The Australian Government’s Overseas Aid Program © Commonwealth of Australia 2003 Australia’s International Development Strategy for HIV Intensifying the response: Halting the spread of HIV

Introduction Replaces Meeting the Challenge (2004)  New knowledge of epidemics  New GoA policy shifts  MDGs  Commitment to ODA at 0.5% GNI by 2015  (GEC – greatest need, cost-effectiveness)  Global policy shifts  Accra Agenda for Action  2006 Political Declaration  Global Fund

Principles Most countries well behind schedule for meeting MDG and universal access targets Selective approach  niche (harm/demand reduction)  expertise (IDU and MSM)  strategic priorities (PNG)  other donors or mechanisms (ART) Heterogeneous epidemics requiring context- specific approaches Country-led responses AusAID country offices lead role

Goal To make a significant and sustained effort to: achieve the MDG target of halting and beginning to reverse the spread of HIV and AIDS by 2015 by assisting partner countries to achieve universal access to HIV prevention, treatment, care and support

Geographic Focus Asia Pacific region, primarily  Closest neighbours  Disproportionately low aid flows  PNG – more intensive and broad-ranging support Africa, relatively small  Strategic partnerships (key multilaterals & NGOs)

Cross-Cutting Issues People with disability  Have equal (or greater) risk of exposure to HIV  Need to consider in HIV service delivery Gender  Addressing inequalities and vulnerabilities of both men and women, and people of diverse gender identities and sexual orientations

Priority 1: Intensify prevention Cornerstone of HIV responses Universal access target: 80% pop n at higher risk  36% SW, 9% MSM, 5% IDU Asia: IDU (harm and demand reduction) MSM (46% of new HIV by 2020) PNG, Pacific, Papua and West Papua: Pop n at higher risk less well-defined Key behaviours and settings Women’s vulnerability to violence and poverty

Priority 2: Optimise the role of health services Integrate HIV services within primary healthcare (where feasible)  Resource efficient, access, continuum of care Linkages with other health issues  TB (PLHIV 50% more likely to develop TB)  SRH (high STI prevalence)  MCH (preventing parent-to-child transmission)  Hepatitis C (impact on ART) PNG: comprehensive HIV responses (including ART)

Priority 3: Strengthen coordination and capacity to scale-up Assisting countries to scale-up (prevention, treatment, care and support) by addressing the barriers Institutional barriers  health system strengthening (through AusAID health programs) – financial systems and workforce development  Global Fund processes (apply, manage, report) Inclusive and coordinated responses  country-led, existing systems, donor harmonisation (Accra)  building skills of participants (incl. twinning with Australian organisations)  valuing the role of PLHIV

Priority 4: Review legal and policy frameworks Review and improve laws and policies that relate to:  Discrimination against PLHIV  disincentivises VCCT  Criminalising at risk behaviours  prevents access to services, participation in responses, increases vulnerability  Prevention used as evidence of illegal behaviour  inhibits access to condoms, needles and syringes  Gender inequality & disempowerment of women  increases vulnerability Assist effective implementation of supportive laws and policies

Priority 5: Build evidence base Can’t fight what we don’t understand Encouraging countries to establish national research agendas to guide responses Strengthening surveillance, and monitoring and evaluation systems Promoting knowledge sharing between neighbouring countries

Priority 6: Demonstrate and foster leadership Key to sustainable change Australia demonstrating leadership  Ambassador for HIV, Minister, Parl Sec, PM  Strategic engagement with multilaterals (UNAIDS, Global Fund)  Interests of Asia Pacific region Supporting leadership in others  Supporting regional advocacy groups  National high-level local champions  Local communities (PLHIV and women)

Next Steps - Implementation Ensure global programs are contributing to our objectives Leadership advocacy plan  consistency of messages around strategic priorities Scoping studies (map, gap analysis, opportunities)  MSM; legal and policy enabling; implementing GIPA  Expert roundtables AusAID country programs lead role Consolidation of activities