Post on 01-Jan-2016
2009 ECONOMIC AND SOCIAL COUNCILANNUAL MINISTERIAL REVIEW
HIV in Latin America and the Caribbean
Implementing agreed goals and commitments
César Antonio Núñez - UNAIDS
Montego Bay, Jamaica, 5-6 June 2009
Halfway between UNGASS (2001) and the Millennium Development
Goals (2015)
HIV in Latin America and The Caribbean
HIV epidemic in Latin America remains stable overall, but continues growing in vulnerable groups.
In 2007, new infections were estimated at 140 000 [88 000–190 000]
Estimated number of PLWHIV is 1.7 millones
Of total PLWHIV, 44,000 are under 15 años
Approximately 63,000 individuals died of AIDS in 2007.
Overall figures – LA
HIV Prevalence remains high among Men who have Sex with Men, Male Sex Workers, Female Sex Workers, Crack Cocaine Users, Prisoners, and Young People
In 2007, 20, 000 New HIV Infections occurred
Total of 230,00 people living with HIV from 210,000 in 2001
Adult HIV prevalence at 1.1% and increasingly affecting females
14,000 people died of AIDS: leading cause of death in the 25-44 years-old
Overall figures – Caribbean
Estimated Adult HIV Prevalence in the Three Regions of the Americas. UNAIDS/WHO, 2007
1.1%
0.6%0.5%
0.00%
0.20%
0.40%
0.60%
0.80%
1.00%
1.20%
Prev
alenc
e
Caribbean North America Latin America
end-2002
end-2004
end-2003
end-2005
0.4
0.8
1.2
1.6
2.2
2.8
Mill
ion
s
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
North Africa and the Middle East
Eastern Europe and Central Asia
East, South and South-East Asia
Latin America and the Caribbean
Sub-Saharan Africa
Number of people receiving antiretroviral drugs in low- and middle income countries, 2002−2007
Geographical Region
Est. # receiving ART Dec
2007
Est. # needing ART
Dec 2007
ART Coverage Dec 2007
LAC 390,000 630,000 62%
Latin America 360,000 560,000 64%
Caribbean 30,000 70,000 43%
Universal Access Report 2007 WHO June 2008.
Estimated # of individuals receiving ART, 2007
Number of HIV-infected children under 15 receiving antiretroviral treatment (2005–2006)
There was a 56% increase in the number
of children receiving ARVs
in LAC
Monitoring the Epidemic: Resource TrackingMonitoring the Epidemic: Resource Tracking Annual expenditures on HIV/AIDS in Latin Annual expenditures on HIV/AIDS in Latin
America by source, 2001-2006America by source, 2001-2006
Mill
ion
US
$
Domestic Public Expenditures
Total International (Excluding GF)
The Global Fund to fight AIDS, Tuberculosis, and Malaria
0
200
400
600
800
1000
1200
2001 2002 2003 2004 2005 2006
División de Financiación y Economía del SIDA, ONUSIDA, 2008
Monitoring the Epidemic: Resource Monitoring the Epidemic: Resource TrackingTracking
Annual expenditures on HIV/AIDS in the Annual expenditures on HIV/AIDS in the Caribbean by sourceCaribbean by source, 2001-2006, 2001-2006
Mill
ion
US
$
Domestic Public Expenditures
Total International (Excluding GF)
The Global Fund to fight AIDS, Tuberculosis, and Malaria
0
50
100
150
200
250
2001 2002 2003 2004 2005 2006
División de Financiación y Economía del SIDA, ONUSIDA, 2008
The Three Ones Principles
Are we monitoring?
ONE HIV/AIDS Action Framework
ONE National AIDS Coordinating Authority
ONE M&E System
UNIVERSAL ACCESS
Under-addressed issues
Quality and availability of relevant data Reporting against the UNGASS and Universal Access,
although improved, is not without notable gaps.
HIV, social vulnerability and risk-taking behaviours: Women and HIV Men who have sex with men (MSM) and transgenders Sex workers (SW) Injecting drug users:
‘Scratching the surface’ of integrated development programming While the interconnectedness among MDGs
is clear, it is not always evident that the correlation of development issues finds its way into cohesive, multisectoral development programming and measurement.
Failure to routinely integrate strategies and services to address undeniably interconnected issues represents a lost opportunity.
Care, Treatment and Support
Further integration into primary health care services
Further integration of community care/support services
Geographic decentralization of treatment sites
Equity in treatment access Close Gaps in coverage Mind treatment costs
Stigma and Discrimination
“ ... In most countries, discrimination remains legal against women, men who have sex with men, sex workers, drug users and ethnic minorities. This must change. ... [I]n countries with legal protection and protection of human rights for these people ..., there are fewer deaths. Not only is it unethical not to protect these groups: it makes no sense from a public health perspective. It hurts us all.”
Ban Ki-moon
UN Secretary General – August 2008
Institutional Response
Monitoring and evaluation
Availability of resources
Integrated Public Health Delivery Systems
Maintaining interest in HIV
Continue to provide community, national and regional leadership and to keep HIV on national and regional agenda
Maintain and/or increase, as far as possible, current national investments in HIV (with a focus on integrated development approaches).
Stronger and more visible national leadership on difficult challenges such as stigma
Maintaining strategic investment in HIV Improved data Right allocation of current and future investments: Strengthening of Health Systems Human rights and social justice programming Strengthening programs to address social
vulnerability and risk: Gender inequity Most-at-risk populations
Prevention: increasing coverage and comprehensiveness.
Improving and enhancing collaborative responses for HIV/TB co-infection
Scaling up HIV Prevention
For each new person put on ART, two new persons become HIV+
Combination HIV prevention programmes must be widely implemented at country and regional levels Biomedical interventions (ABC, Circumcision, STI prevention...) Education programmes, including sexuality education in youth Enabling environment interventions based on human rights Legislations to stop all forms of criminalization related to HIV Creating a movement of social change Expanding access to treatment as a contribution to prevention