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Entering a new phase in the response to AIDS in Africa Joint Annual Meeting of the AU Conference of Ministers of Economy and Finance and ECA Conference.

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Presentation on theme: "Entering a new phase in the response to AIDS in Africa Joint Annual Meeting of the AU Conference of Ministers of Economy and Finance and ECA Conference."— Presentation transcript:

1 Entering a new phase in the response to AIDS in Africa Joint Annual Meeting of the AU Conference of Ministers of Economy and Finance and ECA Conference of African Ministers of Finance, Planning and Economic Development Economic Commission for Africa Addis Ababa, 31 March 2008

2 HIV prevalence in adults in sub-Saharan Africa, 1990−2005

3 Top Causes of Death in Africa 1. HIV/AIDS 2. Malaria 3. Lower respiratory infections 4. Diarrhoeal diseases 5. Perinatal conditions 6. Cerebrovasuclar disease 7. Tuberculosis 8. Ischaemic heart disease 9. Measles 10. Road traffic crashes

4 HIV prevalence and income inequality in sub-Saharan Africa Gillespie et al. Poverty, wealth, HIV transmission. AIDS, Volume 21 Supp. November 2007.

5 HIV Prevalence by Wealth Quintile of Women in Eight African Countries Mishra V, Bignami-Van Assche S, Greener R, Vaessen M, Hong R, et al. (2007) HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. AIDS (supplement)

6 Change in Mean Years of Schooling by HIV Prevalence Jane Forston. Mortality Risk and Human Capital Investment: The Impact of HIV/AIDS in Sub- Saharan Africa. March 2007

7 Number of people receiving ARV therapy in low- and middle- income countries in Sub-Saharan Africa, 2002—2007 end- 2002 end- 2004 end- 2003 end- 2005 0.4 0.8 1.2 1.6 2.2 2.8 Millions Year 2.4 2.6 3.0 0.0 0.2 0.6 1.0 1.4 1.8 2.0 end- 2007 end- 2006

8 Estimated number of people newly infected with HIV in Sub-Saharan Africa, 1990–2007 Year 0 1 2 3 4 5 199019911992199319941995199619971998199920002001200220032004200520062007 Millions Upper range Estimate Lower range Number of people newly infected with HIV

9 [i] 1996-2005 data: Extracted from 2006 Report on the Global AIDS Epidemic (UNAIDS, 2006) [ii] 1986-1993 data: AIDS in the World II. Edited by Jonathan Mann and Daniel J. M. Tarantola (1996) Notes:[1] 1986-2000 figures are for international funds only [2] Domestic funds are included from 2001 onwards Funding Total annual resources available for AIDS, 1986 ‒ 2007 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 US$ million 292 1623 8.3 billion Signing of Declaration of Commitment on HIV/AIDS, UNGASS ‘96‘97‘98‘99‘00‘01‘02‘03‘04‘051986‘87‘88‘89‘90‘91‘92‘93‘94‘95 Less than US$ 1 million 59 212 World Bank MAP launch Global Fund PEPFAR 257 UNAIDS Gates Foundation ‘062007 10 000 8.9 billion 10 billion

10 Domestic Public Per Capita Expenditure on AIDS - USD in Sub-Saharan African Countries by income level (GNI)

11 Resources Required for AIDS Sub-Saharan Africa

12 Breakdown of DAC members’ bilateral aid to health and reproductive health 2000-06 commitments, annual averages in USD million, constant 2005 prices OECD, 2007

13 Change in Under-Five Mortality Rate in Select Countries with High HIV Prevalence, 1990–2003 R. Hecht et al. Putting It Together: AIDS and the Millennium Development Goals. PLoS Medicine, 2005

14 Epidemic Curves T.Barnett, A.Whiteside

15 Volatility in Aid for Health, Selected Countries, 1999–2003 Source: World Health Organization, 2006

16 MOH MOEC MOF PMO PRIVATE SECTORCIVIL SOCIETYLOCALGVT NACP CTU CCAIDS INT NGO PEPFAR Norad CIDA RNE GTZ Sida WB UNICEF UNAIDS WHO CF GFATM USAID NCTP HSSP GFCCP DAC CCM T-MAP 3/5 SWAP UNTG PRSP 200 MUSD 290 MUSD 50 MUSD 60 MUSD

17 The Three Ones  One agreed AIDS action framework  One national AIDS coordinating authority  One agreed country-level monitoring and evaluation system

18 Prices (US$/year) of first-line antiretroviral regimen in Uganda: 1998-2003

19 Optimal Management? Enormous variation in unit costs $1 $10 $100 $1000 010100100010,000 Annual Clients Completing VCT (scale) Cost per VCT Completed (unit cost) Mexico Uganda Russia India South Africa S. Bertozzi


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