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Plenary Sessions ICASA 2011 Summary December 8, 2011. Mikael Hailu, Abraham Gebre-Amlak, Saba Lambert, Misrak Makonnen, Katie Morris & Abiola Tielley-Gyado. Thirty Years Perspective. Tracing the historical perspective of interventions for setting and implementing HIV/AIDS programs

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Plenary Sessions ICASA 2011 Summary December 8, 2011

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Plenary SessionsICASA 2011 SummaryDecember 8, 2011

Mikael Hailu, Abraham Gebre-Amlak, Saba Lambert,

Misrak Makonnen, Katie Morris & Abiola Tielley-Gyado


Thirty Years Perspective

  • Tracing the historical perspective of interventions for setting and implementing HIV/AIDS programs

    • A world of stigma and discrimination

    • A decade of “denial and silence” to “silence to action”

    • From civil societies advocacy to African government commitments and international donor responses

  • Highlights of the successes during the 30 years journey

    • Prevention interventions

    • ART roll-out (5 million on ART)

    • Scientific efforts for vaccine research

    • Mobilization of financial resources


Thirty Years Perspective

  • Setbacks

    • Continuous problem of stigma and discrimination

    • Significant number of PLHIV still in need of ART

    • Low enrollment of children on ART

    • More than 50% of African countries lagging behind in ARV coverage for MTCT

    • Less toxic, more effective and combination drugs are not available in resource limited countries

    • Limitation in financial resources - commitment of African leaders (Abuja Declaration) & International donors (Global Fund Round 11)

    • Ineffective and inefficient use of scarce resources


Thirty Years Perspective

  • From challenges to opportunities for change

    • Need for a “ smarter strategic response”

    • Evidence based interventions with more emphasis on practical and realistic approaches

    • Importance of reassessing past interventions, and following up on key intervention areas

      • Adherence

      • Prevention of new infections

      • Provision of treatment for those in need


Thirty Years Perspective

  • From challenges to opportunities for change

    • A change in funding paradigm

      • Greater responsibility of African leaders in their commitment against HIV/AIDS

      • A level of accountability of international donors

    • A need for strong capacity building to ensure deliverables from and ownership by Africans

    • Synergies with other health programs


Focus Areas

  • Ensuring Key populations, Youth & women’s rights in HIV/AIDS response

    • Lack of representation

    • Limited access to information and services

    • Limited financial support for targeted interventions

  • Way forward

    • Providing targeted programming focusing on the needs and rights of youth, women and key population

    • Ensuring social justice for all


Focus Areas

  • PMTCT – new target and new momentum

    • Long way to reach current status that required strong commitment from scientists, leaders and implementers

    • Zero transmission from mother to child by 2015; new PMTCT guidelines (HAART);

  • Way forward:

    • Building linkages and effective integration with the MCH services and communities

    • Addressing health and social systems bottlenecks

    • Pursuing high level advocacy to ensure shared accountability among leaders

    • Ensuring allocation of needed resources


Focus Area

  • Treatment 2.0

    • Treatment to be more effective, affordable and accessible

    • Strategies developed in order to meet the goal of treating 15M people by 2015

  • TB and HIV

    • Starting TB patients on ART within two weeks regardless of the CD4 count will reduce TB mortality and new cases


Focus Areas

  • Treatment as prevention

    • Transmission is reduced by 35 to 52% when VL < 400

    • Early ART start will reduce HIV transmission by 96%

    • Primary prevention (PEP) – Reduction of HIV transmission

      • Gel: by 39%; TDF/FTC: by 73%

    • Test and treat studies are underway


Focus Area

  • Health System Strengthening

    • Laboratory technologies need functional systems to be successful

    • Using improvement of laboratory services for HIV care delivery as an entry point for greater public health impact

    • Various strategies to build up the capacities of health facilities – infrastructure, laboratory services including quality assurance, and human resources


Efforts undertaken in the last 30 years need to be continued and strengthened

Own, Scale-up and Sustain!


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