1. AU ROADMAP ON SHARED RESPONSIBILITY AND GLOBAL SOLIDARITY FOR AIDS, TB AND MALARIA ADDIS ABABA, ETHIOPIA Parliamentary Roundtable 25-26 March 2014

2. Heads of State and Government (Africa-wide) AWA Champions AWA Consultative Experts Committee (MS) AWA Secretariat AWA Chairperson -Mauritania AWA Vice Chairperson - Mozambique East Africa Tanzania North Africa Tunisia Southern Africa Malawi West Africa Cote d’lvoire Central Africa Gabon

3. Brief Background: AU Roadmap on Shared Responsibility and Global Solidarity 2012 -2015  The Roadmap presents a set of practical African-sourced solutions for enhancing Shared Responsibility and Global Solidarity for AIDS, TB, and Malaria responses in Africa.  The overarching goal of the AU Roadmap is to support African countries to exercise leadership to meet AIDS, TB, malaria targets by 2015 and source African solutions to ensure universal access to health-related services for all those in need on a sustainable basis. The AU Roadmap builds on a number of AU initiatives (e.g. Abuja Declaration)  This practical guide has been developed with indicators to assist the, the African Member States, RECs and other relevant stakeholders to implement the AU Roadmap.  The AU Roadmap suggested solutions are organised around three strategic pillars:

4. AU Roadmap Three Pillars 1 More diversified, balanced and sustainable financing models 2 Access to medicines – local production and regulatory harmonisation 3 Leadership, governance and oversight for sustainability

5. The Roadmap: three action pillars 1 More diversified, balanced and sustainable financing models  Develop financial sustainability plans with clear targets  Ensure development partners meet commitments and align with Africa’s priorities  Maximise opportunities to diversify funding sources and increase domestic resource allocation  Invest in leading medicines manufacturers – focusing on AIDS, TB and malaria  Lay foundations for a single African regulatory agency  Acquire essential skills through technology transfers and south- south cooperation  Incorporate TRIPS flexibilities and avoid "TRIPS-plus" measures in trade agreements  Use strategic investment approaches for scale-up of basic programmes  Support communities to claim their rights and participate in governance of the responses  Ensure investments contribute to health system strengthening  Mobilise leadership at all levels to implement the Roadmap 3 Leadership, governance and oversight for sustainability 2 Access to medicines – local production and regulatory harmonisation Priority actions 5

6. AU ROADMAP PRACTICAL GUIDE: PILLAR NO. 1 LevelAction National Analyzing the costs of the three diseases Building a picture of ‘returns on investment’ Identify innovative sources of domestic funding Building a picture of ‘returns on investment’ Identify innovative sources of domestic funding (see examples in Guide) Work with development partners to ensure they meet their funding commitments Regional Facilitate sharing of ideas and lessons learned on diversifying and innovating funding Continental Monitor and report on progress of member states on biennial basis

7. AU ROADMAP PRACTICAL GUIDE: PILLAR NO. 2 LevelAction National Promote and facilitate investing in leading medicines (e.g ARVs, ACTs, TB.) and health commodities (e.g. ITNs, insecticides) manufacturers in country. Create an enabling regulatory environment within country in order to reduce import tariffs and harmonize regulatory requirements with other countries in the region Create a legislative environment that incorporates the full use of TRIPS flexibilities Regional Undertake functions as defined in African Medicines Regulatory Harmonisation (AMRH) initiative and Pharmaceutical Manufacturing Plan for Africa (PMPA) business plan in the region Work to identify leading companies that can be supported to build their capacity so become quality assured pharmaceutical and commodities (e.g. ITNs) manufacturers in the region for core drugs for the three diseases. Continental Lead on attracting external investors into the continent Advocate at high levels in all member states for sustained attention and investment in pharmacy and commodity manufacturing and regulatory harmony, including through continued support for PMPA and AMRH Establish a Pharma Market Data Initiative Lay the foundations for a single African regulatory authority advocate at a global level for continuation of TRIPS flexibilitiies

8. AU ROADMAP PRACTICAL GUIDE: PILLAR NO. 3 LevelAction National Understand the scale of the three diseases Use existing reviews of disease programme governance and management arrangements to determine where capacity exists to drive forward achieving AU Roadmap objectives Develop strategy for engaging people living with HIV, civil society, key populations, national human rights entities and parliamentarians as partners in implementation and oversight of the Roadmap Determine responsibility and accountability for oversight and reporting on Roadmap progress Regional Facilitate regional multi-stakeholder (including civil society) peer review of Roadmap implementation, including review of national strategies, investment cases, governance arrangements, adherence to human rights agreements and drug regulatory policies and frameworks Organise annual regional forums to share experiences and best practices on achieving Roadmap targets Continental Put in place biennial reporting on AU Roadmap Implementation progress against indicators, starting with reporting at the AU Summit in 2014. Monitor the degree to which both AU member state governments and development partners are meeting their funding commitments Agree with African Peer Review Mechanism the inclusion of indicators on leadership, governance and oversight for the AU Roadmap within the self-assessment form and peer review process. Set up an AU award to go those countries with highest achievement as far as progress towards reaching AU Roadmap targets.

9. AU Roadmap on Shared Responsibility and Global Solidarity for HIV/AIDS, TB and Malaria (2012-2015) PeriodMilestones July 2012AU Roadmap, adopted by AU Assembly July 2012AU Roadmap Practical Guide was developed with Indicators July 2012High-Level Ministerial Dialogue on Value for Money, Sustainability and Accountability in the Health sector calls for reducing aid dependence July 2012African Leaders Malaria Alliance (ALMA) Summit on malaria calls for increased domestic financing and innovative financing Sept 2012United Nations General Assembly African Union High-Level Side Event on Shared Responsibility and Global Solidarity for AIDS March 2013Pan-African Parliament commits to monitoring the implementation of the AU May 2013First Year - AU Roadmap was produced July 2013

10. AU Roadmap on Shared Responsibility and Global Solidarity for HIV/AIDS, TB and Malaria (2012-2015) cont… PeriodMilestones Nov 2013First Year - AU Roadmap was produced July 2012Abuja Special Summit called for acceleration of the implementation of the AU Roadmap on Shared Responsibility and Global Solidarity for HIV/AIDS, TB and Malaria Response in Africa and strengthen the accountability platform; July 2012Ministerial Meeting on Domestic Health Financing

11. AWA Champions - strategic platform to implement AU Roadmap  The AWA meeting in May 2013, appointed Mozambique President Armando Guebuza as the Vice-Chairperson of AWA. The AWA “champions” are as follows:  President Alassane Ouattara of Côte d’Ivoire - West Africa;  President Ali Bongo Ondimba of Gabon - Central Africa;  President Jakaya Kikwete of the United Republic of Tanzania - East Africa;  President Joyce Banda of Malawi - Southern Africa;  President Moncef Marzouki, of the Democratic Republic of Tunisia - North Africa.

12. Example: Leadership of AWA Champion in Implementation of AU Roadmap  The President of Malawi, SADC Chairperson and SADC AWA Champion  Special Breakfast Summit of SADC Heads of States and Government, margins of 33rd SADC Summit  Aim to discuss progress and challenges that the region is facing in the areas of HIV and AIDS, TB and Malaria  SADC AWA Summit directed SADC Ministers of Health and Ministers responsible for HIV and AIDS to deliberate on the above issues and present their recommendations at the next Summit in 2014.