February 2006 WHO's Contribution to Scaling Up towards Universal Access to HIV/AIDS Prevention, Care and Treatment Department of HIV/AIDS

February 2006 WHO's Mission in HIV/AIDS WHO's mission in HIV/AIDS is to achieve the highest possible standard of health for all people by reducing the impact of HIV/AIDS on their lives.

February 2006 Universal access - past and present th WHA "Health for All by 2000" International Conference on Primary Health Care "…universal access to individuals and families…" Millennium Development Goals Declaration of Commitment on HIV/AIDS

February WHO declares a public health emergency WHO and UNAIDS launch the "3 by 5" Initiative 56 th World Health Assembly endorses the Global Health Sector Strategy for HIV/AIDS Global Task Team recommendations for coordination within the multilateral system of the global HIV/AIDS response improving the managerial and technical support to country- led HIV/AIDS responses through the multilateral system. Universal access - past and present

February 2006 July 2005 – G8 leaders announce their intention to "work… with WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention, treatment and care, with the aim of as close as possible to universal access to treatment for all those who need it by 2010". September th Session of the UN General Assembly endorsement of the goal by all UN Member States at the High Level Plenary Meeting Universal access - past and present

February 2006 Universal access in the health sector Universal access refers to access to prevention, treatment, care and support interventions for all who need it. Access (availability, affordability and acceptability) should be measured at the country level within the context of globally accepted guiding principles, ensuring access for all in need to services that provide a minimal standard for quality. Coverage indicates the optimal availability and utilization, in accordance with the epidemiology, of a specific intervention. Proceedings of a Technical Meeting for the Development of a Framework for Universal Access to HIV/AIDS Prevention, Care, Treatment and Support in the Health Sector

February 2006 "The health sector is wide-ranging and encompasses organized public and private health services (including those for health promotion, disease prevention, diagnosis, treatment and care); health ministries; nongovernmental organizations; community groups; and professional associations; as well as institutions which directly input into the health care system (e.g. the pharmaceutical industry, and teaching institutions)." Global Health Sector Strategy for HIV/AIDS Universal access in the health sector

February 2006 WHO's Strategic Directions for Care and treatment are within the domain of the health sector. 2. A significant proportion of prevention activities is delivered by the health sector. 3. Target-driven approaches work in public health.

February A public health approach enables rapid scaling up of quality interventions. 5.Approaches need to be flexible and responsive to different epidemiological contexts. 6. Health systems strengthening and expansion is essential for universal access to be achieved. WHO's Strategic Directions for

February Enabling individuals to know their HIV status through HIV testing and counselling 2.Accelerating the momentum of HIV/AIDS treatment and care scale-up 3.Maximizing the health sector's contribution to HIV prevention 4.Investing in strategic information to guide a more effective HIV/AIDS response 5.Taking urgent action to strengthen and expand health systems WHO's Strategic Directions for

February 2006 Priority Interventions (1) Strategic Direction I:Priority Interventions Enabling individuals to safely know their HIV status through confidential HIV testing and counselling - Voluntary testing and counseling - Provider initiated testing and counseling -Infant diagnosis and family counseling

February 2006 Priority Interventions (2) Strategic Direction II:Priority Interventions Maximizing the health sector's contribution to HIV prevention - Prevention of mother to child transmission (PMTCT) - Prevention of sexual transmission - Prevention of HIV transmission through injecting drug use (harm reduction) - Prevention of HIV transmission within the health care setting - New technologies for HIV prevention - Positive prevention for people living with HIV/AIDS

February 2006 Priority Interventions (3) Strategic Direction III:Priority Interventions Accelerating the scale-up of HIV/AIDS treatment and care -Antiretroviral therapy for paediatric and adults HIV/AIDS -Prevention and management of opportunistic infections and co- morbidities - Care, including nutrition, palliative care and end of life care - Linking HIV/AIDS and tuberculosis services

February 2006 Priority Interventions (4) Strategic Direction IV:Priority Interventions Investing in strategic information to guide a more effective response - Surveillance of HIV/AIDS and STIs -HIV/AIDS treatment monitoring, including HIV drug resistance surveillance and monitoring -Monitoring and evaluation of and reporting on the health sector's response towards universal access - Operational research

February 2006 Priority Interventions (5) Strategic Direction V:Priority Interventions Strengthening and expanding health systems - Leadership & stewardship - National strategic planning and management - Procurement and supply management - Laboratory strengthening - Human resource development and management - Strategies for sustainable financing

February 2006 Operationalizing WHO's contribution to achieving universal access Within the Strategic Directions and Priority Interventions WHO will: 1.Advocate for action and mobilize partnerships 2.Establish and disseminate the evidence base on the effectiveness of different health sector interventions and models of good practice for service delivery; 3.Provide global policy guidance;

February 2006 Operationalizing WHO's contribution to achieving universal access 4. Set norms and standards and develop, update and adapt assessment, policy, programme and monitoring and evaluation tools and guidelines; 5. Provide technical support to countries to scale up national HIV/AIDS responses in the health sector ; 6. Monitor and evaluate the implementation of interventions and programmes and assist countries to select indicators and targets.

February 2006 Operationalizing WHO's contribution to achieving universal access Develop a detailed operational plan to support WHO's contribution Complete the development of the Essential Package for Universal Access to HIV/AIDS Prevention, Care, Treatment and Support in the Health Sector including optimal models for implementation Include as an agenda item for the 59 th World Health Assembly May 2006 Resource mobilization NEXT STEPS

February 2006 Operationalizing WHO's contribution to achieving universal access For more information, please visit The WHO Universal Access website: