October 2009 UNAIDS HIV prevention funding GFATM Rounds 5 and 6 HIV prevention activities in national funding requests to the GFATM

October 2009 UNAIDS HIV prevention funding GFATM Rounds 5 and 6 Analysis of GFATM grants 5 and 6 HIV prevention component 26 countries Round 5 32 countries Round 6 and one multi-country proposal in West Africa Three countries received grants in both Rounds 5 and 6: China, Philippines & Peru The analysis is not the total picture – it does not : include government and other donor & civil society contributions show % of national response funded by GFATM grant Analysis is based on funds requested - not on actual disbursements

October 2009 UNAIDS HIV prevention funding GFATM Rounds 5 and 6 East Asia and Pacific: Cambodia, China, Laos People’s Democratic Republic, Mongolia, Philippines, Timor Leste, Viet Nam Eastern Europe and Central Asia: Albania, Bosnia & Herzegovina, Georgia, Moldova, Montenegro, Romania, Russian Federation, Serbia, Tajikistan, Ukraine Latin America and the Caribbean: Cuba, Haiti, Paraguay, Peru, Suriname South Asia: Bangladesh, Bhutan, India, Maldives, Sri Lanka

October 2009 UNAIDS HIV prevention funding GFATM Rounds 5 and 6 North Africa and the Middle East: Djibouti, Egypt, Jordan, Mauritania, Morocco, Sudan, Tunisia SUB SAHARAN AFRICA East Africa: Burundi, Eritrea, Rwanda, Zanzibar (United Republic of Tanzania) West and Central Africa: Benin, Burkina Faso, Cameroon, Congo (Republic of the), Cote d’Ivoire, Ghana, Guinea, Liberia, Multi-country (West Africa Corridor Programme), Nigeria, Sao Tome & Principe, Senegal, Sierra Leone Southern Africa: Lesotho, Malawi, Mozambique, South Africa, Zimbabwe

October 2009 UNAIDS Methodological problems Problems with defining/classifying prevention – NASA, UNAIDS In some proposals: behaviour change communication (BCC) condoms services for sexually transmitted infections (STI), HIV Testing and counselling/voluntary counselling and testing (VCT), post exposure prophylaxis (PEP) and the prevention of mother to child transmission of HIV (PMTCT) harm reduction services safe blood and universal precautions post exposure prophylaxis Some proposals include “structural prevention” activities such as, advocacy, reduction of stigma and discrimination, partnerships and coordination, and capacity of civil society to be able to respond. Some proposals multiple target groups & “shared” prevention and treatment activities - not possible to assign a budget to each component

October 2009 UNAIDS HIV prevention funding GFATM Rounds 5 and 6 Methodological problems (2) Some proposals refer to the setting in which the intervention takes place, e.g. Schools, community, the workplace or prisons, and the method used - through outreach or peer education. Some proposals interventions are not specified, but are described in terms of the target group they are directed towards. China “Interventions targeting gaps in current prevention efforts for the most vulnerable female sex workers and their clients.” In some cases two or more interventions are combined, such as “behaviour change communication and condom distribution”, “Youth friendly health services, life skill education and condom promotion” and “IEC/BCC, harm reduction and transmission prevention targeting high risk populations, PMTCT, STI, safe blood transfusion”. Target group – may not be specified Risk & vulnerability ”special groups”

October 2009 UNAIDS Funds requested & disbursed

October 2009 UNAIDS Interventions – East Asia & Pacific

October 2009 UNAIDS Interventions - West & Central Africa

October 2009 UNAIDS Interventions Latin America & the Caribbean – non medical

October 2009 UNAIDS Young people Young people mentioned in 39 out of 59 proposals (66%) MSM mentioned in only 10 proposals In African sub-continent only Morocco & Zanzibar included MSM & IDUs

October 2009 UNAIDS Target group Central Eastern Europe & Commonwealth of Independent States

October 2009 UNAIDS Target group Latin America & Caribbean

October 2009 UNAIDS Target group South Asia - 64% of interventions for young people in Bangladesh

October 2009 UNAIDS Case study Commission on AIDS in Asia - over 95 per cent of all new HIV infections among young people occur among most at-risk adolescents/young people. But their needs are not reflected in previous programme responses.

October 2009 UNAIDS Target group East Asia & Pacific

October 2009 UNAIDS Target group Middle East & North Africa

October 2009 UNAIDS Southern Africa

October 2009 UNAIDS West & Central Africa

October 2009 UNAIDS Global level actions 1.Clearer definitions 2.Refined programme guidance 3.High level advocacy to create an enabling environment

October 2009 UNAIDS Clearer definitions Prevention Prevention individual behaviour change (often only knowledge not skills or behaviour)– targeted or not essential packages of prevention Combination prevention Structural prevention - enabling protective environment Age Youth Young people Children/adolescents 10 to 18/19 Most at-risk, high risk, vulnerable, specific, target groups

October 2009 UNAIDS Global level actions Refine guidance on programming based on epidemic scenario

October 2009 UNAIDS Evidence-based programming

October 2009 UNAIDS Global level actions Provide guidance on legal, ethical and confidentiality issues as applied to most at-risk young people and in particular minors Revisit Optional protocol on CRC and develop guidance on social protection needs of MARA Report to UN Security Council on Res – protective role of uniformed services