• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Impact of the Economic Crisis on HIV AIDS
 

Impact of the Economic Crisis on HIV AIDS

on

  • 1,461 views

Presentation for AIDSImpact conference

Presentation for AIDSImpact conference
Gaborone (Botswana) 23 Sept. 2009

Statistics

Views

Total Views
1,461
Views on SlideShare
1,459
Embed Views
2

Actions

Likes
0
Downloads
20
Comments
1

1 Embed 2

http://www.slideshare.net 2

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

11 of 1 previous next

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
  • Very interested.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Impact of the Economic Crisis on HIV AIDS Impact of the Economic Crisis on HIV AIDS Presentation Transcript

    • How the current economic crisis might impact HIV in low and middle income countries ? AIDS Impact Conference, Gaborone, Botswana, 23 September 2009 Economics and Development Analysis Unit, Geneva Erik Lamontagne, Robert Greener UNAIDS
    • Where were we before the crisis
      • 33,2 million of people living with HIV
      • 2,5 million of new infection each year
      • 2,1 million deaths each year
      • => despite a slower progression of the epidemic, there is an increasing number of PLWHIV
      • More than 4 million people under treatment (need=9.5)
        • represent 42% of people in need
      • Scaling down or status quo is not a possibility
    • How might the situation evolve ? Donor’s side
      • Relationship ODA:eco growth=not straightforward
      • but: ODA correlated with financial crisis (+5years)
      • increased difficulties to meet ODA commitments
        •  fiscal deficit due to:  recovery packages,  social countercyclical measures,  tax revenues
      • Downward trend exchange rate:  real ODA
      • All political engagement leading to commitment at G20, UN, parliaments, … = essential
    • How might the situation evolve ? Developing countries
      • Outlook for LIC and MIC: remains challenging
      • Social protection weak or inexistent
      • Public Fin. under pressure, no fiscal space
      • Incapability to finance/imple. countercyclical xpdture
      • Crisis: Poorest groups are hit disproportionally
        • More precarious employment, low revenues, low savings,…
      • Essential role of external aid to supplement social countercyclical measure (including for HIV)
    • Exposed countries
      • Vulnerability of countries to the economic crisis:
        • 1. Exposure to the crisis
        • 1.1 Level of poverty
        • 1.2 impact of the crisis on growth GDP pc
        • 2. Capacity to react and protect its population
        • 2.1 country’s ability to manage higher fiscal deficit
        • 2.2 country’s institutional capacity to reach vuln. pop.
        • 3. Economic share of HIV
        • 3.1 resource needs estimates for 2010 as a share of GNI
    • Lamontagne, Greener, UNAIDS, oct 2009
    • Worst scenario: if funding decreases
      • Risks are
      • Interruption of current treatments (2 nd line)
      • Freeze of ART (no scale-up, no new enrolment)
      • Cut on Prevention activities
      • Some MARP: if not a political priority: left aside the road
        • MSM, IDU, prisoners, … vs pregnant women
    • Worst scenario: consequences
      • Increased mortality and morbidity
      • Increased vulnerability to HIV infection
        • Riskier behaviour (transactional sex, alcohol)
        • Increased migrants, increased vulnerability of poorest
      • Increased pressure on health systems
        • financial, human resources, facilities
      • Persistent reversal of econ. & social gains
    • Evidence
      • Increased riskier behaviour
        • 58% of CSW entered into sex work in the wake of the economic crisis (Cambodia, UN study)
      • Decline in HIV vaccine R&D investment
        • AIDS Vaccine decline by 10% in 2008
      • Increased challenges to bring additional financing
        • GFTAM is currently facing a $5 billion shortfall in order to meet the growing demand from countries applying for funding
    • Crisis: the unsustainable case for vulnerable PLWHIV HIV POVERTY EXTREME POVERTY Coping strategies   Debt   Destitution  Out schooling  Riskier behaviour (CSW)  Migration … Loss of employment / income No social protection HIV => Catastrophic health expenditures Treatment inaccessibility  Food consumption
    • Reducing the impact of the crisis 1
      • Monitor the impact of the crisis on:
        • ART
        • Prevention activities, particularly for MARP
        • Resilience of civil society (NGO & communities)
    • Reducing the impact of the crisis 2
      • 2. Improve how funds are spent
        • Repriorisation and reallocation to top-priorities
          • Avoid ART or cash flow interruptions
        • tracking of the use of funds
        • Search for economies of scale and scope
        • Push for effective integration of HIV activities and health services
        • Lower the cost of treatment
          • Promote the use of generic drugs
          • Regional negotiations for prices of ART
          • TRIPS flexibilities (within internationally agreed measures)
    • Reducing the impact of the crisis 3
      • 3. Internalise the likely decrease in funding
        • Review the priority for long term response
        • Diversify the mix of external and domestic financing mechanisms for HIV programmes
          • Provide a more stable financing base for the long term
        • Bring HIV out of isolation:
          • Integration in health services; social protection
    • Conclusion
      • The current crisis is having strong negative impact on households LWHIV
      • Short term impact must be tracked and responded to
      • We must improve how (where) funds are spent
      • Diminution of HIV financing after the crisis is a scenario that must be considered
      • Political commitment is essential (global and national)
    • Thank you for your attention UNAIDS, Economics and Development Analysis Unit, Geneva Contact: Erik Lamontagne: lamontagneE@unaids.org Robert Greener: greenerR@unaids.org
      • annexes
    • Evolution of ODA
      • No correlation between ODA and economic crisis
      5 years of decrease of ODA while strong economic growth (3,2% yearly) 5-8 years to recover
    • Correlation financial crisis –ODA
    • Current perception
      • Quick assessment survey UNAIDS, WB WHO (03.2009)
      • Perception of UNAIDS country coordinators:
      • Already Impact on ART: 12% of countries surveyed
      • Within 12 Month potential impact on ART: 32% of countries (representing 61% plwhiv)
      • Within 12 Month potential impact on Prevention: 50% of countries (representing 75% plwhiv)