The Impact of the Global Economic Crisis on HIV and AIDS. Carlos Avila. 7 December 2009 UNAIDS Geneva

Transcription

1 The Impact of the Global Economic Crisis on HIV and AIDS Carlos Avila 7 December 2009 UNAIDS Geneva

2 Outline 1. What the monitoring system is telling us? 2. What are the driving forces? 3. What countries are doing? 4. What type of support countries need? 5. Conclusions

3 I. What does the monitoring tell us? Reported and expected impact is getting worse

4 Reported Impact on ART: Worse Now than in March These countries are home to 430,000 people on treatment (March) and 1.3 million people on treatment (July) Percent of countries March July % of countries where impact is reported as of today

5 But Future is Also Looking Worse (July Survey) Expected impact next 12 months

6 What Does the Monitoring Tell Us? Reported and expected impact is getting worse Wrong reallocation of resources: Most crucial programs are the most at risk

7 Regions Treatment, Care and Support Programs most at risk Asia Treatment for MARP, other care and treatment Eastern & Central Europe Eastern and Southern Africa Western and Central Africa Latin America ART, other care and treatment, treatment for most-at-risk groups, support to network of PLWH ART, support to network of PLWH ART, PMTCT, sexual and reproductive health ART, PMTCT Caribbean North Africa and Middle-East Treatment for MARP, sexual and reproductive health, and support to network of PLWH PMTCT, sexual and reproductive health

8 What Does the Monitoring Tell Us? Reported and expected impact is getting worse Most crucial programs are the most at risk Universal goal is off-track

9 Universal Access Postponed (2) People on treatment Expected (No of countries) Declining numbers 7 Maintenance of current numbers on treatment 23 Reduced scale up 30

10 Universal Access Challenge (Coverage of ART) 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Trend for universal access Expected outcomes

11 Trends in Preventive Vaccine R&D Allocations

12 Trends in Preventive Vaccine R&D Allocations

13 Change in Treatment Guidelines to CD4 < Number of Countries Not Probable Probable Highly Probable The feasibility of changing the threshold guidelines for starting treatment to a CD4 count less than less 350 cells/ml is under threat. Respondents in 19 countries, home to 45% of the people currently on treatment, view the feasibility as highly improbable.

14 II. What are the driving forces? Economic slowdown and external shocks Flat or declining budget Growing uncertainty

15 Economic Slow-Down and Shocks 60 Reported Factors Household income Food and nutrition Exchange rate effect Higher user fees

16 Flat or Declining Resources for 2010 Reported Factors Lower budget for HIV 30 countries Reduced external aid 38 countries Percentage of countries Lower government budget Reduced external aid

17 What are the countries needs? 75% of countries are viewed in need of technical assistance for Strategic planning (18 countries) Economic analysis: of impact of crisis (9 countries) Improved tracking, monitoring, evaluation (8 countries) Advocacy and Prevention (6 countries): Resource mobilization strategy: (7 countries) Prioritization and efficiency: 3 countries Mitigation of the impact: Social protection package for poor AIDS affected households (1 country) Strengthening the institutional capacity of civil society Especially CBOs and those providing services to MARPs)

18 What are the main findings? 1. Reported and expected impact is getting worse 2. HIV funding is leveling off 3. Universal access goal is off track 4. Coping with austerity is challenging, but also opens opportunities

19 Conclusions I. Need to improve allocation of resources and efficiency II. III. Need to reduce funding uncertainty Continue with monitoring system IV. Provide technical support and sharing of country experiences V. Provide social protection packages to poor households affected by AIDS