Contribution of ALPHA results to global estimates and policy Mary Mahy, ScD Division Chief Strategic Information and Monitoring UNAIDS, Geneva

Three areas of contribution Improved model parameters Validated results from global estimates Unpackaged complexities of the epidemic

1. Improved model parameters Survival by age at infection East Africa (a) vs South Africa (b) Todd et al AIDS 2007 Presented by Basia Zaba on behalf of the Alpha network consortium at UNAIDS Reference Group meeting 2015

2. Validated model results Observed female adult Life Expectancy trends compared with national level estimates (UN Pop Div & IHME) Mortality rates of people living with HIV, Reniers et al AIDS 2014

3. Unravelling complexities Maternal mortality 8x higher among HIV+ women, however mortality rate much lower among HIV+ pregnant women than HIV+ women Revised global maternal mortality estimates Fertility patterns of HIV+ women versus HIV- women after ART roll out Source: Zaba et al Lancet 2013 Source: Marston presentation on behalf of ALPHA network. UNAIDS Reference Group 2015

Going forward Models: Updates to parameters, Decisions about what level of complexity is required, Interpretation: changing patterns of treatment uptake and drop out and resulting incidence trends Complicated results: Fertility patterns and ART, poverty, and medication Developing systems for unique identifiers, programme data collection, analytical methods, improving quality of services in communities using ALPHA analysis tools