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To Share and To Learn:

To Share and To Learn:. The Case For Canadians To Act Globally Against HIV/AIDS. International Affairs Directorate June, 2000. Introduction Goals of The Case For Canadians To Act Globally Against HIV/AIDS.

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To Share and To Learn:

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  1. To Share and To Learn: The Case For Canadians To Act Globally Against HIV/AIDS International Affairs Directorate June, 2000 International HIV/AIDS Toolkit

  2. IntroductionGoals of The Case For Canadians To Act Globally Against HIV/AIDS • To enhance your understanding of the enormity and devastating impact of the global epidemic. • To highlight how you can become involved. • To profile Canadian leaders in this area. • To highlight the benefits that will accrue to your organization as a result of taking an active role in international HIV/AIDS issues. International HIV/AIDS Toolkit

  3. The FactsThe Global Picture • 40 million people living with HIV/AIDS at the end of 2003 • 5 million people newly infected with HIV in 2003 • 3 million people died of AIDS in 2003 • 95% of people living with HIV/AIDS live in developing countries • 90% do not know they are HIV-positive • Half of all new infections are in women International HIV/AIDS Toolkit

  4. Sub-Saharan Africa: 26.6 million people living with HIV/AIDS (PLWHIV/AIDS) • Women 1.2 times more likely to be HIV-positive than men. • Home to 30% of PLWHIV/AIDS, but only 2% of the world population • AIDS is devastating economies and dramatically lowering life expectancy Success Story: Senegal By acting quickly to implement country-wide prevention education programs, Senegal has avoided a generalized epidemic. International HIV/AIDS Toolkit

  5. Asia and the Pacific: 7.4 million PLWHIV/AIDS • Epidemic largely fueled by injection drug use and commercial sex • Significant local and regional epidemics in India • Emerging epidemics in highly populous countries: China, Indonesia, India Success Story: Thailand Through vigorous and early efforts to promote condom use in the commercial sex trade, Thailand turned around a limited epidemic, thus avoiding a generalized epidemic International HIV/AIDS Toolkit

  6. Latin America and the Caribbean: 2 million PLWHIV/AIDS • Caribbean most affected region after Sub-Saharan Africa • Divergent regional modes of transmission • High levels of stigma and discrimination against vulnerable groups Success Story: Brazil Vigorous prevention efforts and universal access to treatment have helped Brazil contain and manage its epidemic. International HIV/AIDS Toolkit

  7. Eastern Europe and Central Asia:1.5 million PLWHIAV/AIDS • Epidemic still exploding since the mid-1990s • Epidemic driven so far mostly by injection drug use International HIV/AIDS Toolkit

  8. Middle East and Northern Africa:0.6 million PLWHIV/AIDS • Very low prevalence rates • High level of stigma and denial Success Story: Algeria More substantial prevention programs are being developed to address the epidemic. International HIV/AIDS Toolkit

  9. Industrialized Countries:1.6 million PLWHIV/AIDS • Mortality rates continue to decrease due to access to treatment • Prevention activities not keeping pace with changes in epidemic Success Story: Australia Through coordinated prevention efforts and policy changes, the epidemic among gay men has been managed better than in other countries. International HIV/AIDS Toolkit

  10. The Impact HIV/AIDS Burdens Health Care Systems • In greatly affected countries, health care costs are increasing while the total availability of health care is dropping for everyone, especially the poor. • On average, the cost of treating a person living with HIV/AIDS for one year is equivalent to educating 10 primary school students for a year. International HIV/AIDS Toolkit

  11. The Rationale Canada Has Committed Itself To Help • The Canadian Strategy on HIV/AIDS calls on us to increase Canada’s participation in international HIV/AIDS activities and facilitate collaboration. • Canada supports the Convention on the Rights of the Child and the United Nations’ International Guidelines on HIV/AIDS and Human Rights. • In 2001 at the United Nations General Assembly, Canada will champion efforts to address the crisis of children affected by the HIV/AIDS epidemic. International HIV/AIDS Toolkit

  12. The Rationale We Are Internationally Recognized Leaders • Canada has a long and distinguished history as a diverse and outward-looking society, committed to providing significant humanitarian support. • Our work with NATO, our contribution to eliminating landmines and our role in the recent Kosovo crisis confirm our credibility and leadership abilities. • Our medical breakthroughs (e.g. 3TC) allow us to speak with an expert voice on a world stage. International HIV/AIDS Toolkit

  13. Taking ActionShare Technical Expertise • Canada’s reputation for excellence in HIV/AIDS issues ensures that our technical expertise is in great demand around the world. • Taking action could mean providing technical assistance to other Canadian organizations acting globally, international NGOs/ASOs, sponsors of large-scale or multi-disciplinary projects (e.g. CIDA, World Bank, Health Canada, UNAIDS). International HIV/AIDS Toolkit

  14. Taking ActionBuild Communities and Their Capacity • To prevent the continued spread of HIV and mitigate impact, investments must be made in communities to build their capacity to deal with the epidemic and sustain an effective response. • Program ideas include training in public awareness strategies, providing tools to engage the private sector, supporting advocacy groups, providing training in organizational development, and preparing sites for clinical trials of promising preventative measures. International HIV/AIDS Toolkit

  15. Getting StartedEmbarking Upon Your Own Response • Determine areas of strength or “comparative advantage” • Identify institutional readiness to undertake international HIV work • Understand the challenges that you will face • Determine senior management commitment to acting globally International HIV/AIDS Toolkit

  16. Mobilizing for More Focused Advocacy The UNGASS Declaration of Commitment International HIV/AIDS Toolkit

  17. Declaration of Commitment on HIV/AIDS • UN General Assembly Special Session (UNGASS) on HIV/AIDS – June 2001 • Adopted unanimously by all 189 UN member states • A resolution of General Assembly, not a treaty or convention • Statement of intent: a plan governments say they are going to follow International HIV/AIDS Toolkit

  18. Leadership Prevention Care, support and treatment Human rights Reducing vulnerability Children Alleviating social and economic impact Research and development AIDS in conflict and disaster-affected regions Resources Follow-up Declaration of Commitment on HIV/AIDSContains a preamble and a series of commitments divided into 11 areas International HIV/AIDS Toolkit

  19. Why is the Declaration important? • Sets real targets and deadlines • Constitutes unprecedented commitment by governments • More detailed blueprint than national AIDS strategies of most countries • Blueprint NGOs can use for advocacy and education, and to hold governments accountable International HIV/AIDS Toolkit

  20. STRATEGIES (national, state level) • Disseminate Declaration widely • Analyze Declaration • Identify commitments that support existing advocacy • Identify commitments you can use to do new advocacy • Develop advocacy campaigns around commitments you select International HIV/AIDS Toolkit

  21. STRATEGIES • Hold your governments accountable for following through on the commitments • Ask how they plan to reach targets • Tell them what the priority commitments are • Call for action plan with timelines • Ask them how they plan to monitor implementation International HIV/AIDS Toolkit

  22. STRATEGIES • Use Declaration to argue for more resources • Use the Declaration as benchmark • Develop strategies to monitor implementation • Lobby to be part of process • Build coalitions outside HIV/AIDS International HIV/AIDS Toolkit

  23. STRATEGIES (ASO level) • Familiarize your organization with content of Declaration • Distribute copies in your community • Connect with other organizations that have used Declaration International HIV/AIDS Toolkit

  24. STRATEGIES • Identify how Declaration relates to work already doing • Formally endorse Declaration • Use Declaration to support funding proposals • Share your experiences, lessons learned International HIV/AIDS Toolkit

  25. The Global Fund to fight AIDS, Tuberculosis and Malaria International HIV/AIDS Toolkit

  26. Global resources available to address HIV/AIDS • UNAIDS estimates we need about $US10 billion per year by 2005, then $US15 billion per year by 2007 • Resources come from World Bank, Clinton Foundation, Bush Initiative, Global Fund and other bilateral and multilateral support. • 20-30% comes from domestic (personal, state, business) sources the rest from donor assistance • Abuja Declaration commits African countries to earmark 15% to health spending International HIV/AIDS Toolkit

  27. Background • The Global Fund is an international, independent public-private partnership designed to attract and manage significant new sums of money to finance the fight against AIDS, tuberculosis and malaria • Only developing countries can apply for funding • Countries are required to set up multi-sectoral country coordinating mechanisms where communities must be represented International HIV/AIDS Toolkit

  28. Global Fund • Independent, public/private partnerships The Fund does not fall under the UN umbrella. It has autonomy and is structured to conduct its affairs in a business-like and transparent fashion. • Country driven, centrally accountable The Fund defers to countries to design proposals based on local needs, but holds these to central standards of best practice and accountability. • Results based disbursement Recipients must meet their milestones for the funds to keep flowing. • Fund Structure The board is comprised of 18 voting members representing public donors, the private sector, recipient countries and civil society. The World Bank, WHO and UNAIDS are non-voting members International HIV/AIDS Toolkit

  29. Approval Rounds International HIV/AIDS Toolkit

  30. Distribution By Region International HIV/AIDS Toolkit

  31. By disease International HIV/AIDS Toolkit

  32. By Type for Activity International HIV/AIDS Toolkit

  33. By Recipient International HIV/AIDS Toolkit

  34. Global Fund Required Revenue New resources are needed and should not come from existing commitments to international development assistance. • 1.7 billion is needed for 2004, of which only 1.5 has been pledged • Needs for 2005 will total $3.6 billion based on a significant demand on resources for renewals and new proposal rounds • The Goal: • Donor Governments will cover 95%. • Private Foundations and corporations will cover 5%, including major philanthropic foundations and cash donations by private for-profit companies • Individuals will cover less than 1% International HIV/AIDS Toolkit

  35. Equitable Contribution (2002-4) International HIV/AIDS Toolkit

  36. Shortcomings and Risks • Country Coordinating Mechanisms (CCMs) function poorly in some settings • Disbursement has been slow both by the Secretariat and Principle Recipients • Could lose momentum—Round 4 underfunded International HIV/AIDS Toolkit

  37. Challenges • Funding • Measurement of results • Vote for Communities • In-kind contributions International HIV/AIDS Toolkit

  38. Fund the Fund campaign • Created in 2003, the “Fund the Fund” campaign is aimed at civil society organizations including non-governmental, community-based, people living with the diseases, faith-based and trade unions to promote their advocacy for increased investment in the Global Fund • It calls on nations to commit to annual contributions to the Global Fund based on the Equitable Contributions Framework (ECF): Each country’s contribution is based on that country’s gross domestic product (GDP) • Canada should contribute US$55 million in 2004 but has committed only US$25 million • In 2005 based on the ECF Canada should commit US$75 million but so far has pledged US$50 million International HIV/AIDS Toolkit

  39. For more information • Canadian Fund the Fund Campaign • http://ca.groups.yahoo.com/group/fundthefundcanada/ • International Fund the Fund Campaign • www.fundthefund.org International HIV/AIDS Toolkit

  40. Advocacy on Access to Treatment International HIV/AIDS Toolkit

  41. The obstacles • poor health infrastructures • the high cost of drugs • Inadequate political will International HIV/AIDS Toolkit

  42. The Context • Epidemiology: More than 95% of PLWHIV/AIDS live in developing countries, • Per Capita Income: $25,732 in rich countries versus $440 in sub-Saharan Africa and $500 in South Asia, • Per Capita Health Spending: $1500 in North America vs. $204 in Africa and Asia, International HIV/AIDS Toolkit

  43. Context • Other priorities such as; clean water, adequate housing and nutrition, and decent schools and highways. • Other serious epidemics, such as tuberculosis and malaria • The Market for Drugs: Africa accounts for just 1%. International HIV/AIDS Toolkit

  44. Poor Health Infrastructure • Too few clinics, hospital beds and laboratories. • Shortage of competent health care professionals. • lack of medical and laboratory equipment • Drug distribution systems are incomplete. • Adequate food, clean water, International HIV/AIDS Toolkit

  45. Addressing the The High Cost of Drugs • Distribution Pipelines: United States-Venezuela Air Bridge • Bulk Buying: has reduced prices in the countries of the Caribbean • Technology Transfer: Building local infrastructure • Amendment to Canadian Patent Legislation to allow generic manufacturers to export cheaper drugs to countries in need International HIV/AIDS Toolkit

  46. International initiatives • WHO 3by5* -- provides technical assistance and standards concerning the scale up of treatment programs (*3 million on treatment by 2005) • Global Fund to Fight HIV/AIDS, TB and Malaria – provides financing to country-led initiatives • President’s Emergency Plan for AIDS Relief (PEPFAR) will spend US$15 billion over 5 years in 14 countries in the Caribbean and Africa to support AIDS projects • Clinton Foundation – works with governments to help finance projects using bilateral funding mechanisms International HIV/AIDS Toolkit

  47. Global Treatment Access Group (GTAG) • Increasing support to the Global Fund and other bilateral and multi-lateral mechanisms; • All trade agreements (including TRIPS, FTAA and others) must allow for the effective use of compulsory licenses for producing quality generic medicines for export to developing countries; • Official Development Assistance for health care infrastructure in developing countries should be increased. International HIV/AIDS Toolkit

  48. What is GTAG • GTAG is a working group of Canadian non-governmental organizations (NGO’s) sharing information and developing joint campaigning activities aimed at improving access to essential medicines and other aspects of care, treatment and support for people living with HIV/AIDS in developing countries • GTAG focuses its efforts on both the Canadian government and international actors International HIV/AIDS Toolkit

  49. What does GTAG do? • The working group monitors and undertakes activities with respect to issues such as: • Canada’s positions in political and trade forums which affect access to essential medicine for treatment of HIV/AIDS and opportunistic infections • Canada’s contributions to global initiatives such as the Global Fund and Canada’s contributions to ODA and debt cancellation • CIDA policies and guidelines as they related to access to treatment • Prepares policy papers and public education information • Participates in national and international forums dealing with global access to treatment and health care • Letter writing campaigns, policy submissions and other actions directed at government policy makers in Canada and internationally International HIV/AIDS Toolkit

  50. How to become a member • NGO’s are encouraged to become members of GTAG • The NGO should designate a person who can represent it on GTAG and serve as the liaison between their organization and GTAG and be responsible for obtaining the necessary approval of their organization to participate in joint activities • No funding is available for GTAG’s work. Costs of participation and activities are borne by participating NGO’s • Contact Richard Elliott at the Canadian HIV/AIDS Legal Network. Telephone (416) 595-1666 or e-mail relliott@aidslaw.ca International HIV/AIDS Toolkit

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