Evidence-based strategicinvestment to sustain the HIVresponse
Conference on Measuring and Achieving UniversalHealth Coverage (UHC) with Information andCommunication Technology (ICT)Asian Development Bank Auditorium Manila, Philippines2 December 2014
Regional overview of trends in HIV infectionsand AIDS-related deaths
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
HIV and AIDS in Asia and the Pacific1990-2013
2013
People living with HIV
4.8 million
Women living withHIV
1.7 million
New HIVinfections
350 000
Deaths
250 000
2013 “zoom-in”
Children living with HIV
210 000
Youngpeoplelivingwith HIV
610 000
Countries account for >90% PLHIV and new infections andhigh HIV prevalence in key populations
New HIVinfections
(2013)
People livingwith HIV
(2013)
National HIVprevalence
> 5 % amongMSM
National HIVprevalence
> 5% amongPWID
National HIVprevalence
> 5% amongFSW
India*
130,000
2,100,000
Indonesia
80,000
640,000
China*
48,000
780,000
Viet Nam
14,000
250,000
Pakistan
14,000
68,000
Thailand
8,200
440,000
Malaysia
8,000
86,000
Myanmar
6,700
190,000
Philippines
3,400
22,000
Papua New Guinea
2,200
32,000
Cambodia
1,300
75,000
Nepal
1,300
39,000
Regional size estimates
11 million
3.5 million
4.4 million
Source: Prepared by www.aidsdatahub.org based on UNAIDS Estimates 2013; Philippines HIV Estimations and Projections 2014 (Unpublished document);
National HIV Sentinel Surveillance Surveys; and Integrated Biological and Behavioural Surveys
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* 2011 estimates
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org, India Global AIDS Response Progress Report 2012, and Kumar,U. A., ‘Azad Launches Rs 14,295 Crore Phase IV of NACP’, The New Indian Express, 13 February, 2014).
HIV expenditure from domestic sources,
Asia and the Pacific, latest available year, 2009-2013
63% Committed for NACP IV
Evidence is fundamental for anaccelerated and effective AIDS response
•Prioritizing interventions
•Formulating policies
•Making smart decisions on financing
•Demonstrating impact
•Showing return on investment
Reports
Graphs
Data analysis
Modelling,Estimates,Projections
(EPP/Spectrum/AEM)
MonthlyOnlinePublication
AnnualNational andLocalDisseminationForum
National andLocal ProgramReviews,Strategic andInvestmentPlanning
Data stored at the
NationalEpidemiologyCenter, DOH
(Global AIDSProgress Report,others)
Monthly AIDS
Registry data:
•HIV Cases
•AIDS Cases
•Deaths
•etc.
Treatment HubData (ART, etc)
Social HygieneClinic Data (STI)
Surveillance
Sites Data(HIVprevalence)
HIV Data Flow and Use(Philippines)
Evidence-based county investment cases on HIVare being developed to sustain the HIV response
Evidence-based county investment cases on HIVare being developed to sustain the HIV response
•Thailand: “Ending AIDS by 2030”
Inputs:
For each keypopulation:
•Size
•Risk behaviors
•HIV prevalence
For each possibleprogram:
•Population served
•Coverage
•Effectiveness
•Unit cost
Outputs:
For the epidemic:
•Sources of newinfections
•Epidemic trends
For each choice ofprogram(s):
•Infections averted
•Lives saved
•Comparative costs
AEM
AnalyticTool
AIDS Epidemic Model (AEM)
Thailand: Ending AIDS by 2030
64% of
newinfections
44%
41%
10%
30%
10%
6%
66% of new infectionsoccur in 33 provinces
Deliver package of services
•Combination prevention(including treatment as prevention)
•Core prevention services for keyaffected population
•Reach-Recruit-Test-Treat-Retain
•Focus where most new infections occur...
Key investment
•Increase HCT to reach90% coverage in keyaffected populations(MSM, SW, IDU, and theirpartners)
•Earlier ART treatment forall HIV infected persons(regardless of CD4)
•Maintain retention andadherence
•Normalize HIV
Business as usual
Expand HCT and TasP toKAP in the responses
Strategic responses inoriginal HIV plan
Evidence-based county investment cases on HIVare being developed to sustain the HIV response
•Thailand: “Ending AIDS by 2030”
•Triggered a paradigm shift from “Controlling AIDS”to “Ending AIDS by 2030”
•Implementation is underwayOctober 2014: Free ARVs to all who test HIV positive
•Country to graduate fully from external financial supportby 2017
•The current Global Fund support (less than 5% of the annualHIV budget which supports CSO engagement in prevention)cushions Thailand’s transition to full domestic HIV funding
Acknowledgement
•Dr Taweesap SiraprapasiriDirector of the National AIDS Management CenterMinistry of Public Health, Thailand
•Ms Tatiana ShoumilinaUNAIDS Country DirectorThailand
•Mr Peter MosendeStrategic Information AdviserUNAIDS Philippines
•Dr Amala ReddyRegional Strategic Information AdviserUNAIDS Regional Support Team, Asia PacificThailand
Thank you!
Dr Maria Elena G Filio-BorromeoInvestment and Efficiency AdviserUNAIDS Regional Support Team, Asia PacificBangkok, Thailand