Empowering the poor and marginalized for AIDS prevention,

care, and mitigation

Vinod ThomasDirector-General, Evaluation

Independent Evaluation Group, World BankAugust 15, 2006

Africa and Latin America have the world’s highest levels of income inequality

AIDS has reversed decades of hard-won gains in life expectancy in Southern Africa

The marginalized are at higher risk of HIV infection: Female sex workers

0.9 0.92 1.6

6.1

8.79.4

20.8

26.325.5

0

5

10

15

20

25

30

Guatemala India Burkina Faso Cambodia Kenya

HIV

pre

vale

nce

(per

cent

)

General population

Female sex workers

Source: UNAIDS 2006

The marginalized are at higher risk of HIV infection: Injecting drug users

0.1 0.5 0.6 1.1 1.4 1.4

22.9

30.6

23

12.4

38.8

48.8

0

10

20

30

40

50

60

Pakistan Vietnam Argentina Russia Thailand Ukraine

HIV

pre

vale

nce

(per

cent

)

General population

Injecting drug users

Source: UNAIDS 2006

Public sector support for prevention among high-risk groups is declining in Africa

89

78 78

44 44

33

0

10

20

30

40

50

60

70

80

90

100

Condoms STD treatment IEC

Perc

ent o

f cou

ntrie

s

MAP I countries

MAP II countries

Source: IEG (OED) 2005.

Growth in targeted interventions for high-risk groups in Brazil, 1999-2003

Growth in targeted interventions for high-risk groups during

AIDS II, 1999-2003

1730

57

234

30

49

125

160

267

25

54

106

235

127

138

0

50

100

150

200

250

300

1999 2000 2001 2002 2003

MSMIDUCSW

Source: IEG (OED) 2005