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Eb briefing hiv_strategy

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  • 1. Global Health Sector Strategy for HIV, 2011-2015: Overview Department of HIV/AIDS 12 January 2011
  • 2. Resolution WHA 63.19 asks for ….
    • A WHO HIV/AIDS strategy for 2011-15
    • To be developed through inclusive consultative process
    • Be aligned with broader strategic frameworks
    • Considers the changing international public health architecture
  • 3. Presentation structure
    • Structure and key features of Strategy
    • Consultation process
    • Next steps
  • 4. Background
    • Three elements
    • Reaffirms global goals for the health sector response to HIV
    • Proposes four strategic directions to guide national HIV responses
    • Provides a framework for WHO action at global, regional and country levels (a "corporate approach to HIV")
    • Alignment & coherence
    • Aligned with UNAIDS Strategy 2011-2015
    • Coherent with other health sector strategies (e.g. reproductive health; Stop TB; STIs; Public Health, Innovation and IP)…
    • Compliments strategies of partners (e.g. PEPFAR)
  • 5. Strategy Outline
    • Introduction
      • Alignment with UNAIDS and other strategies
      • Principle features and guiding principles of strategy
    • Strategic context ("situation analysis")
    • Global vision, goals and four strategic directions ("the onion")
    • Policies and interventions for countries
    • WHO action
    • Strategy implementation
  • 6. Section I: Introduction
    • Principal features
    • Defines health sector role within a multisectoral response
    • Global in scope but recognizes diversity of epidemics and need to tailor responses in countries.
    • Embeds HIV in the broader health agenda, aims at programmatic linkages and broader health outcomes.
    • Aims to enhance effectiveness and efficiency, ensure equity and improve quality and coverage of HIV programmes
    • Looks towards sustainability through strengthening health and community systems and addressing social determinants.
  • 7. Section II: Strategic Context & Considerations
    • HIV service coverage low, poorly targeted & poor quality
    • Linkages between HIV and other programmes not optimized – e.g. MNCH, TB services
    • Weak health systems hinder HIV responses – e.g. data use, access to medicines, inadequate human resources
    • Structural barriers impede access to services and increase vulnerability – e.g. stigma in the health work force that marginalizes most-at-risk populations
  • 8. Challenges
    • Less than 40% of people living with HIV know their status
    • Only 28% of children in need of HIV treatment had access in 2009
    • Coverage of prevention interventions among groups at higher risk for HIV infection remains <50% in many countries
    • In low income countries only 48% of blood donations were being screened in quality assured manner
    • 38% of countries reporting experienced at least one or more stock-out of antiretroviral drugs in health facilities in 2009
    • 18% of patients initiating treatment were lost to follow-up during the first year
  • 9. Evolving context – public health
    • Early treatment for people with HIV is not only life-saving but a critical element of prevention
    • Strong HIV response contributes to reducing maternal and child mortality
    • Antiretroviral drugs given to pregnant and breastfeeding women can virtually eliminate HIV in children - Elimination of transmission from mother to child by 2015
    • New prevention technologies (eg, microbicide gels, PrEP, etc.)
    • Efficiency gains through greater integration and decentralization of services
  • 10. Section III: Global Vision
    • A world free of new HIV infections and where all people living with HIV enjoy long and healthy lives
  • 11. Section III: Global goals
    • Overarching goals
      • Universal access to HIV prevention, treatment and care
      • Contribute to MDG6 and other MDGs (3, 4, 5 and 8)
    • Specific goals
      • Reduce new HIV infections
      • Eliminate HIV infection in children
      • Reduce HIV-related mortality
      • Reduce TB-related mortality
  • 12. Strategic Directions
  • 13. Section IV: Priority policies & interventions for countries
    • SD1 – Optimize HIV specific interventions
      • HIV testing & counselling
      • HIV prevention (including PMTCT, sexual transmission, IDUs)
      • HIV treatment and care (including HIV/TB)
      • Comprehensive HIV services for MARPs
    • SD2 – Strengthen linkages with key services:
      • TB
      • MNCH
      • Sexual and reproductive health
      • Drug dependence treatment and harm reduction
      • Chronic care and non-communicable diseases
      • Blood and injection safety
  • 14. Section IV: Priority policies & interventions for countries
    • SD3 – Build strong systems
      • Service delivery models
      • Health financing
      • Health workforce
      • Strategic information
      • HIV medicines, diagnostics and other commodities
      • Strategic planning
    • SD4 – Reduce vulnerability and remove structural barriers
      • Health in all policies
      • Stigma and discrimination and human rights
      • Gender equality
      • Community systems
      • Humanitarian crises
      • Laws and regulations
  • 15. Section V: What WHO will do
    • Support countries implement national HIV programmes through WHO's six core functions
    • Focus on 5 key contributions
      • Scale-up and innovation in HIV prevention (Prevention Revolution)
      • Treatment and care optimization (Treatment 2.0)
      • Health for women and children (Elimination of HIV in Children)
      • Health sector information and planning
      • Health equity and HIV
  • 16. Section VI: Strategy Implementation
    • Optimizing WHO HIV programme structure
    • WHO as a Cosponsor of UNAIDS
    • Collaboration with other partners
    • Monitoring and evaluating progress and reporting
  • 17. Consultation process
    • Broad and inclusive consultation process involving all key stakeholders and constituencies
    • More than 60 direct consultations with major constituencies and in all WHO regions
    • Civil society consultation and inclusion of CS in country consultations
    • 7-week on-line consultation
    • Overall, 109 Member States, and over 2,000 individuals or organizations provided input
  • 18. The Strategy - Consultation streams
    • Member States – Regional consultations
    • UNAIDS family and PCB members
    • Community – People living with HIV and key populations
    • Broader civil society – NGOs, FBOs, CBOs
    • Development partners
    • Strategic and Technical Advisory Committee on HIV/AIDS
    • Web-based consultation
    • Internal WHO
    • Guided by external advisory group (incl. Member States, UNAIDS, Global Fund, development agencies, civil society)
  • 19. Next Steps
    • 128 th WHO Executive Board, January 2011
      • Recommendation to WHA
    • 64 th World Health Assembly, May 2011
      • Possible endorsement of Strategy
    • Operationalization of Strategy
      • Support countries to implement national programmes
      • Plan WHO Secretariat action
        • Integrate into WHO Programme Budget
        • Regional adaptations through Regional Committees and Offices
      • Promote coherence with key partner strategies and plans