The document discusses a new investment framework for HIV/AIDS that was published in The Lancet in June 2011. The framework projects increasing spending on HIV/AIDS programs until 2015, followed by declining spending from 2015-2020 as programs reach critical coverage levels and transmission rates decline. The framework prioritizes six HIV program areas and identifies "critical enablers" like community mobilization that are needed to effectively implement programs. It provides a new model for planning and advocating for HIV resources that accounts for eventual declines in needed funding and services as control efforts succeed.
The document presents a new investment framework for the global HIV response. It identifies six basic program activities that are essential for an effective HIV response. Implementing the framework is estimated to avert over 12 million new HIV infections and 7 million deaths between 2011-2020, while gaining nearly 30 million life years. The framework provides a roadmap to accelerate progress in the global HIV response through more strategic allocation of resources based on evidence of effective prevention, treatment, and support programs.
The document proposes a new strategic investment framework for HIV/AIDS responses to improve effectiveness and efficiency. The framework categorizes investments into basic program activities, critical enablers, and synergies with other development sectors. Modeling suggests implementing this framework could avert over 12 million new infections and 7 million AIDS deaths between 2011-2020 compared to current approaches, at a cost-effective price of $1060 per life-year gained. The additional investment required would be offset by savings from reduced treatment costs.
Diseases do not respect boundaries Once diseases spread beyond a localized region, their expansion becomes exponential and difficult to contain. Early detection and containment by effective disease surveillance networks are critical to arresting pandemics in their early stages. Cross-country disease surveillance networks are a mechanism that encompass human resources deployment, rapid communication, and transparent collaboration for early detection and response to emerging diseases and pandemics.
This document summarizes key findings from recent literature reviews on community mobilization in the context of the UNAIDS Investment Framework. It finds that community mobilization is a crucial enabler for improving HIV program uptake and promoting local advocacy. Specifically, it discusses how community-based organizations are uniquely positioned to address scale-up of HIV services. It also outlines several themes around the importance of community involvement, including that communities best understand their own needs, people living with HIV should play a leading role, and peer groups are particularly effective.
Bridging the Humanitarian Development Nexus in HealthCORE Group
Development partners can bridge the humanitarian-development nexus in health by working collaboratively across institutional boundaries based on comparative advantages. New financing options include the Grand Bargain which brings humanitarian and development actors together, and the Global Concessional Financing Facility which provides concessional financing for development projects in refugee host countries. Addressing health challenges in humanitarian crises requires moving from separate humanitarian and development assistance approaches to an integrated nexus approach.
Monitoring progress towards universal health coverage at country and global l...The Rockefeller Foundation
A movement towards universal health coverage (UHC) – ensuring that everyone who needs health services is able to get them, without undue financial hardship – has been growing across the globe (1). This has led to a sharp increase in the demand for expertise, evidence and measures of progress and a push to make UHC one of the goals of the post-2015 development agenda (2). This paper proposes a framework for tracking country and global progress towards UHC; its aim is to inform and guide these discussions and assessment of both aggregate and equitable coverage of essential health services as well as financial protection. Monitoring progress towards these two components of UHC will be complementary and critical to achieving desirable health outcome goals, such as ending preventable deaths and promoting healthy life expectancy and also reducing poverty and protecting household incomes.
This paper was written jointly by the World Health Organization (WHO) and The World Bank Group on the basis of consultations and discussions with country representatives, technical experts and global health and development partners (3). A draft of this paper was posted online and circulated widely for consultation between December 2013 and February 2014. Nearly 70 submissions were received from countries, development partners, civil society, academics and other interested stakeholders. The feedback was synthesized and reviewed at a meeting of country and global experts in Bellagio, Italy, in March 2014 (4). The paper was modified to reflect the views emerging from these consultations.
The Neglected Dimension of Global Security: A Framework to Counter Infectious...The Rockefeller Foundation
The Ebola crisis in West Africa was both a tragedy and a wakeup call, revealing dangerous deficiencies across global systems to prevent, prepare, and respond to infectious disease crises. To address these shortcomings and inform a more effective response in the future, the National Academy of Medicine convened the Commission on a Global Health Risk Framework for the Future (GHRF Commission)—an independent, international group of experts in finance, governance, R&D, health systems, and the social sciences.
The Commission’s report highlights the essential role of pandemic preparedness in national security and economic stability—a critical but often under-examined dimension of the global conversation post-Ebola. Importantly, the report demonstrates that the impact of infectious disease crises goes far beyond human health alone—and that mitigation, likewise, requires the mobilization and long-term commitment of multiple sectors.
The document presents a new investment framework for the global HIV response. It identifies six basic program activities that are essential for an effective HIV response. Implementing the framework is estimated to avert over 12 million new HIV infections and 7 million deaths between 2011-2020, while gaining nearly 30 million life years. The framework provides a roadmap to accelerate progress in the global HIV response through more strategic allocation of resources based on evidence of effective prevention, treatment, and support programs.
The document proposes a new strategic investment framework for HIV/AIDS responses to improve effectiveness and efficiency. The framework categorizes investments into basic program activities, critical enablers, and synergies with other development sectors. Modeling suggests implementing this framework could avert over 12 million new infections and 7 million AIDS deaths between 2011-2020 compared to current approaches, at a cost-effective price of $1060 per life-year gained. The additional investment required would be offset by savings from reduced treatment costs.
Diseases do not respect boundaries Once diseases spread beyond a localized region, their expansion becomes exponential and difficult to contain. Early detection and containment by effective disease surveillance networks are critical to arresting pandemics in their early stages. Cross-country disease surveillance networks are a mechanism that encompass human resources deployment, rapid communication, and transparent collaboration for early detection and response to emerging diseases and pandemics.
This document summarizes key findings from recent literature reviews on community mobilization in the context of the UNAIDS Investment Framework. It finds that community mobilization is a crucial enabler for improving HIV program uptake and promoting local advocacy. Specifically, it discusses how community-based organizations are uniquely positioned to address scale-up of HIV services. It also outlines several themes around the importance of community involvement, including that communities best understand their own needs, people living with HIV should play a leading role, and peer groups are particularly effective.
Bridging the Humanitarian Development Nexus in HealthCORE Group
Development partners can bridge the humanitarian-development nexus in health by working collaboratively across institutional boundaries based on comparative advantages. New financing options include the Grand Bargain which brings humanitarian and development actors together, and the Global Concessional Financing Facility which provides concessional financing for development projects in refugee host countries. Addressing health challenges in humanitarian crises requires moving from separate humanitarian and development assistance approaches to an integrated nexus approach.
Monitoring progress towards universal health coverage at country and global l...The Rockefeller Foundation
A movement towards universal health coverage (UHC) – ensuring that everyone who needs health services is able to get them, without undue financial hardship – has been growing across the globe (1). This has led to a sharp increase in the demand for expertise, evidence and measures of progress and a push to make UHC one of the goals of the post-2015 development agenda (2). This paper proposes a framework for tracking country and global progress towards UHC; its aim is to inform and guide these discussions and assessment of both aggregate and equitable coverage of essential health services as well as financial protection. Monitoring progress towards these two components of UHC will be complementary and critical to achieving desirable health outcome goals, such as ending preventable deaths and promoting healthy life expectancy and also reducing poverty and protecting household incomes.
This paper was written jointly by the World Health Organization (WHO) and The World Bank Group on the basis of consultations and discussions with country representatives, technical experts and global health and development partners (3). A draft of this paper was posted online and circulated widely for consultation between December 2013 and February 2014. Nearly 70 submissions were received from countries, development partners, civil society, academics and other interested stakeholders. The feedback was synthesized and reviewed at a meeting of country and global experts in Bellagio, Italy, in March 2014 (4). The paper was modified to reflect the views emerging from these consultations.
The Neglected Dimension of Global Security: A Framework to Counter Infectious...The Rockefeller Foundation
The Ebola crisis in West Africa was both a tragedy and a wakeup call, revealing dangerous deficiencies across global systems to prevent, prepare, and respond to infectious disease crises. To address these shortcomings and inform a more effective response in the future, the National Academy of Medicine convened the Commission on a Global Health Risk Framework for the Future (GHRF Commission)—an independent, international group of experts in finance, governance, R&D, health systems, and the social sciences.
The Commission’s report highlights the essential role of pandemic preparedness in national security and economic stability—a critical but often under-examined dimension of the global conversation post-Ebola. Importantly, the report demonstrates that the impact of infectious disease crises goes far beyond human health alone—and that mitigation, likewise, requires the mobilization and long-term commitment of multiple sectors.
Future of Healthcare Provision Jan 2017Future Agenda
Building on insights from our 2015 future of health discussions, this is a new initial view on how healthcare provision may change, especially given emerging opportunities for improved patient engagement. As well as insights from discussions in India, UK, Canada, Singapore and the US it also includes other additional perspectives shared in interviews and workshops over the past 12 months.
We recognise that given the multi-factored nature of this topic and the rapid emergence of new options, what we have summarised in this document is itself in flux. As such, over the next few months we will be sharing this more widely for additional feedback ahead of publication of an updated paper over the summer. So, if you have any comments on changes and additions or issues that you think need more detail, please let us know and we will include.
As with all Future Agenda output, this is being published under creative commons (share alike non commercial) so you are free to share and quote as suits.
The document summarizes the key aspects of the Global Fund's New Funding Model (NFM) application process. It describes the NFM's emphasis on enhancing civil society and key population participation at all stages. It provides an overview of the application timeline and stages, including development of a National Strategic Plan, country dialogue, concept note submission and review, grant-making, approval, and implementation. It offers guidance for key populations and advocates on meaningful involvement at each stage, especially in developing robust epidemiological data and ensuring representation in country dialogue.
Countdown to 2015 was a conference held in London May 2010 which examined and critiqued many orthodoxies. It provided a chance to survey the fields of sexual and reproductive health and HIV from a very broad perspective, looking at issues from the clinical to the socio-economic.
For the poor in urban slums, the majority of the programs targeting community health are often to combat communicable diseases or do not prioritize NCD related outcomes.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
Minorities mobile broadband and the management of chronic diseasesEd Dodds
This document discusses a roundtable convened by the Joint Center for Political and Economic Studies to explore how mobile broadband technologies can help address health inequities experienced by racial and ethnic minority groups in the United States. The roundtable brought together leaders from government, healthcare, technology, and health policy to develop strategies to advance the use of mobile tools for chronic disease management. Chronic diseases disproportionately impact communities of color and mobile technologies offer promise in improving health outcomes through enhanced access to preventive care and disease self-management. However, some minority communities still face barriers to broadband access. Harnessing mobile technologies represents an important part of comprehensive efforts needed to reduce health disparities.
The document discusses sustaining progress against AIDS in Asia and the Pacific. While new HIV infections declined by 30% between 2001-2009, progress has since stalled. Most infections occur among key populations like sex workers, clients, men who have sex with men, transgender people and people who inject drugs. Countries that have prioritized these groups have seen lower infection rates. Treatment access has increased nine-fold since 2005, reducing AIDS deaths by 27%, but only 1 in 3 people with HIV are on treatment. More work is needed to reach key populations for testing and treatment and sustain funding to end the epidemic.
This document discusses the issues faced by male sex workers globally. It notes that male sex workers experience invisibility due to assumptions that they are gay and that their needs fit narratives of female exploitation. They face criminalization both for sex work and homosexuality in many areas. This leads to barriers in health services due to stigma, and increased risks of violence from clients and authorities. However, male sex worker communities have mobilized to advocate for their rights and visibility through groups like NSWP. The document calls for greater awareness and understanding of the diversity of male sex workers' realities and needs.
The Future of Patient Centric Data - initial perspectiveFuture Agenda
We are delighted to announce another major Future Agenda project – exploring the potential for more and better patient data to transform healthcare.
During the second half of 2017 a series of events are taking place around the world to bring together different views on how evolutions in data creation, availability and sharing are providing greater autonomy, control and access to patient information while simultaneously ensuring safety and security. Following the well-regarded Future Agenda format, these will be discussions between experts in health, data and adjacent areas exploring how the emerging shifts may evolve, play out and with what implications.
This is the emerging view of some of the key issues that different organisations believe will have impact how we access, share and make better use of patient data. This is the starting point for a wider global discussion that will highlight the most important shifts taking place, their likely effect and implications – as well as the associated security and safety concerns.
Investigating the topic from the perspectives of hospitals, insurance companies, pharmaceuticals, health-care providers, technology firms, advisors, researchers, medical device manufacturers, data managers and regulators, this initiative will not only highlight the global issues but also focus on regional differences and implications.
As with other recent Future Agenda projects on the Future of Trade, Cities and Philanthropy, the Future of Patient Data will produce a comprehensive view of what many different organisations and experts around the world see as the likely direction over the next decade. The resulting report will identify the key benefits, enablers and constraints and where are the major areas for further research, innovation and collaboration.
For this project we have assembled a superb combination of events with hosts including leading companies, universities and governments. The current schedule of events is:
Dubai (27th September) hosted by Herman Miller
Johannesburg (10th October) hosted by Discovery Health
Oslo (30th October) hosted by Accenture
Brussels (9th November) hosted by UCB
Sydney (15th November) co-hosted by TAL, Telstra and Pfizer
Singapore (13th or 20th November) hosted by Accenture
Mumbai (23rd November) co-hosted by Tata Consulting Services
Toronto (early December) co-hosted by Cisco and York University
San Francisco (early December) host TBC
Boston (early December) host TBC
London (14th December) hosted by Accenture
We are also looking at adding extra events as diaries allow in Copenhagen, Munich, Sao Paulo and Tel-Aviv.
As usual, throughout out the project we will share new insights gained from these discussions on Linked-In, SlideShare, Flickr and twitter so that others can comment, add to and challenge the views as they develop. Once the workshops are complete, we will compile a final report similar in format to the recent Future of Cities.
A new health and development paradigm post-2015: grounded in human rightsLisa Hallgarten
Marge Berer, Editor of RHM, presentation at meeting
Divided we stand? Universal health coverage and the unfinished agenda of the health MDGs
Institute of Tropical Medicine, Antwerp February 11th 2014
The Role of Human Rights in Responses to HIV, TB and Malaria - March 2013Emilie Pradichit
“The Role of Human Rights in Responses to HIV, Tuberculosis and Malaria” documents cases in which rights-based responses have resulted in positive health outcomes, noting that promoting human rights principles enhances disease prevention and increases accessibility and quality of services. Such responses support uptake of services and promote sustainability by empowering individuals to proactively address health needs.
http://www.undp.org/content/undp/en/home/librarypage/hiv-aids/the-role-of-human-rights-in-responses-to-hiv--tuberculosis-and-m.html
This document discusses coordination mechanisms for HIV/AIDS responses in Namibia. It begins by outlining four forms of coordination: vertical and horizontal intra-organizational coordination within government, and vertical and horizontal inter-organizational coordination between government and external groups. The document then examines vertical, horizontal, and informal coordination structures for HIV/AIDS, including their strengths and challenges. It analyzes case studies from other countries and identifies keys to successful multisectoral coordination, such as developing a common agenda and open communication. The goal is to analyze different coordination approaches and lessons to inform Namibia's response.
Kenya has transitioned to lower-middle income status but still faces health challenges, with 43% living on less than $1.25 per day and poor coverage and access in some areas. The report examines financing options for health in Kenya as it aims to achieve universal health coverage. It looks at the balance between domestic resource mobilization and funding from donors, finding that both will be needed to close funding gaps and reduce the unmet need for health services. Recommendations include increasing domestic revenues through taxes and efficiency while donors avoid withdrawing support too quickly as most developing countries will still need assistance for many years.
The document discusses activities of the Global Agenda Council on Ageing from 2014-2016 focused on cognitive decline, financial services, and technology. Key activities included a four-part symposia series exploring these topics across different regions. The Council also published reports, launched the New York City Ageing Alliance, and developed recommendations to link health and wealth, promote planning and cooperation, and regulate for longevity. The document emphasizes the need to address cognitive decline's financial impacts as populations age and live longer.
This document summarizes a study on humanitarian financing for older people. The key findings are that very few humanitarian projects (less than 2%) specifically target or mention the needs of older people, despite older people being disproportionately affected in crises. The response to Typhoon Haiyan in the Philippines was more inclusive of older people's needs than other appeals, likely due to advocacy efforts. Funding gaps for projects addressing older people are larger than overall humanitarian funding gaps, with critical implications for impartial response. The report calls for donors and humanitarian organizations to more fully identify, fund, and address the needs of older people.
The document provides an introduction to the concept of "the last mile" in the context of achieving sustainable and inclusive development in Least Developed Countries. It defines the last mile as referring not only to the poorest people but also underserved communities, households, and small businesses where needs are greatest and resources are scarcest. Reaching the last mile is important for achieving the Sustainable Development Goals' vision of leaving no one behind. While many countries have reduced poverty significantly, exclusions and inequalities mean some segments of societies have not benefited. New approaches are needed that prioritize and target the last mile to ensure inclusive growth.
This document discusses opportunities and challenges for scaling up HIV treatment and prevention. It summarizes discussions from community meetings in Asia and Africa. Key points include:
- New evidence shows antiretroviral treatment can prevent HIV transmission, offering an opportunity to integrate treatment and prevention services. However, concerns were raised about ensuring resources prioritize those most in need of treatment.
- Ambitious new goals for treatment scale-up and reducing HIV transmission face challenges of sufficient long-term funding from governments.
- Communities emphasized the importance of human rights frameworks and community-based service delivery to effectively reach populations in need.
The document describes an investment framework to help countries make strategic funding decisions regarding their national HIV/AIDS response. It outlines six essential program activities (e.g. eliminating new HIV infections in children, treatment for those living with HIV) and underlying enablers (e.g. outreach, stigma reduction) that need to be delivered together at scale. The framework is a new tool that emphasizes investing in these core programs known to work, prioritizing high burden populations and locations, and implementing efficiently. Modeling shows this approach could avert over 12 million new infections and 7 million AIDS deaths by 2020 compared to current strategies, in a highly cost-effective and sustainable manner.
The document provides information on the Transitional Funding Mechanism (TFM) established by the Global Fund Board to replace Round 11 funding due to inadequate resources. Key points:
1) TFM will provide limited, temporary funding to prevent disruption of essential health services in countries with existing Global Fund grants until March 2014.
2) Funding amounts cannot be guaranteed and will depend on donations. Commitments may be staggered and varied to best utilize available resources.
3) Eligibility criteria and application/review processes have been modified for TFM, focusing on continuation of core prevention, treatment, and care services.
This document discusses community systems strengthening (CSS), which promotes the development and sustainability of communities and community organizations to contribute to long-term health outcomes. CSS aims to improve access to and utilization of health services through increased community engagement in areas like advocacy, health promotion, and home-based care. For communities to effectively impact health, they must have strong, sustainable systems for activities, services, and funding. The core components of CSS systems include enabling environments, community networks, resources and capacity building, community activities, organizational strengthening, and monitoring and evaluation.
This document provides information on 15 notable gangster films, including Bonnie and Clyde (1967), The Godfather (1972), Goodfellas (1990), and Pulp Fiction (1994). It summarizes the key plot details and stars of each film. Images and information are credited to www. for each film highlighted in the document.
Future of Healthcare Provision Jan 2017Future Agenda
Building on insights from our 2015 future of health discussions, this is a new initial view on how healthcare provision may change, especially given emerging opportunities for improved patient engagement. As well as insights from discussions in India, UK, Canada, Singapore and the US it also includes other additional perspectives shared in interviews and workshops over the past 12 months.
We recognise that given the multi-factored nature of this topic and the rapid emergence of new options, what we have summarised in this document is itself in flux. As such, over the next few months we will be sharing this more widely for additional feedback ahead of publication of an updated paper over the summer. So, if you have any comments on changes and additions or issues that you think need more detail, please let us know and we will include.
As with all Future Agenda output, this is being published under creative commons (share alike non commercial) so you are free to share and quote as suits.
The document summarizes the key aspects of the Global Fund's New Funding Model (NFM) application process. It describes the NFM's emphasis on enhancing civil society and key population participation at all stages. It provides an overview of the application timeline and stages, including development of a National Strategic Plan, country dialogue, concept note submission and review, grant-making, approval, and implementation. It offers guidance for key populations and advocates on meaningful involvement at each stage, especially in developing robust epidemiological data and ensuring representation in country dialogue.
Countdown to 2015 was a conference held in London May 2010 which examined and critiqued many orthodoxies. It provided a chance to survey the fields of sexual and reproductive health and HIV from a very broad perspective, looking at issues from the clinical to the socio-economic.
For the poor in urban slums, the majority of the programs targeting community health are often to combat communicable diseases or do not prioritize NCD related outcomes.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
Minorities mobile broadband and the management of chronic diseasesEd Dodds
This document discusses a roundtable convened by the Joint Center for Political and Economic Studies to explore how mobile broadband technologies can help address health inequities experienced by racial and ethnic minority groups in the United States. The roundtable brought together leaders from government, healthcare, technology, and health policy to develop strategies to advance the use of mobile tools for chronic disease management. Chronic diseases disproportionately impact communities of color and mobile technologies offer promise in improving health outcomes through enhanced access to preventive care and disease self-management. However, some minority communities still face barriers to broadband access. Harnessing mobile technologies represents an important part of comprehensive efforts needed to reduce health disparities.
The document discusses sustaining progress against AIDS in Asia and the Pacific. While new HIV infections declined by 30% between 2001-2009, progress has since stalled. Most infections occur among key populations like sex workers, clients, men who have sex with men, transgender people and people who inject drugs. Countries that have prioritized these groups have seen lower infection rates. Treatment access has increased nine-fold since 2005, reducing AIDS deaths by 27%, but only 1 in 3 people with HIV are on treatment. More work is needed to reach key populations for testing and treatment and sustain funding to end the epidemic.
This document discusses the issues faced by male sex workers globally. It notes that male sex workers experience invisibility due to assumptions that they are gay and that their needs fit narratives of female exploitation. They face criminalization both for sex work and homosexuality in many areas. This leads to barriers in health services due to stigma, and increased risks of violence from clients and authorities. However, male sex worker communities have mobilized to advocate for their rights and visibility through groups like NSWP. The document calls for greater awareness and understanding of the diversity of male sex workers' realities and needs.
The Future of Patient Centric Data - initial perspectiveFuture Agenda
We are delighted to announce another major Future Agenda project – exploring the potential for more and better patient data to transform healthcare.
During the second half of 2017 a series of events are taking place around the world to bring together different views on how evolutions in data creation, availability and sharing are providing greater autonomy, control and access to patient information while simultaneously ensuring safety and security. Following the well-regarded Future Agenda format, these will be discussions between experts in health, data and adjacent areas exploring how the emerging shifts may evolve, play out and with what implications.
This is the emerging view of some of the key issues that different organisations believe will have impact how we access, share and make better use of patient data. This is the starting point for a wider global discussion that will highlight the most important shifts taking place, their likely effect and implications – as well as the associated security and safety concerns.
Investigating the topic from the perspectives of hospitals, insurance companies, pharmaceuticals, health-care providers, technology firms, advisors, researchers, medical device manufacturers, data managers and regulators, this initiative will not only highlight the global issues but also focus on regional differences and implications.
As with other recent Future Agenda projects on the Future of Trade, Cities and Philanthropy, the Future of Patient Data will produce a comprehensive view of what many different organisations and experts around the world see as the likely direction over the next decade. The resulting report will identify the key benefits, enablers and constraints and where are the major areas for further research, innovation and collaboration.
For this project we have assembled a superb combination of events with hosts including leading companies, universities and governments. The current schedule of events is:
Dubai (27th September) hosted by Herman Miller
Johannesburg (10th October) hosted by Discovery Health
Oslo (30th October) hosted by Accenture
Brussels (9th November) hosted by UCB
Sydney (15th November) co-hosted by TAL, Telstra and Pfizer
Singapore (13th or 20th November) hosted by Accenture
Mumbai (23rd November) co-hosted by Tata Consulting Services
Toronto (early December) co-hosted by Cisco and York University
San Francisco (early December) host TBC
Boston (early December) host TBC
London (14th December) hosted by Accenture
We are also looking at adding extra events as diaries allow in Copenhagen, Munich, Sao Paulo and Tel-Aviv.
As usual, throughout out the project we will share new insights gained from these discussions on Linked-In, SlideShare, Flickr and twitter so that others can comment, add to and challenge the views as they develop. Once the workshops are complete, we will compile a final report similar in format to the recent Future of Cities.
A new health and development paradigm post-2015: grounded in human rightsLisa Hallgarten
Marge Berer, Editor of RHM, presentation at meeting
Divided we stand? Universal health coverage and the unfinished agenda of the health MDGs
Institute of Tropical Medicine, Antwerp February 11th 2014
The Role of Human Rights in Responses to HIV, TB and Malaria - March 2013Emilie Pradichit
“The Role of Human Rights in Responses to HIV, Tuberculosis and Malaria” documents cases in which rights-based responses have resulted in positive health outcomes, noting that promoting human rights principles enhances disease prevention and increases accessibility and quality of services. Such responses support uptake of services and promote sustainability by empowering individuals to proactively address health needs.
http://www.undp.org/content/undp/en/home/librarypage/hiv-aids/the-role-of-human-rights-in-responses-to-hiv--tuberculosis-and-m.html
This document discusses coordination mechanisms for HIV/AIDS responses in Namibia. It begins by outlining four forms of coordination: vertical and horizontal intra-organizational coordination within government, and vertical and horizontal inter-organizational coordination between government and external groups. The document then examines vertical, horizontal, and informal coordination structures for HIV/AIDS, including their strengths and challenges. It analyzes case studies from other countries and identifies keys to successful multisectoral coordination, such as developing a common agenda and open communication. The goal is to analyze different coordination approaches and lessons to inform Namibia's response.
Kenya has transitioned to lower-middle income status but still faces health challenges, with 43% living on less than $1.25 per day and poor coverage and access in some areas. The report examines financing options for health in Kenya as it aims to achieve universal health coverage. It looks at the balance between domestic resource mobilization and funding from donors, finding that both will be needed to close funding gaps and reduce the unmet need for health services. Recommendations include increasing domestic revenues through taxes and efficiency while donors avoid withdrawing support too quickly as most developing countries will still need assistance for many years.
The document discusses activities of the Global Agenda Council on Ageing from 2014-2016 focused on cognitive decline, financial services, and technology. Key activities included a four-part symposia series exploring these topics across different regions. The Council also published reports, launched the New York City Ageing Alliance, and developed recommendations to link health and wealth, promote planning and cooperation, and regulate for longevity. The document emphasizes the need to address cognitive decline's financial impacts as populations age and live longer.
This document summarizes a study on humanitarian financing for older people. The key findings are that very few humanitarian projects (less than 2%) specifically target or mention the needs of older people, despite older people being disproportionately affected in crises. The response to Typhoon Haiyan in the Philippines was more inclusive of older people's needs than other appeals, likely due to advocacy efforts. Funding gaps for projects addressing older people are larger than overall humanitarian funding gaps, with critical implications for impartial response. The report calls for donors and humanitarian organizations to more fully identify, fund, and address the needs of older people.
The document provides an introduction to the concept of "the last mile" in the context of achieving sustainable and inclusive development in Least Developed Countries. It defines the last mile as referring not only to the poorest people but also underserved communities, households, and small businesses where needs are greatest and resources are scarcest. Reaching the last mile is important for achieving the Sustainable Development Goals' vision of leaving no one behind. While many countries have reduced poverty significantly, exclusions and inequalities mean some segments of societies have not benefited. New approaches are needed that prioritize and target the last mile to ensure inclusive growth.
This document discusses opportunities and challenges for scaling up HIV treatment and prevention. It summarizes discussions from community meetings in Asia and Africa. Key points include:
- New evidence shows antiretroviral treatment can prevent HIV transmission, offering an opportunity to integrate treatment and prevention services. However, concerns were raised about ensuring resources prioritize those most in need of treatment.
- Ambitious new goals for treatment scale-up and reducing HIV transmission face challenges of sufficient long-term funding from governments.
- Communities emphasized the importance of human rights frameworks and community-based service delivery to effectively reach populations in need.
The document describes an investment framework to help countries make strategic funding decisions regarding their national HIV/AIDS response. It outlines six essential program activities (e.g. eliminating new HIV infections in children, treatment for those living with HIV) and underlying enablers (e.g. outreach, stigma reduction) that need to be delivered together at scale. The framework is a new tool that emphasizes investing in these core programs known to work, prioritizing high burden populations and locations, and implementing efficiently. Modeling shows this approach could avert over 12 million new infections and 7 million AIDS deaths by 2020 compared to current strategies, in a highly cost-effective and sustainable manner.
The document provides information on the Transitional Funding Mechanism (TFM) established by the Global Fund Board to replace Round 11 funding due to inadequate resources. Key points:
1) TFM will provide limited, temporary funding to prevent disruption of essential health services in countries with existing Global Fund grants until March 2014.
2) Funding amounts cannot be guaranteed and will depend on donations. Commitments may be staggered and varied to best utilize available resources.
3) Eligibility criteria and application/review processes have been modified for TFM, focusing on continuation of core prevention, treatment, and care services.
This document discusses community systems strengthening (CSS), which promotes the development and sustainability of communities and community organizations to contribute to long-term health outcomes. CSS aims to improve access to and utilization of health services through increased community engagement in areas like advocacy, health promotion, and home-based care. For communities to effectively impact health, they must have strong, sustainable systems for activities, services, and funding. The core components of CSS systems include enabling environments, community networks, resources and capacity building, community activities, organizational strengthening, and monitoring and evaluation.
This document provides information on 15 notable gangster films, including Bonnie and Clyde (1967), The Godfather (1972), Goodfellas (1990), and Pulp Fiction (1994). It summarizes the key plot details and stars of each film. Images and information are credited to www. for each film highlighted in the document.
This document outlines the Cape Town Call to Action from the People's Health Movement. It reaffirms commitments to foundational documents and outlines an alternate vision that values people over profits. It describes the global health crisis as stemming from neoliberal policies that prioritize capitalism and have led to growing inequities. Specific health issues are highlighted for different populations. The document calls for mobilizing people and building alliances to work towards more just, equitable and sustainable political, economic and social systems.
The Global Fund Strategy 2012-2016 aims to sustain and accelerate progress in fighting HIV/AIDS, tuberculosis, and malaria. It sets goals to save 10 million lives and prevent 140-180 million new infections between 2012-2016.
The strategy outlines five strategic objectives: 1) invest more strategically in high-impact interventions and populations, 2) evolve the funding model to be more flexible, 3) actively support grant implementation success, 4) promote and protect human rights, and 5) sustain gains and mobilize resources.
It also identifies two strategic enablers necessary for success: enhancing partnerships and transforming operations to improve governance, effectiveness and controls. The strategy seeks to position the Global Fund to maximize impact through more
The document outlines a new investment framework for the global HIV response. The framework aims to maximize benefits, support rational resource allocation based on epidemiology and context, and encourage prioritizing effective programs. It identifies six basic program activities shown to work together at scale for maximum impact: programs for key populations at higher risk; eliminating new child infections; behavior change programs; condom distribution; treatment, care, and support; and voluntary medical male circumcision. The framework also identifies critical enablers and synergies with development sectors needed to support HIV programs. Modeling shows the framework could avert over 12 million new infections and 7 million AIDS deaths from 2011-2020 in a highly cost-effective way.
This document proposes a new strategic investment framework for responding to the HIV/AIDS epidemic that aims to be more targeted and efficient than current approaches. The framework categorizes investments into basic programmatic activities, efforts to create an enabling environment, and related health/development programs. It is estimated to avert over 12 million new infections and 7 million AIDS deaths between 2011-2020 compared to current approaches, gaining 29.4 million life years at a cost-effectiveness of $1060 per life year. The additional investment required would be offset by savings in treatment costs alone.
This document outlines FHI's strategic framework for developing behavior change communication programs for HIV/AIDS prevention. It describes a 12-step process for developing an integrated BCC strategy, including defining goals, involving stakeholders, assessing target populations, developing objectives and messages, pre-testing materials, implementing activities, and evaluating impact through monitoring and feedback. The framework is intended to guide the practical development and implementation of collaborative, evidence-based BCC strategies.
This document summarizes a research study that assessed the effect of strategic planning on the implementation of the second HIV Program Development Project (HPDPII) in Abuja, Nigeria by civil society organizations (CSOs).
The study found a positive significant relationship between strategic planning and HPDPII implementation, though the effect size was small. CSOs that had clear, well-defined written vision and mission statements were found to have a better chance of successful project implementation.
The document provides background on HIV/AIDS rates and programs in Nigeria, and discusses the roles of the National Agency for the Control of AIDS and CSOs in the country's HIV/AIDS response. It reviews literature on strategic planning and
Sustaining the HIV and AIDS Response in St. Vincent and the Grenadines: Inves...HFG Project
National surveillance reports estimate that there were about 649 persons living with HIV in St. Vincent and the Grenadines at the end of 2011, which translates to 1.2% of the adult population (15-49 years) or 0.7% of the total population. The epidemic is male-dominant, illustrated by the fact that the cumulative case reporting from 1984-2013 indicates that 60.6% of new cases are reported among males and 38.1% females (1.3% unknown). In response to the growing epidemic, the country quickly scaled up its national HIV/AIDS program in 2004. While care and treatment remains a high priority, St. Vincent and the Grenadines has devoted significant resources to preventative activities, including HIV counseling and rapid testing, education and workplace programs, and other behavioral interventions.
Despite a marked decline in HIV and AIDS cases, significant challenges for the country’s response remain. Close to 20% of persons with advanced HIV infection discontinue treatment within 12 months of initiation, suggesting the need to reinforce adherence and retention to care. The country also faces an imminent decline in donor funding and domestic reprioritization of chronic and non-communicable diseases; without renewed sources of external funding or greater domestic resources allocated to HIV/AIDS, progress made since 2004 could regress.
In response to these challenges, key priorities outlined in the country’s strategic framework (2014-2025) include: 1) institutionalizing HIV education through collaborative programs with different sectors, 2) targeting high risk groups, 3) strengthening HIV testing and counseling, including routine testing for pregnant women and, 4) ensuring access and retention to care and treatment for those with HIV and AIDS and TB. St. Vincent and the Grenadines has also taken steps to integrate HIV and AIDS services into the broader health system and included the HIV and AIDS program as part of the Ministry of Health, Environment and Wellness’ overall health framework. These actions are the beginning of efforts to improve access to care, reduce costs, and improve efficiencies.
AIDS and its vengeance saw a back seat after we achieved the zero level of growth for it. But worries regarding the people living with AIDS are still on and we need to take care of these segments in an integrated manner
The document discusses the advocacy achievements of the Bridging the Gaps global partners from 2011-2014. It describes the program's establishment in 2011 with funding from the Netherlands Ministry of Foreign Affairs to achieve universal access to HIV services for key populations. Through the efforts of global and local partner organizations, nearly 700,000 people received HIV services, over 200 organizations engaged in human rights advocacy, and key population services were integrated into nearly 100 health facilities. The document provides details on the program's approach and a theory of change to guide advocacy work.
This document discusses the development of priority digital health products to support the World Health Organization's End TB Strategy. A Global Task Force on Digital Health for TB was established in 2015 to identify and develop target product profiles (TPPs) for digital health innovations. The Task Force worked with partners to define TPPs for nine priority digital health concepts and products across four areas: patient care, surveillance and monitoring, program management, and eLearning. The TPPs provide strategic guidance for developers to create tailored solutions that can enhance TB action at the country level in alignment with the goals of the End TB Strategy.
This document summarizes key findings from recent literature reviews on community mobilization in the context of the UNAIDS Investment Framework. It finds that community mobilization is a crucial enabler for improving HIV program uptake and promoting local advocacy. Specifically, it discusses how community-based organizations are uniquely positioned to address scale-up of HIV services. It also outlines several themes around the importance of community involvement, including that communities best understand their own needs, people living with HIV play a special role, and peer groups are a powerful mobilization approach.
This document outlines the purpose and context of a research study on the impact of health education on HIV prevention in Canada. [1] The study aims to understand how education impacts various intervention programs and factors that help education be successful. [2] It will also seek to understand perceptions incorporated in education that help HIV education programs. [3] Key issues examined will include whether education targets at-risk groups and whether service providers are flexible in assisting people with HIV.
The document summarizes India's National AIDS Control Programme (NACP) which aims to contain the spread of HIV in India through a four-pronged strategy of prevention, care and support, treatment, and strengthening infrastructure. The HIV epidemic in India is concentrated among high-risk groups like female sex workers, men who have sex with men, and injecting drug users. The NACP implements targeted interventions for these groups, promotes condom use, treats sexually transmitted infections, and provides counseling, testing, and treatment services. While the response has stabilized the epidemic in some states, emerging hotspots in northern states require increased focus and attention to fully achieve reversal goals.
The document discusses community systems strengthening (CSS) and how it relates to key populations affected by HIV/AIDS. It provides background on key populations and their vulnerability to HIV, as well as the role of the Global Fund in funding programs. It describes how the Global Fund introduced CSS in 2009 to strengthen community mobilization and service delivery. However, CSS faces technical challenges such as unclear definitions and limited tools for assessment. It also faces political challenges like continued skepticism of key population programming. The document concludes with recommendations to strengthen CSS and ensure it effectively serves key populations.
This document provides guidance for UNAIDS on strengthening partnerships with civil society, including key populations and people living with HIV, to help achieve global targets for eliminating HIV/AIDS. It outlines principles, structures, and priorities for meaningful partnership, and minimum standards to operationalize effective collaboration. The guidance is intended to help UNAIDS and its partners deliver on commitments in the 2011 UN Political Declaration on HIV/AIDS and UNAIDS' strategy of Getting to Zero. Effective engagement with civil society is seen as critical to driving major transformations in the AIDS response.
UNAIDS guidance for partnerships with civil societyclac.cab
The UNAIDS guidance document provides guidance for strengthening partnerships between UNAIDS and civil society, including key populations and people living with HIV. It recognizes civil society as central to achieving targets in the 2011 UN Political Declaration on HIV/AIDS. The guidance establishes principles for meaningful partnership and monitoring roles and responsibilities. It aims to ensure civil society is treated as an essential partner at all stages of collaboration and that UN AIDS staff recognize the importance of learning from civil society experiences and perspectives.
This case study describes the SIMpill project in South Africa, which aims to improve TB treatment compliance monitoring using a wireless pill bottle that sends SMS notifications when opened. Initial pilots involving 100 and 130 patients found that treatment adherence increased significantly with the use of the technology. Larger trials are now planned, though high per-patient costs remain a challenge. The project demonstrates the potential for mHealth technologies to enhance DOTS programs through remote electronic monitoring of medication use.
Sustainability and transition - Nicolas Cantau, The Global FundOECD Governance
This presentation was made by Nicolas Cantau, The Global Fund, at the 2nd Health Systems Joint Network Meeting for Central, Eastern and Southeastern European Countries held in Tallinn, Estonia, on 1-2 December 2016
This document discusses the importance of global health initiatives. It outlines 5 major global health initiatives: [1] The Global Fund which invests over $4 billion annually to fight AIDS, tuberculosis, and malaria in over 100 countries; [2] GAVI which provides vaccines to children in poor countries; [3] The World Health Organization which coordinates global health leadership and initiatives; [4] The United Nations Development Programme which aims to eradicate poverty and build resilience; [5] UNICEF which provides humanitarian and developmental aid to children worldwide. The document emphasizes that these initiatives are critical to improving health outcomes, ensuring vaccine delivery, strengthening health systems, and achieving sustainable development goals.
- Explicit insurance does not offer a panacea for HIV/AIDS service coverage on its own. Where insurance systems already exist, they can be expanded to include HIV/AIDS services.
- Introducing social health insurance is complicated and will take time to cover all people. The process should not be rushed and existing mechanisms should continue in the meantime. Some people will remain inadequately covered and should not be forgotten.
- Political commitment is indispensable for including HIV services in any coverage mechanism. A political-economy analysis will be useful. Financial feasibility is also key, and external funding may be needed initially before being replaced by government funds over time. Not all people will be able to contribute to insurance schemes
This document summarizes the AIDS epidemic in Eastern and Southern Africa and progress towards meeting international targets on HIV/AIDS. Some key points:
1) There are 34 million people living with HIV globally in 2011, with 1.2 million new infections in Eastern and Southern Africa. Several countries have reduced new infections by over 50% since 2001.
2) Coverage of prevention of mother-to-child transmission services was 72% in 2011 in the region. 5.2 million people were receiving antiretroviral treatment out of 8.1 million estimated to be eligible.
3) Reducing sexual transmission by 50% and reaching 15 million people on HIV treatment by 2015 are among key global targets, but
Similar to 6 discussion-paper-investment-framework (20)
Community mobilization activities aim to address HIV at the interpersonal, community, and structural levels for key populations. At the interpersonal level, activities include safe sex workshops, peer leader programs, outreach providing condoms and referring individuals to services, and behavior change messaging. These activities often overlap and are implemented through community-based organizations. However, key populations still face stigma, discrimination and legal barriers that limit access to services. Greater structural interventions are needed to improve health outcomes and rights for these groups.
This document provides detailed methods and assumptions used to estimate the annual cost of implementing HIV programs under a proposed new investment framework. The framework aims to achieve universal access to HIV treatment, care, and support by 2015 through scaling up a small number of basic program activities to reach key populations, implementing critical interventions to create an enabling environment, and supporting related health and development efforts. Costing methods and projections are described for treatment, prevention of mother-to-child transmission, harm reduction for injecting drug users, behavior change programs, and other components.
This document provides a framework for community systems strengthening (CSS). CSS aims to develop the roles of communities and community organizations in improving health outcomes. The framework defines key terms, describes the purpose and intended audience of the CSS framework, and explains why CSS is important for health. It outlines the core components of functional community systems and provides guidance for implementing CSS interventions and monitoring & evaluation.
Ini adalah perbandingan harga obat ARV generik lokal dan ARV generik Import. ARV adalah nama obat yang digunakan bagi terapi Orang terinfeksi HIV (ODHA)
Keputusan Menteri Kesehatan menetapkan rumah sakit rujukan bagi orang dengan HIV dan AIDS di setiap provinsi, mengatur tugas dan tanggung jawab rumah sakit tersebut serta melakukan monitoring dan evaluasi pelayanan kesehatan bagi pasien HIV dan AIDS.
Indonesia has an estimated HIV prevalence of 0.27% among people aged 15-49. While most provinces have a concentrated epidemic among key populations like sex workers and injecting drug users, the provinces of Papua and West Papua have a generalized epidemic of 2.4% prevalence. Coverage of HIV prevention programs has increased for many key populations, though more work is needed to reach targets. Access to antiretroviral treatment has also expanded significantly. Looking ahead, Indonesia aims to achieve its targets under the UN General Assembly Special Session on HIV/AIDS by continuing and strengthening effective interventions led by the National AIDS Commission.
The document summarizes antiretroviral drug prices negotiated by the Clinton Health Access Initiative (CHAI) for its Procurement Consortium members. It lists ceiling prices per year, pack, and unit for various HIV drugs and combinations from eight generic drug manufacturers. The prices are available to over 70 member countries to support public HIV treatment programs.
Pedoman ini memberikan panduan mengenai tatalaksana klinis infeksi HIV dan terapi antiretroviral pada orang dewasa dan remaja. Pedoman ini mencakup rekomendasi mengenai saat memulai terapi ARV, paduan obat yang dianjurkan, pemantauan selama terapi, dan penatalaksanaan populasi khusus seperti ibu hamil dan pasien ko-infeksi."
Dokumen tersebut membahas komitmen pemerintah dalam Deklarasi Politik 2011 untuk HIV/AIDS terkait dengan akses pengobatan, khususnya:
1) Mengakui pentingnya obat-obatan yang terjangkau dan memperluas fleksibilitas hak kekayaan intelektual
2) Berkomitmen untuk meningkatkan akses 15 juta orang terhadap pengobatan ARV pada 2015
3) Mengurangi ko-infeksi dengan tuberkolosis dan hepatitis melalui integr
Dokumen tersebut merupakan daftar buku yang diterbitkan oleh organisasi Indonesia AIDS Coalition. Daftar tersebut terbagi menjadi beberapa kategori seperti filsafat, cultural studies, demokrasi, dan populer yang masing-masing memuat judul buku, tahun terbit, dan nama pengarangnya.
This document is the table of contents for Global Health Watch 3: An Alternative World Health Report published in 2011. It outlines the various sections and chapters of the report which cover topics such as the global political and economic architecture, current issues in health systems, issues beyond healthcare, and resistance, actions and change. The report is published by a collaboration of organizations and aims to provide alternative perspectives on global health issues.
Pedoman ini memberikan panduan untuk mencegah penularan HIV dari ibu ke anak dengan melaksanakan kegiatan 4 prong yang meliputi pencegahan penularan pada perempuan usia reproduksi, pencegahan kehamilan tidak direncanakan, pencegahan penularan selama kehamilan dan persalinan, serta pemberian dukungan bagi ibu dan anak. Tujuannya adalah menurunkan angka penularan HIV dari ibu ke anak di Indonesia.
This document outlines indicators to measure progress toward targets set in the 2011 UN Political Declaration on HIV/AIDS. It lists 14 specific targets to be achieved by 2015 related to reducing transmission, increasing access to treatment, and strengthening synergies with development. Data on over 30 indicators will be collected biennially from countries and used to assess progress in annual UN reports on the global AIDS response. The indicators and guidelines aim to provide standardized measurement of commitments to respond to the AIDS epidemic.
This document outlines urgent actions needed by member states and the WHO to address the social determinants of health and protect the right to health. It calls for 1) implementing universal healthcare and social protection systems, 2) using taxes to finance actions on social determinants of health, and 3) recognizing the impact of unregulated corporations and financial institutions on health inequalities. It emphasizes the need for intersectoral action, public participation in policymaking, and accountability to promote health equity globally.
Kebijakan penanggulangan HIV/AIDS di Indonesia membutuhkan penelitian operasional untuk meningkatkan efektivitas program. Penelitian operasional dapat mengidentifikasi masalah program dan menguji intervensi untuk memecahkannya, sehingga hasilnya dapat digunakan untuk memperbaiki program. Jenis penelitian operasional yang dibutuhkan antara lain studi diagnostik, studi intervensi, dan studi evaluatif.
Yayasan Kusuma Buana telah berpengalaman lebih dari 10 tahun dalam pencegahan HIV/AIDS, namun masih banyak tantangan seperti koordinasi antar sektor yang belum optimal dan keterlibatan pemerintah daerah yang masih perlu ditingkatkan. Upaya ke depan perlu melibatkan seluruh pemangku kepentingan dan mencari sumber pendanaan domestik.
3. DISCUSSION PAPER
Supporting community action on AIDS in developing countries
Figure 1: Investment framework
The investment
The model calculates the
increase in investment
required – such as a
$12.9 billion increase
to $22 billion by 2015
followed by a decrease
to $10.6 billion by 2020
– in order to avert 12.2
million new infections
and to prevent 7.4
million deaths due to
AIDS.
The decrease in
investment after 2015
results from the impact
of reaching optimal HIV
programme coverage
levels, along with
cost efficiencies, and
importantly, the declines
in illness and death that
are predicted because
larger numbers of people
are receiving ART. Figure 2: Resources required
So our calls for more
investment in HIV (What’s
Preventing Prevention?)
for the first time, can
be accompanied by
a scientific, modelled
prediction of a decline in
HIV/AIDS by the end of
this decade.
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4. DISCUSSION PAPER
Supporting community action on AIDS in developing countries
The investment framework in more detail
HIV programming priorities in the Critical enablers
framework
The framework articulates a very important
What is new is that the framework provides an concept for the Alliance, critical enablers. In
evidence based and costed case for doing more this framework, critical enablers are defined
of what we do already in order to reach a critical in two categories – social enablers such as
point where the need for programmes and services community mobilisation, changing laws and stigma
will decline. It argues for, and calculates, the reduction. The second category of critical enablers
value and potential impact of good quality HIV are programme enablers, or efforts to make
programming. Developments in our understanding programmes work, such as community centred
of the potential of ART feature here as well - the design and delivery, communication, management,
potential of ART to prevent HIV transmission, procurement and research and innovation. These
and to prevent tuberculosis amongst people are important and familiar concepts in the Alliance.
living with HIV.
The framework gives prominence to the concept
The six programme areas that are emphasised are: of community mobilisation – a concept very
•
PMTCT close to the Alliance’s heart. We understand how
important the mobilisation of communities is to HIV
• Condom promotion and distribution
programming, but this has rarely been described
• Key populations (sex work, MSM, IDU (and described as ‘critical’) in other models. It will
programmes) be important to use this opportunity to intensify
• Treatment, care and support to people living with efforts at the community level.
HIV/AIDS (including facility-based testing)
• Male circumcision Looking at the HIV programming priorities, and
• Behaviour change programmes. analysing them alongside the critical enablers,
essential work at the community level is clear.
Male circumcision is specified as being applicable For example, PMTCT is the first of the six HIV
in generalised epidemics with a low prevalence of programme priorities outlined. What are the critical
male circumcision. This is not a blueprint for male enablers for PMTCT? They might include some or
circumcision in every country. all of the following:
• advocacy for political commitment to a national
How does this list match with HIV PMTCT programme
programme efforts in your country? • change in practices such as discrimination by
health care providers towards women living with
How is progress on each of these HIV, in particular, in the area of family planning
programmes in your country? and provision of sexual reproductive health
services
Does this list of priorities miss something • community mobilisation for PMTCT so that
important? local communities know about PMTCT and HIV
testing, and can access PMTCT services
If funding follows this list, what does it mean • local efforts to incentivise PMTCT programmes
for our current work? • design of services so that they meet the needs
of communities
• research on the best models of delivery.
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5. DISCUSSION PAPER
Supporting community action on AIDS in developing countries
These are examples of potential efforts we might How can we use the framework?
highlight in order to make PMTCT more effective.
Much of this effort lies outside the clinic and in In our advocacy and resource mobilisation.
communities. Using this framework, we can Instead of asking for more money for AIDS with
articulate the need for work at the community level, an implied ever-increasing need, our advocacy for
with community organisations, in order to make the more resources for HIV has more precise goals –
investment in PMTCT clinics work optimally. coverage goals that will need to be set nationally
and locally – in order to reach a point where the
‘Synergies with development sectors’ need for this investment declines. Optimal coverage
will be reached, efficiency gains will be realised
Another area of focus for the Investment Framework
and the decrease in new HIV infections will result in
is broader development sectors and their links to
decreased need for services.
HIV programmes and critical enablers. The sectors
referenced include ‘social protection, education, In our planning. In order to understand the
legal reform, gender equality, poverty reduction , implications of this framework for HIV programming
gender-based violence, health systems, community at a country level, we need to answer a set of critical
systems, and employer practices.’ programming questions:
How does the list of development sector
synergies match with HIV programme efforts in What are the communities/populations that
your country? are most critical to the dynamics of HIV
transmission in each country?
Is there clarity on what each of these synergies
involves? (for example, what are the overlaps What are the critical enablers and how do they
between HIV programmes and education?) influence or affect the sexual and injecting
practice or health seeking practice of the priority
How is progress on each of these synergies in communities/populations?
your country?
What are the most critical HIV interventions for
Does this list of priorities miss something impor- the priority communities/populations?
tant?
What are the optimal coverage levels for key
If funding follows this list, what does it mean for HIV/TB interventions in each country?
our current work?
What are the critical programmatic enablers?
What are our programmes contributing to
Thinking through the meaning of each aspect of meeting coverage targets in each country? And
these three areas (programme activities, critical what is their potential?
enablers and development sector synergies) at a
country level is important work. This might lead to What is our work in civil society to address
a re-programming of HIV efforts, and we will need the critical enablers? What is the role of
to ensure that we can point to where our HIV/TB government?
programming efforts, and our advocacy efforts, are
What are the most important synergies for these
supported in the framework. For many of us, we
populations, targets? Social protection? Human
will need to advocate for changing the investments
rights protections? Poverty reduction? Health
in HIV at the national or local level. We might be
systems? Community systems? Education?
advocating for re-programming, or for the need to
build capacity in different sectors to make this happen.
Page 5
6. DISCUSSION PAPER
Supporting community action on AIDS in developing countries
Some of us will have the answers to these know about ART and can see the benefit of it for
questions, some of us will need to work with others themselves and their families? Increased support for
to seek or calculate the answers. The answers to community health workers and caregivers to deliver
these questions, and the assumptions contained in ART and support adherence?
the framework, should increasingly form the basis of
national HIV plans, including Global Fund proposals. Left solely to public health planners, some of these
These questions and their answers are critical for types of questions may not be asked. Increasing
our strategic planning and fundraising efforts. We ART provision is a goal for all of us, but getting
are contributing a lot to this national and global the right actions in place in order to achieve this is
effort, but we need to be clearer in defining the HIV more complex. Community activists and community
impact of this work, and in forecasting the potential based programmers must be part of this analysis
of this work to achieve the point, in each country, to ensure that plans go well beyond the provision
where HIV is in decline. of more clinical services. And when the goal is
to shift more aspects of ART service provision to
Articulating the role we play in supporting the communities and their organisations, that this effort
critical enablers will be important work for Alliance is costed and funded properly, not undermined by
Linking Organisations – both the social enablers ‘doing it cheaply’, dependent on volunteer labour,
and programme enablers. What are our theories unpaid care and the under-funding of community
of change for each critical enabler? It is widely organisations and their staff.
acknowledged that defining, planning and costing
efforts to address the critical enablers is the weakest Limitations of the framework
part of this model. We have to focus attention to
this, and help shape this work. Defining, planning As described above, the ‘critical enablers’ described
and costing the vital pieces of the model such as in the framework are poorly defined, costed and
community mobilisation; changing laws, policies tested. They are not universally agreed either, and
and practices; stigma reduction; changing risk rest uneasily on an unstable body of evidence.
environments; capacity building, management, Further work is required to understand the barriers
procurement, research and innovation. and enablers to effective HIV responses in every
context, and to define and demonstrate the value for
Testing the assumptions inherent in the model money of key interventions that are enabling.
will be important in each country. For example,
the model depends heavily on increases in ART The daily struggles to ensure access to HIV
provision. Is that assumption realistic and feasible services to and to protect the human rights of very
from the perspective of very marginalised people? marginalised and poor people are well understood
And if not, what are the changes, what are the by community organisations. Sometimes a list of
critical enablers, in order to reach and increase clinical and health promotion interventions fails to
the uptake of ART amongst marginalised people?
‘get at’ the range of needs, struggles and problems
Improved drug procurement and distribution
shaping the lives of people who are detained,
systems? Reduced discrimination towards key
denied services, who are subject to violence,
populations in health care settings? ART more
breaches of privacy, hate crime, discrimination and
accessible in a wider range of settings? Improved
access to opiate substitution treatment for other violations, who live far from health services,
injecting drug users? Changes in policy so that who have uncertain immigration status or who
people without identity cards, or people in prison are poor, young, old or socially isolated. Social
or detention, can access ART? More intensive and behavioural research, political science and
community mobilisation so that more people operations research can define HIV and other
Page 6
7. DISCUSSION PAPER
Supporting community action on AIDS in developing countries
needs more deeply. They can help to build a bridge populations, programmes and investments. Analyse
between our understanding of the complexity and how these programmes and critical enablers
extent of social and personal needs, and a set of are synergising with other development sectors.
health programmes that can stop HIV. The science Identify the most important critical enablers
that we bring to the model needs more social to ensure the programmes are of high quality
science, and more implementation science. and are reaching sufficient numbers of people
from specifically targeted populations. Seek
The critical programmatic enablers need to address endorsement for your analysis, including from
corruption, capacity building, building social government. Analyse the assumptions in the
capital, strengthening community systems and model for your country. What interventions will
strengthening health systems so that health systems make increases in ART most feasible? How do
better serve all people with HIV needs, including behaviour change communication and condom
those who are criminalised and marginalised. promotion interventions change as a result of
increased evidence for treatment as prevention,
Acting on the investment framework and male circumcision? What will be the effects
on sexual and injecting practice, and how will
We need to act on this investment framework to behaviour change communication respond? What
more directly promote effective and community are the community mobilisation efforts for the six
driven responses to HIV in each country where the programme areas?
Alliance operates. There is some critical thinking
to be done. We can use this framework to intensify Advocate for a more high impact, precisely
and improve national planning for HIV. Informed by targeted and costed national HIV programme.
the investment framework, some immediate tasks Use this framework to advocate for more precision
arise: in targeting and for a more expanded and nuanced
role for communities and their organisations. It will
Ensure the framework is on the national agenda. help to analyse current investments in HIV to ensure
Do your national planning institutions (NACs, that our best efforts focus on high impact – the
CCMs) know about it? Get this framework onto potential to prevent 12.2 million new HIV infections
the agenda of these committees. Foster debate and prevent 7.4 million deaths due to AIDS by 2020.
about the model. Brief government, civil society
and relevant professional agencies about it. With ABOUT THE ALLIANCE
UNAIDS and WHO colleagues, form a working
Established in 1993, the International HIV/AIDS
group made up of relevant specialists to examine Alliance is a global partnership of nationally-
the meaning of the framework in your country: based linking organisations working in over 40
national HIV government/public health planners, countries, to support community action on AIDS
HIV civil society organisations – both key population in developing countries.
representatives and HIV programme implementers, International HIV/AIDS Alliance
HIV/TB clinicians and social/care providers, HIV (International secretariat)
technical agencies, clinical researchers, HIV/TB/
91-101 Davigdor Road
SRH epidemiologists, HIV social scientists, HIV Hove, East Sussex
social care experts, HIV human rights specialists. BN3 1RE United Kingdom
Identify the key populations, programmes and Tel: +44 1273 718 900
Fax: +44 1273 718 901
coverage levels in your country, and analyse
Email: mail@aidsalliance.org
assumptions.
Work with other experts to identify the most important Registered charity no. 1038860
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