• Progress towards the MDGs

• Positioning health in the post-2015 framework

• Addressing HIV in the new development agenda:

• Building on the unfinished business of the MDGs

• Integrating HIV into universal health coverage

OUTLINE

MDGs DRIVING ADVANCES IN HEALTH

-47%Target: - 66%(1990 – 2015)

-53% Target: - 75%(1990 – 2015)

Incidence Mortality

-42%-29% -45%-33%

+3800%

Malaria (2000-2012) TB (1990-2012)

Mortality New Infections(2001-2012)

ART(2002-2013)

HIV

Maternal mortality 2010

Child mortality 2012

1. End poverty 2. End hunger; food security & nutrition; sustainable agriculture

3. Ensure healthy lives and promote well-being for all at all ages  

4. Education and life-long learning

5. Gender equality, empower women & girls 6. Water and sanitation

7. Modern energy services 8 Sustainable economic growth & decent work

9. Sustainable industrialization and innovation

10. Reduce inequality within and among countries

11. Safe, inclusive & sustainable cities and settlements

12. Sustainable consumption and production patterns

13. Climate change 14. Marine resources

15. Terrestrial ecosystems and biodiversity 16. Peaceful and inclusive societies & rule of law

17. Global partnership for sustainable development

 

BEYOND MDGs - POSSIBLE FOCUS AREAS FOR SDGs

OVERARCHING HEALTH GOAL

Ensure healthy lives and promote well-being for all at all ages

HEALTHSUB-GOALS: 1. Maternal mortality (build on MDG)

2. Child (<5 years) mortality (MDG)3. End epidemics of AIDS, TB, malaria and NTDs and

combat hepatitis and other communicable diseases4. NCDs and mental health5. Alcohol and other substance use6. Road traffic accidents7. Sexual and reproductive health8. Universal Health Coverage incl. financial risk protection9. Hazardous chemicals, pollution & contamination

POSSIBLE HEALTH GOAL AND SUBGOALS

1. Focus on those MDGs most off-track

BUILD ON MDGs

2. More ambitious targets for those on track – ending AIDS, TB and malaria epidemicsUniversal access to HIV prevention, treatment, care and support servicesSustain and build on gains in TB – new TB strategy with goal of eliminating TBSustain and build on gains in the fight against malaria – new strategy in development

All people receive the services they need of adequate quality without incurring financial hardship

UNIVERSAL HEALTH COVERAGE – 3 DIMENSIONS

Examples of HIV contributions to UHC• HIV intervention packages• Intervention framework -

HIV prevention, care & treatment cascade

• Research agenda and innovation (basic, clinical, operational, social sciences)

COMPREHENSIVE QUALITY HEALTH SERVICES

Future priorities• Better defining core interventions• Expand coverage through progressive realization• Quality assurance & improvement• Linking HIV with other health areas – NCDs, SRH• Single framework for national strategic planning and costing

Examples of HIV contributions to UHC• Normative guidance for key populations• Models of service delivery to reach

marginalized and remote populations • Civil society as equal partners• Health & community systems

strengthening• Interventions for enabling environments

EQUITABLE COVERAGE FOR ALL

Future priorities• Improve & disaggregate strategic information • Address social determinants• Focus on populations and locations most affected • Focus on interventions where response is lagging• Research and innovation for better service delivery

FSW MSW MSM PWID0%5%

10%15%20%25%30%35%40%45%

42% 41% 39%

28%

Percentage of HIV testing coverage among key populations, regional median, 2007-2012

Data from multiple sources, with some sampling limitations

Examples of HIV contributions to UHC• Assessing resource needs and

programme costing• New investments in health• New funding approaches• Innovative financing (e.g. public-private

partnerships)• Improved efficiencies in service delivery• Access to affordable medicines and

other health commodities

FINANCING HIV RESPONSE

Future priorities• Continued external development assistance• Greater focus on domestic funding• Universal financial risk protection schemes • Cover associated out-of-pocket expenses• Address specific needs of middle-income countries

WHERE TO FROM NOW?

• SDGs: Position HIV prominently in the health goal and include HIV-sensitive indicators in other goals.

• MDGs: Build on the MDGs with even more ambitious HIV-related targets.

• UHC: Use the HIV experience to achieve UHC and use the UHC framework to accelerate and strengthen the HIV response.– Define core HIV interventions to be included in UHC packages– Expand HIV links with other health areas to achieve health equity– Focus where interventions are needed and responses lagging– Emphasize efficiency and quality– Ensure universal financial and social protection