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Towards an AIDS-Free Generation Women & Girls and HIV in PEPFAR

Towards an AIDS-Free Generation Women & Girls and HIV in PEPFAR. Ambassador Deborah Birx Global AIDS Coordinator US Department of State September 9, 2014. History of the Epidemic & Response. Celebrating success and a call to action. 1. Where we were before PEPFAR…. 1991 – 2001: Peak

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Towards an AIDS-Free Generation Women & Girls and HIV in PEPFAR

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  1. Towards an AIDS-Free GenerationWomen & Girls and HIV in PEPFAR Ambassador Deborah Birx Global AIDS Coordinator US Department of State September 9, 2014

  2. History of the Epidemic & Response Celebrating success and a call to action 1

  3. Where we were before PEPFAR… 1991 – 2001: Peak of the Pandemic • 2001: Nearly 10,000 new HIV infections daily • 2002: 50,000 on treatment in sub-Saharan Africa • Health systems overwhelmed by the epidemic • Life expectancy declines of over 20 years in some countries • Loss of working age population – reversing decades of development progress

  4. Unwavering Leadership from CongressDemonstrated Commitment to Ending the AIDS Pandemic Delivering an AIDS-Free Generation

  5. PEPFAR Has Saved Millions of Lives New Infections Halved since Peak of Epidemic Trends in New HIV Infections, 1990-2013

  6. 2 Leaving no one behind Women face disproportionally high burden of HIV/AIDS

  7. Key Populations Face a Significantly Higher Risk of Acquiring HIV/AIDS Young women Sex work People who inject drugs Men who have sex with men Transgender Migrants Prisoners Displaced Pregnant women 50+ Disabled African American women Intimate partners Young women in Sub-Saharan Africa are by far the largest group with a disparately high risk of acquiring HIV Source: UNAIDS, 2014

  8. Disparately High HIV Prevalence among Young Women Compared to Young Men New HIV Infections in Sub-Saharan Africa by Age & Sex, 2013 Source: UNAIDS 2014

  9. In Eastern and Southern Africa, HIV is the leading cause of death in girls aged 15-19 HIV Leading Cause of Death among Adolescent Girls in SSA • 16.9 Source: Global Burden of Disease 2010

  10. 3 PEPFAR: Improving Outcomes for Women & Girls

  11. Women & Girls on Lifesaving Treatment

  12. ACT: Accelerating Children’s HIV/AIDS Treatment PEPFAR & CIFF (the Children’s Investment Fund Foundation) launched a public-private partnership to keep Children & Adolescents alive and healthy • This $200 million initiative aims to double the number of children on treatment in at least 10 countries in sub-Saharan Africa • With this initiative, we could avert an additional 250,000 HIV-related deaths of children under the age of five • Additional HIV-related deaths will be averted in the 5-15 year old age group.

  13. Maternal Deaths & HIV Maternal mortality ratio, 2010 Every day 800 mothers die due to pregnancy & childbirth WHO estimates that 18% of all maternal deaths are attributable to HIV People Living with HIV by Region, 2011 Source: WHO, 2011/2012

  14. PMTCT: HIV Testing for Pregnant Women Over half of HIV+ pregnant women in the world are tested and identified with PEPFAR support 6.9%

  15. PMTCT: Getting Lifesaving ART to HIV+ Pregnant Women to Protect Maternal & Infant Health In 2013, 56% of women received lifelong ART, up from 23% in 2011.

  16. Saving Mothers Giving LifeAn Innovative Public-Private Partnership • SMGL is bringing together key partners… • To address the 3 delays that contribute to maternal mortality: • Delay in decision to seek care • Delay in reaching care • Delay in receiving quality health care

  17. SMGL Phase 1 Results: Institutional Maternal Mortality Declined in both Uganda & Zambia - 35% - 35% - 36% - 35% Percentage declines noted are statistically significant

  18. Pink Ribbon Red Ribbon Public-Private Partnership to Combat HIV & Cervical and Breast Cancers in Africa HIV-infected women have a significantly higher risk of acquiring cervical cancer • Cervical cancer – one of most common cancers among women in developing world • 275,000 deaths each year • >85% global burden in developing countries • $85 million over 5 years currently committed • Zambia and Botswana are initial PRRR countries • Major expansion of “screen and treat” programs • Pilot programs for HPV vaccination • Training for breast cancer awareness and CBE • Founding PRRR members include: • PEPFAR • The George W. Bush Institute • Susan G. Komen for the Cure • UNAIDS • Multiple private sector partners

  19. PEPFAR Gender Strategy • in the past four years, PEPFAR reached over 114,000 survivors of sexual violence with post-exposure prophylaxisto prevent HIV • Increasing gender equity in HIV/AIDS programs and services, including reproductive health services • Preventing and responding to gender-based violence • Engaging men and boys to address norms and behaviors around masculinity and sexuality • Increasing gender-related policies and laws that increase legal protection • Increasing gender equitable access to income and productive resources, including education

  20. Impacts of social protection on girls’ past-year incidence of transactional sex Mitigation as Prevention: OVC Programs

  21. Together for Girls A Unique Public-Private Partnership

  22. Our work is not done. This week alone… Over 3600 children died this week from HIV Over 25,000 adults died this week from HIV Over 4,600 babies were infected with HIV Over 36,500 adults were infected of which more than 7000 were young women

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