1. No money, no results! New estimates of need No money, no results! New estimates of need Carlos Avila and Catherine Hankins Joint United Nations Programme on HIV/AIDS XVIII International AIDS Conference Vienna, Austria, 18-23 July 2010

2. Collectively we’ve made remarkable progress in many aspects of the response to HIV… … antiretroviral treatment, incidence of new infections, human rights

4. People in the poorest places have access to life- prolonging medicines

5. Young people are leading the prevention revolution by taking definitive action to protect themselves from HIV

6. Some high-burden countries have achieved a 25% reduction in HIV prevalence among young people by 2010

7. Know your epidemic and response synthesis process Epidemiological Review: Drivers/ country specificity Incidence data (modelled or otherwise) Prevention policies, response and strategic info review Review of resources for prevention SYNTHESIS ANALYSIS OF EPIDEMIC ANALYSIS OF RESPONSE

8. Human rights issues and the AIDS movement “Gay couple freed by Malawi presidential pardon return to home villages” Human rights campaigner says men have not been reunited amid fears for their safety Recent advances include the decision of the Delhi high court to strike down an anti-sodomy law dating back to the early days of the British Raj China’s launching of needle exchange and methadone programmes for people who inject drugs need to be multiplied

9. One of the biggest human rights issues facing the AIDS movement is funding

10. TOTAL annual resources available for AIDS in low and middle income countries, 1996-2009

11. $0.10 - $1 per capita > $10 per capita$1 - $10 per capita < $0.10 per capita Spending per capita for HIV Source: UNAIDS global report 2008, Annex 2

12. International AIDS Assistance: Trends in G8/EC & Other Donor Government Assistance, 2002-2009 USD billions Commitments (Enacted Amounts) Disbursements Sources: KFF and UNAIDS, Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments in 2009, July 2010

15. Eastern Europe and Central Asia Latin America and the Caribbean Sub-Saharan Africa South East Asia and the Pacific DONOR 3.5 BILLION DONOR 2 BILLION DONOR 21 MILLION DONOR 8 MILLION ____________ _________ ___ ________ ________ ___ _________ ____ ____________ _________ ___ ________ ________ ___ _________ ____ International Assistance for HIV, domestic spending, and financing gaps

16. Now is not the time to slow down the response Now is the time to accelerate it!

17. Worst case scenarios if funding decreases: Increased mortality and morbidity Greater transmission risks Treatment interruption Increased burden on health systems Reversal of economic and social gains 17

18. Resources needed to provide ART under two CD4 eligibility criteria (New WHO ART guidelines) 18 0 2,000 4,000 6,000 8,000 10,000 12,000 201020112012201320142015 US$ Millions CD4 <350 CD4 <200

19. A call for efficiency!

20. Improve how money is spent: Spending at efficient scale Long-term view to programming Making available money work harder: –Collaboration –Technical support –Bridge funding 20

21. Efficiency is not a choice; it is a necessity Opportunity to improve efficiency of programming: –Choose interventions strategically –Focus them where they will have maximum benefit 21

22. Tie funding to performance  Efficient mechanisms (e.g. World Bank, Global Fund, bilateral)  Efficient implementers  Efficient technical assistance

23. Assessing Fair Share 2: Donor Rank by Disbursements for AIDS per US$1 Million GDP*, 2009 Sources: KFF and UNAIDS, Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments in 2009, July 2010

24. Resource mobilization action! Financing options Increase domestic funding Fair share from bilaterals Corporate Partnerships Framework Agreement on Debt2Health Airline ticket tax BRIC governments becoming donors Huge accumulation of wealth (Sovereign Wealth Funds, HNI) Robin Hood Tax (take a look at the videos on http://robinhoodtax.org.uk/) 24

25. How much is too much? -255075100125150175200 Cost of war in Iraq in 2008 Amounts spent on Valentine's day Bonus paid to London Financial staff at Christmas 2006 Bilateral Aid for AIDS in 2008 US$ billion

26. What will it take for you? What will it take for everyone of us……. …..to think strategically, raise our voices to advocate, and take action for the funding of a decent response to AIDS?

27. THANK YOU!