Innovative Financing : Exceptionality of AIDS Brookings Institution and the Health Financing Task Force Washington D.C. 25 July 2006 Dr Peter Piot, UNAIDS Executive Director

AIDS Resource Needs

Global AIDS Funding World Bank Multi-Country AIDS Program The Global Fund to fight AIDS, Tuberculosis and Malaria Presidents Emergency Plan for AIDS Relief

Funding US$ billion needed by 2010 Who will pay? (Domestically, internationally) Predictability and sustainability of financing Predictability and sustainability of financing

Expenditure by source of funding Expenditure by allocation of funding

Expenditure by source in 13 LAC countries, Total expenditure = USD$ 588,550,000 Brazil is not included in the sample. 4.6% is for administration and infrastructure

Expenditure by Source in West African countries, 2003 Expenditure by Source in West African countries, 2003 Total expenditure = USD$ 51,858, % is for administration and infrastructure

Innovative Mechanisms International Financing Facility Solidarity Contribution on Airline Tickets Red Campaign National AIDS Levy (Zimbabwe)

Making the money work Reduce unit costs Specific AIDS services as part of health system Invest in human, institutional and community capacity Use money for results and impact 3 Ones: Ownership, coherence and accountability- OECD / DAC

Making the money work Reduce unit costs Specific AIDS services as part of health system Invest in human, institutional and community capacity Use money for results and impact 3 Ones: Ownership, coherence and accountability- OECD / DAC

Specific HIV treatment services as part of health system Ryan White Act Brazil: Federal programme on antiretroviral therapy Mexico: Universal access to antiretroviral therapy Thailand: 30-baht scheme includes antiretroviral therapy South Africa

Making the money work Reduce unit costs Specific AIDS services as part of health system Invest in human, institutional and community capacity Use money for results and impact 3 Ones: Ownership, coherence and accountability- OECD / DAC

Making the money work Reduce unit costs Specific AIDS services as part of health system Invest in human, institutional and community capacity Use money for results and impact 3 Ones: Ownership, coherence and accountability-OECD / DAC

Funding of health services will not stop AIDS HIV prevention largely outside health services Tackle drivers of epidemic

Social change: Tackle the structural drivers of the epidemic Gender HIV related stigma and discrimination Sexuality, including homosexuality Social and economic inequalities directly related to AIDS

Southern Africa: Need for an AIDS Marshall plan? Enormous impact of AIDS epidemic Even major intensification of current efforts may not be enough Exceptional financing and policy measures needed

Maintaining the exceptionality of AIDS – but at the core of development & health agendas, not outside

AIDS has rewritten the rules; to prevail we too must continually rewrite the rules.

Thank you