PWG Scale Up report deck

Bringing HIV Prevention to Scale: 

Bringing HIV Prevention to Scale Global HIV Prevention Working Group June 2007

The Global HIV Prevention Working Group: 

The Global HIV Prevention Working Group Launched in 2002 to inform global policy-making, program planning, and donor decisions Convened by the Gates Foundation and the Kaiser Family Foundation International panel of public health experts, researchers and advocates Issues periodic reports and fact sheets on prevention science and policy Advocates for a comprehensive, science-based response to HIV/AIDS

Previous PWG Reports: 

Previous PWG Reports Global Mobilization for HIV Prevention: A Blueprint for Action (July 2002) Access to HIV Prevention: Closing the Gap (May 2003) HIV Prevention in the Era of Expanded Treatment Access (June 2004) New Approaches to HIV Prevention: Accelerating Research and Ensuring Future Access (August 2006)

New Report on Scale Up: 

New Report on Scale Up Every form of HIV transmission is preventable Strong evidence for prevention effectiveness and replicable models for prevention scale up But effort to reduce incidence is faltering Limited access to prevention interventions Few examples of comprehensive, sustained prevention scaled to the national level, targeting the right populations with the right intensity Advocacy often lacking for prevention; prevention and treatment advocacy should be reinforcing Prevention must be brought to scale Report makes recommendations for governments, donors, multilateral agencies, providers, researchers and civil society

What Is Meant by “Scaling-Up” HIV Prevention?: 

What Is Meant by “Scaling-Up” HIV Prevention? A mix of evidence-based prevention strategies delivered with sufficient coverage, uptake, intensity, and duration to have optimal public health impact Based on sound epidemiological evidence and evaluation data, and tailored to the dynamics of the national epidemic Concrete milestones (or targets) to promote accountability Involving a broad array of stakeholders in planning, including civil society and people living with HIV

Addressing Factors that Increase Vulnerability: 

Addressing Factors that Increase Vulnerability Risk of infection is an interplay of individual behavior and social context Need policy actions to address underlying drivers of the epidemic, including: Gender inequality Institutionalized discrimination against vulnerable groups Poverty HIV stigma Conflict and humanitarian emergencies

Inadequate Current Access to Prevention: 

Inadequate Current Access to Prevention Condoms Used in only 9% of risky sex acts Supply millions short of need Testing Only 12% of men and 10% of women in the most heavily affected SSA countries know their status PMTCT+ 11% of HIV-infected pregnant women in low and middle income countries receive ARV prophylaxis Sterile Syringes 3% of IDUs have access to sterile syringes Access among vulnerable groups 9% MSM; <20% sex workers

New Projections on HIV Incidence: 

New Projections on HIV Incidence Current trend… 60 million new infections by 2015 Annual new infections up 20% by 2012 With comprehensive prevention delivery… Could avert half of the infections projected to occur by 2015; could avert 52% of projected infections in sub-Saharan Africa Annual HIV incidence in 2015 reduced by nearly two-thirds Includes male circumcision as part of a comprehensive package of programs

Current Barriers to Prevention Scale Up: 

Current Barriers to Prevention Scale Up Inadequate financing Highest risk groups not adequately targeted Capacity limitations Service fragmentation Stigma and discrimination

Common Elements of Successful National Efforts: 

Common Elements of Successful National Efforts Successful prevention campaigns in Brazil, Senegal, Thailand, and Uganda shared common elements: Adequate and sustained financing Visible political support Targeted, evidence-informed action Use of mass media and other channels to raise HIV awareness Anti-stigma measures Involvement of affected communities and diverse sectors

Emerging Prevention Successes?: 

Emerging Prevention Successes? Cambodia Cut HIV prevalence in half in a decade Haiti HIV prevalence among pregnant women nearly halved Kenya Doubling of condom use among young women; delayed age of sexual debut Declining HIV prevalence Zambia Increase in condom sales; delayed age of sexual debut Declining HIV prevalence among pregnant women Zimbabwe Six-fold increase in VCT visits Declines in HIV prevalence and incidence

Recommendations: 

Recommendations National governments Develop inclusive national planning process Set prevention targets Strengthen surveillance Address vulnerability factors and stigma Integrate prevention and treatment Improve monitoring and evaluation Continually assess and refine efforts Promote prevention research

Recommendations: 

Recommendations International donors Double HIV assistance, including for prevention Harmonize efforts with partners Build civil society capacity Work towards universal access Multilateral and technical agencies Coordinate technical support to meet country needs Provide independent assessments of national strategies Help improve national HIV information systems Monitor resource flows

Recommendations: 

Recommendations Health care settings Integrate HIV prevention in health systems Regularly report data on utilization and impact Adopt infection control practices Train workers in sexual health Research Improve understanding of vulnerability factors Expand operations and implementation research Develop new technologies and approaches Civil society Support a comprehensive response Monitor national prevention responses Participate in national planning bodies

New PWG Website: 

New PWG Website www.GlobalHIVPrevention.org Available at website: PWG reports and fact sheets Key statistics Information for policy makers Prevention-related links Sign up for mailing list to receive updates