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Elizabeth Lule Manager, ACTafrica

The Unfinished HIV/AIDS Agenda for Africa Africa Region Consultation Kigali, Rwanda June 13,2007. Elizabeth Lule Manager, ACTafrica. % HIV prevalence, adult (15-49). Status of the AIDS Epidemic. HIV epidemic in sub-Saharan Africa, 1985‒2005*. Global HIV epidemic, 1990‒2005*.

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Elizabeth Lule Manager, ACTafrica

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  1. The Unfinished HIV/AIDS Agenda for AfricaAfrica Region ConsultationKigali, RwandaJune 13,2007 Elizabeth Lule Manager, ACTafrica

  2. % HIV prevalence, adult (15-49) Status of the AIDS Epidemic HIV epidemic in sub-Saharan Africa, 1985‒2005* Global HIV epidemic, 1990‒2005* Number of people living with HIV (millions) % HIV prevalence, adult (15‒49) Number of people living with HIV (millions) % HIV prevalence, adult (15‒49) 50 5.0 30 15.0 12.5 25 40 4.0 20 10.0 30 3.0 7.5 15 20 2.0 5.0 10 10 1.0 2.5 5 0 0.0 0 0.0 1990 1995 2000 2005 1985 1990 1995 2000 2005 Number of people living with HIV This bar indicates the range around the estimate Source: UNAIDS, 2006

  3. Outline • Why a new Africa HIV/AIDS Agenda for Action? • What is the new “HIV/AIDS Agenda for Action”? • What are the Bank’s comparative advantage and value-added? • What guidance do we need from the decision meeting?

  4. Why A New Agenda for Action? • Epidemic has changed • More financial resources, but great need to ensure resources are used effectively and efficiently • Unfinished multisectoral agenda • Country needs have changed • Bank must continue to learn how to address epidemics

  5. Middle-income countries are hardest hit 0-0.1% 1-5% 3-7% 15-35% Source: UNAIDS 2004 estimates used unless recent national population-based HIV survey available

  6. Gender inequalities in HIV/AIDSHIV Prevalence in Francistown, Botswana Source: BAIS, 2005

  7. Africa’s children are paying the price Source: UNAIDS, 2006

  8. Global Resources Available Compared to Estimated Need • Most available • resources are: • Volatile • Short term • Off-budget • Not strategic • Poorly coordinated • External priorities • Technology focused $11.6 billion $14.9 billion $22.1 billion Source: The Henry J. Kaiser Family Foundation (www.kff.org) Original source UNAIDS

  9. Our AIDS portfolio has declined IDA 13 IDA 14 Source: Business Warehouse, March 2007. Data includes total commitments for MAP projects and coded amounts for projects with HIV/AIDS components.

  10. How MAP Funds were spent Local Response US $502m committed US $306m spent Public Sector Response(beyond health) US $172m committed US $104m spent 13% 38% 17% Health Sector Response $223m committed $137m spent 32% Institutional Strengthening $423m committed $258m spent

  11. The Unfinished Multisectoral Agenda

  12. What Our Partners Want From Us • Macro and micro-economic analysis (impact of HIV/AIDS) • Financing gaps: prevention, especially interventions for populations at risk • Capacity building • Predictable, sustainable and flexible funding • Major/only funding for some countries • Focus on fiduciary aspects, governance and accountability • Reaching communities • Multi-sectoral approach

  13. Bottom line HIV/AIDS undermines the Bank’s Poverty Reduction mission and achievement of the MDGs • We need to build on results achieved thus far • Epidemic resurgence in Uganda reflects declining prevention efforts • Mainstreaming HIV/AIDS in key sectors is an unfinished agenda • Uniquely positioned to put HIV/AIDS on the development agenda • Respond to the changing global AID architecture

  14. Agenda for Action: Conceptual Framework

  15. Strategic Pillars • Foundation of the four strategic pillars is to Renew the Bank’s commitment • Pillar 1: Focus the response through evidence based and prioritized national HIV/AIDS strategies • Pillar 2: Scale-up targeted multi-sectoral and civil society response • Pillar 3: Deliver effective results through increased country M&E capacity • Pillar 4: Harmonize donor collaboration

  16. Selected Anticipated Results

  17. The Cost of Inaction A girl at a daycare center in Kibera, in Nairobi, Kenya. The center provides basic education and meals for orphaned children. A boy and his grandmother in Maseru, Lesotho. He is one of three grandchildren she cares for following the death of their parents from AIDS. The 19-year-old girl on the left cares for herself, her two siblings, and her older sister's three children in Harare, Zimbabwe. Her parents and older sister died of AIDS. Source: UNAIDS, UNICEF and USAID, Children on the Brink 2004.

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