Making the Money Work AIDS Strategy and Action Plan (ASAP) A service of UNAIDS Caribbean Regional Workshop Patrick L. Osewe World Bank June 4-15, 2007. Mexico ASAP Website: www.worldbank.org/asap 1
Global spending for HIV/AIDS (US$ millions) ASAP a service of UNAIDS 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 Avg Price of ARVs $7,944-20,224/ Person per year World Bank MAP 3 by 5 GFATM PEPFAR 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005* G8 Avg Price of ARVs $50-200/Person per year * Projected funding Source: UNAIDS, 2004. 2
Why Strategies? National HIV/AIDS Strategies are needed to: Attract and sustain funding (Ministry of Finance, donors, Global Fund, etc.) Assure an important role for civil society and communities Align external support to national strategies Respond to heterogeneity of epidemics Implement the principles of the Three Ones 3
Why Action Plans? Annual Action Plans are needed to: Move from project to program support Improve implementation Ensure timely response to changing epidemics and environment Link to government planning cycles and budgets 4
Review of Existing Strategies Strengths Forging high level commitment Broad range of actions Consultative process and involvement of various stakeholders Focus on stigma reduction and multisectoral responses Limitations Not always based on evidence and transmission patterns Not prioritized Limited monitoring and evaluation Limited costing Not translated into implementable action plans Not fully inclusive AIDS ASAP Strategy Website: and Action www.worldbank.org/asap Plan (ASAP) A service of UNAIDS 5
Review of Existing Strategies ASAP review shows evidence base and prioritization weakest - management and costing also weak 0.9 86% % of Satisfactory Strategies 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 43% 29% 57% 57% 0 Goals EvidencePrioritization Mgmnt Base Costing 6 Source: World Bank, 2005
The Challenge: Wasting Money 100% 80% 78% 76% 99.2% 60% 40% 20% 0% Sex workers.08% 0.8% 24% 2.2% General population HIV prevalence Transmission sources Funding Sources: NACP, GAC, MAP, 2005 7
Adapting the response to evolving epidemics 100% Composition of People Living with HIV/AIDS Thailand 1988-2010 80% 60% 40% 20% Extramarital Wife from Husband Husband from wife Sex worker Male from sex worker Male sex with male Injection Drug User 0% 1988 1990 1995 2000 2005 2010 8
Origin of ASAP Created by the Global Task Team Major partners: ILO, UNICEF, UNFPA, UNDP, UNAIDS Secretariat, WHO, World Bank (lead partner) Principles: Demand driven Flexible Consultative ASAP Website: www.worldbank.org/asap 9
ASAP Governance UNAIDS ASAP Advisory Group Composed of UNICEF, UNESCO, UNDP, ILO, WHO, WB, UNAIDS Secretariat. Provides overall guidance on ASAP operations ASAP Technical Advisory Group HIV/AIDS strategic planning experts (civil society, the private sector, donors, UN agencies and international experts) Developed ASAP Business Plan ASAP Training Advisory Committee Chaired by UNDP Established in April 2007 to provide guidance on capacity building. 10
Component of ASAP Service Peer Review of Draft Strategies Technical and financial support for strategy development Regional Capacity Building Workshops 11
ASAP Operations Requests for support come from: NACs/CCMs UNAIDS Country Coordinators UNAIDS Cosponsors Consultation process for providing support: Country Stakeholders UNAIDS Technical Support Facilities Interested UNAIDS Co-sponsors Development Partners AIDS ASAP Strategy Website: and Action www.worldbank.org/asap Plan (ASAP) A service of UNAIDS 12
Demand for ASAP Support Peer Review Confidential review of strategies by international experts - e.g. Barbados and Jamaica Technical and financial support for strategy development Specialized e.g Guyana Comprehensive - Barbados and Jamaica Pipeline 10 countries ASAP Website: www.worldbank.org/asap 13
Demand for ASAP Support Tool Development Self-Assessment Tool and Guidelines Road Map for strategy development Practice Notes ( strategic planning, costing) Capacity Building Strengthen capacity of policy makers and technical staff at the country level. Strengthen regional institutions to deliver workshops and knowledge generation, and provide technical assistance 50 countries in 2007-2008 following pilot workshop in Caribbean, Dec 2006 for policy makers. June 2007 Caribbean workshop for technical staff ASAP Website: www.worldbank.org/asap 14
Lessons Learned in Year 1 Availability and use of epidemiologic and surveillance data - strategies need to start from reliable data Prioritization - select few priorities that will make the most impact Government Ownership -Strong involvement of NACs is key. Not all task can be delegated to consultants. Early Planning 15
How to Access ASAP Services Contact the World Bank s Global HIV/AIDS Program at: Or a simple email will do! Jonathan C. Brown Operations Adviser Global HIV/AIDS Program 1818H Street, NW MSN # G8-802 Washington DC 20433 USA jbrown3@worldbank.org 16