1. What Will it Take to Reach the Fast Track Prevention Targets? July 18, 2016, International AIDS Conference Karl L. Dehne, Chief Prevention, UNAIDS

3. Towards Global Prevention Plan GLOBAL PLAN TOWARDS THE ELIMINATION OF NEW HIV INFECTIONS AMONG CHILDREN BY 2015 AND KEEPING THEIR MOTHERS ALIVE

4. Trends in New Adult HIV Infections & 2020 Target 2020 and 2030 targets Source: UNAIDS 2016 New HIV infections among adults (15+) (million) 75%

5. 6 Countries Accounted for about 50% of New HIV Infections Worldwide in 2015 COUNTRYNumber of new HIV infections South Africa370 000 Nigeria210 000 Russia110 000 Uganda80 000 India76 000 Mozambique75 000

6. 30 countries accounted for over 80 % of new HIV infections in 2015 COUNTRYNumber of new HIV infectionsCOUNTRY Number of new HIV infections South Africa 370 000Malawi28 000 Nigeria 210 000Ethiopia… Russia 110 000Angola22 000 Uganda 80 000Côte d’Ivoire21 000 India 76 000Lesotho17 000 Mozambique 75 000Pakistan16 000 Kenya 71 000Ukraine15 000 Indonesia 68 000Vietnam14 000 China 59 000South Sudan13 000 Zimbabwe 59 000DR Congo12 000 Zambia 55 000Mexico11 000 USA 50 000Myanmar11 000 Tanzania 48 000Swaziland11 000 Brazil 44 000Ghana11 000 Cameroon40 000Colombia10 000

7. Distribution of new HIV infections among population groups, selected regions, 2014 Methodological note: Estimated numbers of new HIV infections by key population were compiled from country Spectrum files submitted in 2015 to UNAIDS (2014 data), available modes-of- transmission studies and additional sources of data drawn from GARPR reports. Where data were lacking, regional medians were calculated from available data and applied to countries’ populations.

8. 5 Prevention Pillars

9. Core results for HIV prevention by 2020

10. Speed and scale South Africa- Number of people receiving ART, 2012-2015 (in millions)

11. Kenya cumulative circumcisions, 2008–2011 (in thousands)

12. India-Number of female sex workers contacted through outreach, 2004-2008 (in thousands) Source: Sex Trans Infect 2010; 86 (Suppl 1): i 76 – i 82. doi: 10.1136/sti.2009.039115

13. KwaZulu Natal, South Africa- number of male condoms distributed (in millions) 2010/1 to 2014/5

14. A management framework for HIV prevention

15. Core capacities needed in a national HIV prevention management team

16. Call for Action National level Adjust national results frameworks to ensure 90% of key populations and priority groups in high-prevalence settings access combination prevention Strengthen national HIV prevention management systems Develop or adjust a mechanism for accountability Analyse determinants of prevention demand, uptake, and adherence Develop or adapt standard operating procedures, including health and community components that include aspect of demand, delivery and adherence Develop mechanisms for domestic financing of prevention Subnational level (district or city) Develop simple subnational implementation plans including operational targets for service delivery and demand generation Establish a dynamic implementation management group for HIV prevention Regular mentoring and monitoring visits, tracking and review of progress and bottlenecks Facility level Deliver effective prevention services as population-specific packages Strengthen provider approaches towards core results on condom distribution/promotion, PrEP, VMMC, ART Integrate prevention and treatment communication and service delivery Orient service providers on the right to prevention for everyone at risk

17. Community level Ensure community empowerment and participation in service delivery Accelerate integrated demand generation for core prevention outcomes, testing and treatment Streamline delivery system of community- based programs Global level Engage high-level politicians in priority countries & donors to ensure commitment to and investment in scaling and speeding up delivery of prevention programs Develop and promote a global plan to reduce new adult infections including a concise results framework Convene a global partnership including priority county leadership to agree on accountability mechanism Develop tracking mechanism e.g. scorecard for outcomes Convene global review meetings of priority countries in 2018 and 2020 Call for Action

18. Reaching the 2020 Fast-Track Prevention Targets is possible, but requires that we do business differently!