entering a new phase in the response to aids in africa joint annual meeting of the au conference of...
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Entering a new phase in the Entering a new phase in the response to AIDS in Africaresponse to AIDS in Africa
Joint Annual Meeting of the AU Conference of Joint Annual Meeting of the AU Conference of Ministers of Economy and Finance and ECA Ministers of Economy and Finance and ECA
Conference of African Ministers of Finance, Planning Conference of African Ministers of Finance, Planning and Economic Developmentand Economic Development
Economic Commission for Africa Economic Commission for Africa
Addis Ababa, 31 March 2008Addis Ababa, 31 March 2008
HIV prevalence in adults HIV prevalence in adults in sub-Saharan Africa, 1990−2005in sub-Saharan Africa, 1990−2005
Top Causes of Death in AfricaTop Causes of Death in Africa
1.1. HIV/AIDSHIV/AIDS2.2. MalariaMalaria3.3. Lower respiratory infectionsLower respiratory infections4.4. Diarrhoeal diseasesDiarrhoeal diseases5.5. Perinatal conditionsPerinatal conditions6.6. Cerebrovasuclar diseaseCerebrovasuclar disease7.7. TuberculosisTuberculosis8.8. Ischaemic heart disease Ischaemic heart disease 9.9. MeaslesMeasles10.10. Road traffic crashes Road traffic crashes
HIV prevalence and income inequality in
sub-Saharan Africa
Gillespie et al. Poverty, wealth, HIV transmission. AIDS, Volume 21 Supp. November 2007.
HIV Prevalence by Wealth Quintile of HIV Prevalence by Wealth Quintile of Women in Eight African CountriesWomen in Eight African Countries
0
5
10
15
20
25
30
35
Burkin
a Fas
o
Ghana
Cameroon
Uganda
Kenya
Tanza
nia
Mala
wi
Leso
tho
Poorest
Middle
Wealthiest
Mishra V, Bignami-Van Assche S, Greener R, Vaessen M, Hong R, et al. (2007) HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. AIDS (supplement)
Change in Mean Years of Schooling by Change in Mean Years of Schooling by HIV PrevalenceHIV Prevalence
Jane Forston. Mortality Risk and Human Capital Investment: The Impact of HIV/AIDS in Sub-Saharan Africa. March 2007
Number of people receiving ARV therapy in low- and middle-Number of people receiving ARV therapy in low- and middle-income countries in Sub-Saharan Africa, 2002—2007income countries in Sub-Saharan Africa, 2002—2007
end-2002
end-2004
end-2003
end-2005
0.4
0.8
1.2
1.6
2.2
2.8
Mill
ion
s
Year
2.4
2.6
3.0
0.0
0.2
0.6
1.0
1.4
1.8
2.0
end-2007
end-2006
Estimated number of people newly infected with HIVEstimated number of people newly infected with HIVin Sub-Saharan Africa, 1990–2007in Sub-Saharan Africa, 1990–2007
Year
0
1
2
3
4
5
199019911992 199319941995 199619971998 199920002001 200220032004 200520062007
Milli
ons
Upper range
Estimate
Lower range
Number of people newly infected with HIV
[i] 1996-2005 data: Extracted from 2006 Report on the Global AIDS Epidemic (UNAIDS, 2006)[ii] 1986-1993 data: AIDS in the World II. Edited by Jonathan Mann and Daniel J. M. Tarantola (1996)
Notes: [1] 1986-2000 figures are for international funds only [2] Domestic funds are included from 2001 onwards
Funding Funding Total annual resources available for AIDS, 1986 ‒2007Total annual resources available for AIDS, 1986 ‒2007
Funding Funding Total annual resources available for AIDS, 1986 ‒2007Total annual resources available for AIDS, 1986 ‒2007
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
US$ million
2921623
8.3 billion
Signing of Declaration of Commitment on HIV/AIDS, UNGASS
‘96 ‘97 ‘98 ‘99 ‘00 ‘01 ‘02 ‘03 ‘04 ‘051986 ‘87 ‘88 ‘89 ‘90 ‘91 ‘92 ‘93 ‘94 ‘95
Less than US$ 1 million
59212
World BankMAP launch
Global Fund
PEPFAR
257
UNAIDS Gates
Foundation
‘06 2007
10 000
8.9 billion
10 billion
Domestic Public Per Capita Expenditure on AIDS - USD in Domestic Public Per Capita Expenditure on AIDS - USD in Sub-Saharan African Countries by income level (GNI)Sub-Saharan African Countries by income level (GNI)
$0.00
$2.00
$4.00
$6.00
$8.00
$10.00
$12.00
$14.00
2004 2005 2006 2007
Sub-Saharan Africa - Uppermiddle income
Sub-Saharan Africa - Lowermiddle income
Sub-Saharan Africa - Lowincome
Resources Required for AIDSResources Required for AIDSSub-Saharan AfricaSub-Saharan Africa
5,277 6,632 7,974 9,141 9,578 10,437 11,358 12,116 13,209
Resources Required by Scenario (US$ Millions)
0 2,000 4,000 6,000 8,000
10,000 12,000 14,000
2007 2008 2009 2010 2011 2012 2013 2014 2015
Current Scale-up
Breakdown of DAC members’ bilateral aid to health and Breakdown of DAC members’ bilateral aid to health and reproductive healthreproductive health
2000-06 commitments, annual averages in USD million, constant 2005 prices2000-06 commitments, annual averages in USD million, constant 2005 prices
OECD, 2007
Change in Under-Five Mortality Rate in Select Change in Under-Five Mortality Rate in Select Countries with High HIV Prevalence, 1990–2003Countries with High HIV Prevalence, 1990–2003Change in Under-Five Mortality Rate in Select Change in Under-Five Mortality Rate in Select
Countries with High HIV Prevalence, 1990–2003Countries with High HIV Prevalence, 1990–2003
R. Hecht et al. Putting It Together: AIDS and the Millennium Development Goals. PLoS Medicine, 2005
Epidemic CurvesEpidemic Curves
T.Barnett, A.Whiteside
T1 T2 Time
Numbers
A1A2
HIV prevalence
B1
A
B
AIDS - cumulative
Impact
Volatility in Aid for Health, Selected Countries, Volatility in Aid for Health, Selected Countries, 1999–20031999–2003
Volatility in Aid for Health, Selected Countries, Volatility in Aid for Health, Selected Countries, 1999–20031999–2003
Source: World Health Organization, 2006
MOH MOEC
MOF
PMO
PRIVATE SECTORCIVIL SOCIETYLOCALGVT
NACP
CTU
CCAIDS
INT NGO
PEPFAR
Norad
CIDA
RNE
GTZ
SidaWB
UNICEF
UNAIDSWHO
CF
GFATM
USAID
NCTP
NCTP
HSSP
HSSP
GFCCPGFCCPDAC
CCM
T-MAP
3/5
SWAPSWAP
UNTG
PRSP PRSP
200 MUSD
290 MUSD
50 MUSD
60 MUSD
The Three OnesThe Three Ones
One agreed AIDS action frameworkOne agreed AIDS action framework
One national AIDS coordinating authorityOne national AIDS coordinating authority
One agreed country-level monitoring and One agreed country-level monitoring and evaluation system evaluation system
Prices (US$/year) of first-line antiretroviral Prices (US$/year) of first-line antiretroviral regimen in Uganda: 1998-2003regimen in Uganda: 1998-2003
Prices (US$/year) of first-line antiretroviral Prices (US$/year) of first-line antiretroviral regimen in Uganda: 1998-2003regimen in Uganda: 1998-2003
Optimal Management?Optimal Management?Enormous variation in unit costsEnormous variation in unit costs
$1
$10
$100
$1000
0 10 100 1000 10,000
Annual Clients Completing VCT (scale)
Co
st p
er V
CT
Co
mp
lete
d (
un
it c
ost
)
MexicoUgandaRussiaIndiaSouth Africa
S. Bertozzi