Debbi Birx, MDPEPFAR/CDC
WORKSHOP - Mini Room 7
Center for Global Health
Division of Global HIV/AIDS
Getting to Six MillionPEPFAR Track 1.0 Treatment Partners
& Shared Vision for Sustainability
1Focus on sustainability from day 1: local FBO and pubic sector partnerships with international partners
CDC/DGHA FY 11 Funding – All SourcesMajority of funding invested in Cooperative Agreements
Cooperative Agreements
$1,284,453,152 82%
Contracts $74,955,081
5%
Technical Personnel and
all Management &Operations $204,451,274
13%
CDC Extramural & IntramuralInvestments in FY 2011
Benefits of investing in CoAgs
• Allows CDC technical experts maximum engagement & partner oversight
• Facilitates side-by-side planning and implementation, allowing for mentoring & transference of skill
• CDC experts ensure programs are of highest quality while preserving local ownership
Investment Strategy by Partner TypeCDC/DGHA FY11 Budget
Faith-Based Organization
(FBO)/ International,
$8,708,501
Local Indigenous Faith-Based Organization
(FBO), $84,062,166
Ministry of Health (MOH), $287,720,833
Local Indigenous
Non-Governmental Organization
(NGO), $243,402,610
Local Indigenous University, $81,627,269
Multi-Lateral, $13,463,503
NGO/ International-
U.S. Based, $260,235,760
University/ International-
U.S. Based, $305,232,510 Financial Investments Reflect
DGHA Priorities
DGHA builds local capacity by investing in Ministries and indigenous partners
DGHA promotes science & innovation by investing in universities
Scale-up of investments in MOH must be deliberate and strategic
For the past 20 years CDC has had the sole USG/MoH agreements in Sub-Saharan Africa
We have built agreements carefully and strategically over time – scaling-up slowly and pairing funding with extensive technical support to ministries
Many CDC offices are co-located with MOH to facilitate mentoring and the transference of skills
Standing up these funding mechanisms is initially very resource intensive – both at HQ and in the field – but ultimately cost effective and sustainable
Stepwise Approach to Building MOH Capacity The cornerstone to realizing country ownership
2004 2005 2006 2007 2008 2009 2010 20110
50
100
150
200
250
300
International Indigenous
Number of CDC Cooperative Agree-ments in PEPFAR Focus Countries
(FY04-FY11)
Investing through Cooperative AgreementsCDC is scaling up the number of CoAgs with indigenous partners
2004 2005 2006 2007 2008 2009 2010 2011$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,000
$700,000,000
$800,000,000
Indigenous International
CDC Program Funds through Cooperative Agreements with Local PartnersFY 2004 – FY 2011
In 2011, CDC invested more resources in
local/indigenous organizations than
international
Investing through Cooperative AgreementsCDC is investing more resources in CoAgs with indigenous partners
2Saving lives together: Implementing OGAC’s vision for PEPFAR
1980-1985
1985-1990
1990-1995
1995-2000
2000-2005
2005-2010
35
40
45
50
55
60
65
70
BotswanaSouth AfricaSwazilandZambiaZimbabwe
PEPFAR2004-present
Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm For definition of variables, check the link Glossary of Demographic Terms Saturday, May 05, 2012; 11:17:16 AM
Life Expectancy at Birth in Selected Countries Affected by HIV/AIDS
Dramatic impact of HIV on life expectancyImpact of HIV on 5 High-Burden Countries – Model Updated in 2010
New UNAIDS Global Report : Together We Will End AIDS
The end is in sight: Maintaining momentum is critical
Current ART Coverage at CD4 of 350
3Saving lives and changing the face of the epidemic : commitment of providers and patients
Incremental Progress : Saving Lives and Changing the Epidemic
2003 2004 2005 2006 2007 2008 2009 2010 20112,200,0002,300,0002,400,0002,500,0002,600,0002,700,0002,800,0002,900,0003,000,0003,100,000
01,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,000
New HIV Infections and Number of People on ART, 2003-2011
# of New HIV Infections (Global)# of People on ART (Low and Middle Income Countries)
# of
New
HIV
Infe
ction
s
# of
Peo
ple
on A
RT
UNAIDS Global Report 2012
4Towards virtual elimination of new HIV infections in children: PMTCT
New Pediatric Infections from MTCT
2009 20110
10000
20000
30000
40000
50000
60000
70000
80000Nigeria
South Africa
NigeriaSouth AfricaMozambiqueTanzaniaUgandaMalawiKenyaEthiopiaZimbabweZambiaCameroonAngolaChadCote d'IvoireLesothoGhanaBurundiSwazilandNamibia
Source: UNAIDS. Together We will End AIDS, 2012.
New Pediatric Infections from MTCTAmong Sub-Set of Countries with High Contribution to Global Burden
2009 20110
5000
10000
15000
20000
25000
30000
MozambiqueTanzaniaUgandaMalawiKenyaEthiopiaZimbabweZambiaCameroon
Source: UNAIDS. Together We will End AIDS, 2012.
Aggressively pursuing the virtual elimination of pediatric AIDS
UNAIDS Global Report 2012
5The end of AIDS is in sight, and our success will depend on our mutual commitment
Programs are People
• Financial resources are important but the key to the progress to date has been the commitment of each person on the ground
• Importance of local innovation and focus on the sustainability and impact from day one
• Shared commitment to transition and quality with embedded monitoring and evaluation
Top Related