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HIV and the health MDGs: critical interactions, policy evolution and implications

HIV and the health MDGs: critical interactions, policy evolution and implications. Dr. Gottfried Hirnschall Director Department of HIV/AIDS. The fight against HIV/AIDS: links to all the MDGs. Global progress - selected MDGs/indicators. Progress is uneven across regions - 2010.

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HIV and the health MDGs: critical interactions, policy evolution and implications

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  1. HIV and the health MDGs:critical interactions, policy evolution and implications Dr. Gottfried Hirnschall Director Department of HIV/AIDS

  2. The fight against HIV/AIDS: links to all the MDGs

  3. Global progress - selected MDGs/indicators

  4. Progress is uneven across regions - 2010

  5. FAST – scale-up of people receiving ARVs in low- and middle-income countries The pace of change differs between interventions • SLOW – coverage of skilled attendant at delivery , especially in Africa Skilled birth attendant % Millions

  6. Health policy: allocation of resources (million $) 1992-2005 Source: J. Shiffman, Health Policy and Planning 2008; 23: 95-100

  7. Proportion (%) Proportion (%) 2001 2002 2003 2004 2005 2007 1990 1991 1993 1995 1996 1997 1998 2000 2002 2003 2004 2005 2007 2000 2006 1992 1994 1999 2001 2006 1998 1990 1991 1993 1995 1996 1997 1999 1992 1994 25 25 25 25 20 20 20 20 Proportion (%) Proportion (%) 15 15 15 15 10 10 10 10 5 5 5 5 0 0 0 0 2000 2001 2002 2003 2004 2005 2007 1996 1998 2006 1992 1993 1994 1995 1997 1999 1990 1991 1992 1993 1995 1997 1998 1999 2000 2001 2002 2003 2004 2006 1991 1994 1996 2005 2007 1990 Proportion of under-five mortality associated with HIV in Africa, 1990-2007 West Africa Central Africa EastAfrica Southern Africa Source: Black et al., 2010 for the Child Health Epidemiology Reference Group of WHO& UNICEF

  8. Links between HIV and maternal health: Causes of death among women of reproductive age (15-44 yrs) Source: Women and Health report, WHO, 2009

  9. Work on HIV can impact maternal health: Links between HIV and maternal mortality, 1980-2008 Source: Hogan et al, 2010

  10. Dealing with HIV helps decrease the impact of TB Incidence of TB Incidence of HIV infection Source: WHO/UNAIDS Source: WHO

  11. Don't turn away now! • 2.7 m new HIV infections • 10 m people without access to ART • ~ 0.5 m cases multidrug resistant TB • 3 – 800 000 maternal deaths • 8.8 m deaths in children under 5 years

  12. Variation in coverage across interventionsin low- and lower middle-income countries Median (%)

  13. The need for integration throughout the health system Political commitment

  14. Addressing the challenges • Sustain and increase high level commitments • Advocate for and ensure fully funded responses (HIV and SRH and MNCH) • Efficiency gains are key • Strengthen systems for integrated services • Ensure access for those most vulnerable and excluded • Document what works

  15. The time is now to deliver on promises

  16. Incremental costs by year, by disease and health system building block to reach MDGs in 49 low income countries

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