1. UNAIDS 2011-2015 Strategy and key tools

2. Purpose of the Strategy  Builds on our new vision and mission – providing a pathway towards long-term vision of getting to zero  Responds to a changing world – the HIV response is at a pivotal juncture, we need to face threats and take advantage of opportunities  Presents a transformative agenda to help break the trajectory and sustain support

3. Transformation imperative  Progress scaling up treatment & stabilising/decreasing incidence  But we are challenged by  Flat-lining resources  Fragmented & generic responses  10 million people need treatment  Weak systems  Social injustice  We must seize opportunities  Better tools to measure incidence  Better strategic information—drivers of vulnerability  Momentum in development of better prevention tools  Political shifts that can produce breakthrough progress Reframing HIV response is critical at this pivotal juncture

4. Transformation agenda  Focus – Directing resources to where they have most impact on the epidemic—to hotspots, interventions, countries  Efficiency – Reducing unit cost, innovative delivery systems, involving communities, integrating services  Partnership – Supporting country ownership and south-south cooperation, engaging communities and emerging economies  Enhancing mutual accountability through shared ownership  People  Countries  Synergies Focus and efficiency to radically reduce new infections

5. Strategic Directions Catalysing the next phase of treatment, care & support  Access to effective treatment when people need it  Strong national & community systems  Access to care, support & social protection Revolutionising HIV prevention  Political commitment to why people are getting infected  Communities demand transformative change  Resources directed to hotspots and what works Advancing human rights & gender equality  Protective social & legal environments enable access  Equitable service provision reaches people most in need  HIV-related needs and rights women and girls addressed

6. Zero new HIV infections: Revolutionise HIV Prevention Strategic Direction 1 Vision UNAIDS Partnerships Impact Areas Illustrative Examples of Joint Working Vision & Strategic Direction  Support to countries to implement learning objectives in the International Technical Guidance on Sexuality Education  Analytic work on HIV transmission dynamics  Synthesis of global epidemics of HIV in sex workers  Networks of PLWHIV and other key populations  Synergies with sexual and reproductive health communities  Academic and professional societies  Lesson-learning partnerships  Funding entities  Young people Objectives Impact Areas To mobilise communities to demand transformative change Leaders positively incentivised to make the right decisions Political and legal blockages mapped & addressed Positive Health, Dignity and Prevention approaches scaled up Young people empowered to redress harmful social norms To generate political commitment to how and why people are getting infected To direct resources to epidemic hotspots Strategies emphasise prioritised prevention programmes Effective prevention approaches introduced & scaled up

7. To strengthen national & community systems to deliver services Capacity for registration & scale up of use of TRIPS Zero AIDS-related deaths: Catalyse next phase of treatment, care & support Strategic Direction 2 Vision UNAIDS Partnerships Objectives Impact Areas Illustrative Examples of Joint Working Vision & Strategic Direction  Reduction of HIV-related TB risk factors  Collaboration of GNP+, Int’l Community of Women with HIV/AIDS, Young Positives, EngenderHealth, IPPF, to produce The Advancing the Sexual & Reproductive Health and Human Rights of People Living with HIV guidance package  Families, communities & faith-based organisations  Public-private partnerships  Pharmaceutical industry  Companies, business associates & employers’ federations  Health providers & multi-disciplinary societies Objectives Impact Areas Community system capacity for service delivery To ensure people living with HIV can access treatment Better drugs and point-of- care tools developed Non-drug- related cost savings identified and gained To scale up access to care, support and social protection services Care & support services adapted to diverse needs HIV-sensitive social transfers embedded into national programmes

8. Zero discrimination: Advance human rights & gender equality for the HIV response Strategic Direction 3 Vision UNAIDS Partnerships Key populations empowered to claim their rights Objectives Impact Areas Illustrative Examples of Joint Working Vision & Strategic Direction  The Global Commission on HIV and the Law will assist in developing rights- based recommendations for effective HIV responses. Recent dialogues rolled out through inter- agency action.  Implement the Action Framework on Women, Girls, Gender Equality and HIV  Regional & country networks of key populations  Civil society networks  Women’s rights advocates  Faith-based organisations People living with HIV mobilised as forces of change Programmes implemented that support women & girls all their lives Complete information on legal frameworks disseminated Data collection with people at higher risk strengthened & put to use Programmes to counter gender-based violence implemented Objectives Impact Areas To support countries to protect human rights in the context of HIV To advance country capacity for equitable service provision To ensure needs of women & girls addressed in national HIV strategies

9. MECHANISMS UBW – UBAF Division of Labour UN Reform Country Leadership & Sustainability Knowledge Translation Resource mobilisation Organisational Strengthening STRATEGIC PLAN GLOBAL COMMITM’TS GOALS STRATEGIC DIRECTIONS CORE THEMES OBJECTIVES PARTNERSHIP Enable country owned responses, south-south cooperation & move beyond HIV/ health sectors Forge political alliances that link HIV movements with movements for social justice Generate political commitment Mobilise communities Resources to epidemic hotspots Ensure access to treatment Systems strengthening Scale up access to social protection Revolutionize PreventionTreatment, care & supportHuman rights & gender equality VISION Universal Access - Halt and reverse the spread of HIV and contribute to the MDGs Zero New HIV InfectionsZero AIDS-Related DeathsZero Discrimination Halve Sexual transmission Eliminate vertical transmission and halve maternal deaths Eliminate IDU transmission Universal access to treatment for all who need it Halve TB/HIV deaths Care & support for all No punitive laws No travel restrictions Nat’l strategies address W&G Zero tolerance for VAW&G PeopleCountriesSynergies Support countries to protect rights & remove punitive laws Reduce stigma and discrim. W&G needs addressed

10.  Sexual transmission of HIV reduced by half, including among young people, men who have sex with men and transmission in the context of sex work  Vertical transmission of HIV eliminated and AIDS-related maternal deaths reduced by half  All new HIV infections prevented among people who use drugs  Universal access to antiretroviral therapy for people living with HIV who are eligible for treatment  TB deaths among people living with HIV reduced by half  People living with HIV and households affected by HIV are addressed in all national social protection strategies and have access to essential care and support  Countries with punitive laws and practices around HIV transmission, sex work, drug use or homosexuality reduced by half  HIV-related restrictions on entry, stay and residence eliminated in half of the countries that have such restrictions  Zero tolerance for gender-based violence  HIV-specific needs of women and girls addressed in at least half of all national HIV responses Revolutionise HIV prevention Catalyse the next phase of treatment, care and support Advance human rights and gender equality Goals for 2015

11. Trends in HIV prevalence among ANC attendees

12. Maternal HIV prevalence by age group in South Africa: 2003-2008

13. UNAIDS Tools Two main tools –EPP /Spectrum –NASA

14. EPP and Spectrum Short term projection and estimates of HIV New generation software to be launched in March 2011

15. Estimation and Projection Package (EPP) Surveillance data from pregnant women at ANC and survey data from national population based surveys Spectrum PLHIV New HIV infections AIDS deaths Orphans due to AIDS ART and PMTCT needs Adult HIV prevalence and incidence UN Population Division’s population estimates Epidemiology assumptions and program coverage HIV Estimation process (Generalized Epidemics)

16. Spectrum INPUT : National HIV incidence estimates (from EPP) Population estimates Programme coverage data ART, PMTCT, Cotrimoxazole Programme characteristics Assumptions on survival, fertility, sex ratio of HIV prevalence, age distribution of infection OUTPUT: Numbers living with HIV New HIV infections Number in need of treatment HIV+ pregnant women Deaths due to AIDS Orphans Vital events (births) Uncertainty analysis

17. PLHIV, annual new infections, AIDS-related deaths and total population:15-49 years in South Africa

18. Estimated annual HIV incidence: South African population aged 15+

19. Estimated provincial number of new HIV infections aged 15-49 (2009)

20. Estimated number of new infections by province

21. Purpose and objectives on NASA Identify all sources of financing for HIV/AIDS & TB; Measure all the public, external and private financial resources allocated/ committed and spent for HIV/AIDS and TB activities; Identify the providers of HIV/AIDS & TB services; Identify activities on which the funds were spent, according to the NASA classifications and priorities; Identify the beneficiaries of the spending on HIV/AIDS and TB activities

22. Rationale for doing NASA Budgetary allocations indicate commitment Little data on how previous allocations have been spent in various programmes, activities and outcomes. Resource tracking of HIV/AIDS expenditure enables countries to monitor spending according to its National Strategic Plan (NSP) Measures degree of harmonization and alignment of all actors’ involved in HIV/AIDS Measure financing gap, so as to improve decision-making and resource mobilization processes

23. Rationale (2) NASA contributes to the strengthening of comprehensive tracking of actual spending from all sources that comprises the national response to HIV and AIDS in a country Leveraging technical and financial support for: –development, –implementation, –management, –monitoring and evaluation of the national HIV/AIDS response.

24. Aids spending in selected SADC countries (million US $: 2006)

25. HIV Allocation: S.A. Government funds

26. Spending by Kwazulu Natal: ES vs CG

27. KZN Conditional Grant Spending by Activity: 2007/8 & 2008/9

28. KZN Spending on ART: 2007-2009

29. KZN Total voted funds by activity: 2007/8-2008/9

30. VISION ZERO NEW HIV INFECTIONS. ZERO DISCRIMINATION. ZERO AIDS-RELATED DEATHS.