UNAIDS Program Coordinating Board Meeting 10 December 2009 Geneva The Impact of the Global Economic Crisis on HIV and AIDS

“report at the 25th Programme Coordinating Board Meeting on the anticipated impact that the financial crisis will have on countries’ ability to meet their universal access targets and to include recommendations and mitigation strategies.” The context At the 24th Meeting of the UNAIDS Programme Coordinating Board in June, the Board requested that UNAIDS:

1. UCCs survey a.March survey 71 responses b.July survey 63 responses 2. CSOs survey a.PCB Delegates provided the list of NGOs b.458 CSOs started the survey and 80 fully completed it c.CSOs respondents from 75 countries 3. Country Case studies a.12 country case studies 4. Cosponsor’s contributions 5. Donor’s interviews a.Structured interviews with the top five bilateral donors plus the Global Fund and World Bank Monitoring system: sources of information

Reported and expected impact is getting worse (UCCs July Survey)

Percentage of countries in each region where funding reduction is expected to affect prevention APCaribbeanESAFECALAMENAWCA VCT 18%67%36%20%33%67%25% Condoms 18%67%27%50%33%67%23% AIDS education 18%67%27%30%33%0%19% IDUs programs 18%33%9%60.017%67%17% MSM programs 36%100%18%30%50%67%24% SW programs 46%100%36%30%33%67%28% Human rights and advocacy 18%100%18%30%50%33%24% Reduction of stigma and discrimination 27%100%18%50% 0%27% Violence against women 18%100%9%20%17%0%15% Empowerment of young people 36%67%27%40%17%33%26%

32 off-track 19 on track Universal Access off-track (Coverage of ART for illustration) 12 not available

Economic slowdown and external shocks Flat international resources Competing priorities for development assistance Growing uncertainty at the country level II. What are the driving forces?

Macro and Micro Impacts related to HIV/AIDS

Economic Slow-Down and Shocks: UCCs reported risk factors

Factors perceived by CSOs to affect HIV and AIDS of the Crisis on HIV/AIDS

Impact of the Crisis on HIV/AIDS Programs: CSOs perspective

Strategic planning: 20 countries Improved tracking, monitoring, evaluation 9 countries Economic analysis: of impact of crisis 8 countries Prioritization and efficiency: 8 countries Resource mobilization strategy: 7 countries Mitigation of the impact and Social protection package for poor AIDS affected households (1 country) Capacity building and strengthening the institutional capacity of civil society What are the countries’ needs for technical assistance?

Interviews with major donors, plus the Global Fund and World Bank, suggest that: Donors and International Financing Institutions are striving to maintain financial support for AIDS in the context of a very challenging environment There are significant shifts towards: –funding for health systems and other development agendas. –favouring countries with a high burden of disease and lower income status. The outlook for donors

1.Reported and expected impact is getting worse with the biggest impacts experienced by prevention programs delivered by CSOs 2.HIV funding is leveling off 3.Universal access goal is off track What are the main findings?

I.Target better existing but constrained resources to protect priority services and populations including those delivered by CSOs. II.Pursue greater efficiencies in existing programmes III.Develop funding diversification strategies IV.Increase the stability and predictability of funding V.Expand “safety net” services for poor and vulnerable populations What can be done to address the negative effects of the economic crisis on AIDS programs

Each and every one of us has a responsibility to improve the picture of the response to HIV/AIDS!