female condoms Potentially: Microbicides PREP Vaccine Cure Behaviour change that works
  • What Should Work in Prevention Behaviour change Fewer partners Less concurrency Later sexual debut What Needs to be Addressed… • Poverty/ economic inequalities • Gender inequalities • Leadership and policy • Etc.
  • Total annual resources available for AIDS in low and middle income countries Domestic contributionSource: UNAIDS analysis based on (1) Kaiser Family Foundation and UNAIDS , financing the Response to AIDS in low andmiddle income countries from the G8, European Commission and other Donor Governments in 2009, July 2010; (2)UNAIDSOECD/DAC online database (last visited on January 05, 2011); (3) Funders Concerned About AIDS (FCAA), 2010; (4)European HIV/AIDS Funders Group (EFG, 2010; (5) UNAIDS Unified Budget of Work (UBW) for 2010 & 2011); (6) Disbursementsreports and pledges and contributions reports from the GFATM (last visited on Jan 06 2011(7) budget review from Donorgovernments and multilateral organizations.
  • Donor funding for Africa flattened, domesticfunding increasing (UNAIDS)
  • African Treatment Programmes aid dependent!
  • Fiscal Space for Health SpendingHealth expenditure per capita is predicted by GDP Source: International AIDS Society presentation by van der Gaag, McGreevey & Stimac
  • National Health Expenditures
  • Global Positioning 2012The United States:Terra Nova: How to achieve a successful PEPFARTransition in South Africa, A report of the CSIS GlobalHealth Policy Centre, December 2011The Global Fund:Round 11 Cancelled Pledges not metUNAIDS:AIDS Dependency Crisis Sourcing African Solutions
  • AIDS Dependency Crisis: Sourcing African Solutions (UNAIDS)1. Strengthen African ownership, exploit & diversifysources • Negotiate long-term predicable money from donors • Grow African investments • Compact for shared differentiated responsibilities • Explore sustainable innovative financing2. Quality Assured Medicines sooner to those in need3. Establish centres of excellent for local production of medicines in Africa
  • 2007 DHS and 2011 SHIMS HIV Prevalence in Swaziland (ages 18-49)Men: Prevalence by Age Women: Prevalence by Age
  • Conclusion • The HIV epidemic is no longer on the top of the agenda – it is being overtaken and mainstreamed • Understand your epidemic • Prioritize • Be realistic
  • THANK YOU