Madagascar Second Multisectoral STI/HIV/AIDS Prevention Project

The Second Multisectoral STI/HIV/AIDS Prevention Project aims at supporting the Government of Madagascar's efforts to promote a multi-sectoral response to the HIV/AIDS crisis and to contain the spread of HIV/AIDS on its territory. 

In this context, and in line with the recommendations of the December 2008 mid-term review as well as the April and October 2011 supervision missions, the restructuring includes: (a) eliminating the Fund for STI/HIV/AIDS Prevention and Care-Taking which was not effective in delivering key interventions to target populations, (b) increasing the health sector response by scaling-up contracting with non-government organizations (NGOs) for delivery of services directly to target populations, and (c) strengthening monitoring and evaluation (M&E) including better aligning project activities to intermediate and outcome indicators. 

In addition, the project closing date will be extended by one year to December 31, 2012 in order to consolidate achievements and measure the results of proposed changes.

World Bank. Document Date:2011/12/23. Document Type: Project Paper. Report Number: 65780 

Main Report

Data Sheet

For more information about Projects in Madagascar see EASTERN AFRICA Projects

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Benin.Second Multisectoral HIV/AIDS Control Project

HIV/AIDS imposes enormous economic, social, health, and human costs and will continue to do so for the foreseeable future. The challenge is particularly acute in Sub-Saharan Africa, home to two-thirds (22.5 million) of the people living with HIV/AIDS globally, and where HIV/AIDS has become the leading cause of premature death. But now, after decades of misery and frustration with the disease, there are signs of hope. HIV prevalence rates in Africa are stabilizing. This book sheds light on these concerns by analyzing the fiscal implications of HIV/AIDS in Southern Africa, the epicenter of the epidemic. It uses the toolbox of public finance to assess the sustainability of HIV/AIDS programs.

Importantly, it highlights the long-term nature of the fiscal commitments implied by HIV/AIDS programs, and explicitly discusses the link between HIV infections and the resulting commitments of fiscal resources. The analysis shows that, absent adjustments to policies, treatment is not sustainable. But it also shows that, by accompanying treatment with prevention, and making existing programs more cost-effective, these countries can manage both treatment and fiscal sustainability. Even in countries where HIV/AIDS-related spending is high or increasing (as past infections translate into an increasing demand for treatment), the fiscal space absorbed by the costs of HIV/AIDS-related services will decline if progress in containing and rolling back the number of new infections can be sustained. The purpose of this study is to refine the analysis of the fiscal burden of HIV/AIDS on national governments and assess the fiscal risks associated with scaling-up national HIV/AIDS responses.

The study complements and contributes to the agenda on identifying and creating fiscal space for HIV/AIDS and other development expenditures. The findings from this study, and the analytical tools developed in it, could help governments in defining policy objectives, improving fiscal planning, and conducting their dialogue with donor agencies.

World Bank.Author:  Lule, Elizabeth ; Haacker, Markus.Document Date:  2011/01/01.Document Type:Publication.Report Number:65658.Volume No: 1 of 1

Benin - Second Multisectoral HIV/AIDS Control Project : restructuring

Main Report

Data Sheet

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The fiscal dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda

HIV/AIDS imposes enormous economic, social, health, and human costs and will continue to do so for the foreseeable future. The challenge is particularly acute in Sub-Saharan Africa, home to two-thirds (22.5 million) of the people living with HIV/AIDS globally, and where HIV/AIDS has become the leading cause of premature death. But now, after decades of misery and frustration with the disease, there are signs of hope. HIV prevalence rates in Africa are stabilizing. This book sheds light on these concerns by analyzing the fiscal implications of HIV/AIDS in Southern Africa, the epicenter of the epidemic. It uses the toolbox of public finance to assess the sustainability of HIV/AIDS programs.

Importantly, it highlights the long-term nature of the fiscal commitments implied by HIV/AIDS programs, and explicitly discusses the link between HIV infections and the resulting commitments of fiscal resources. The analysis shows that, absent adjustments to policies, treatment is not sustainable. But it also shows that, by accompanying treatment with prevention, and making existing programs more cost-effective, these countries can manage both treatment and fiscal sustainability. Even in countries where HIV/AIDS-related spending is high or increasing (as past infections translate into an increasing demand for treatment), the fiscal space absorbed by the costs of HIV/AIDS-related services will decline if progress in containing and rolling back the number of new infections can be sustained. The purpose of this study is to refine the analysis of the fiscal burden of HIV/AIDS on national governments and assess the fiscal risks associated with scaling-up national HIV/AIDS responses.

The study complements and contributes to the agenda on identifying and creating fiscal space for HIV/AIDS and other development expenditures. The findings from this study, and the analytical tools developed in it, could help governments in defining policy objectives, improving fiscal planning, and conducting their dialogue with donor agencies.

World Bank.Author:  Lule, Elizabeth ; Haacker, Markus.Document Date:  2011/01/01.Document Type:Publication.Report Number:65658.Volume No: 1 of 1

The fiscal dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Ugandan

President Obama announces new efforts to end the AIDS epidemic in the United States

HSS. FOR IMMEDIATE RELEASE. December 1, 2011. President Barack Obama  announced accelerated efforts to increase the availability of treatment to people living with HIV/AIDS in the United States in conjunction with World AIDS Day 2011.  The president directed the U.S. Department of Health and Human Services (HHS) to invest approximately $50 million in new funding to support AIDS Drug Assistance Programs in states and increase access to HIV/AIDS care services.

“President Obama has laid out a compelling vision that has the power to change the course of the epidemic,” said HHS Secretary Kathleen Sebelius.  “Now it’s up to all of us to make our National HIV/AIDS Strategy real.  Treatment not only improves and extends the lives of people living with HIV, but it also drastically reduces their risk of spreading the virus.  Today we have a unique opportunity to significantly alter the course of the AIDS epidemic in the United States.”

The president emphasized that critical HHS resources will help ensure that HIV-positive Americans get the best care and treatment possible.  HHS will commit approximately $35 million in new funding and enhanced technical assistance through the Health Resources and Services Administration (HRSA) to support state AIDS Drug Assistance Programs so that approximately 3,000 people living with HIV/AIDS will have access to life-saving medications.  In addition, HHS will provide $15 million in new funding to support experienced community-based providers of care for individuals with HIV/AIDS.

As part of today’s announcement, HHS will sponsor new activities focused on improving adherence to medications and encouraging consistent access to HIV care.  The Centers for Disease Control and Prevention (CDC) estimates that 34 percent of HIV/AIDS patients do not receive consistent care and only 28 percent of HIV/AIDS patients have their HIV under control.  Consequently, HHS will help providers improve quality of health care delivered and states monitor and improve the continuum of HIV care for patients.

Today’s announcement builds upon the Obama Administration’s new testing initiatives to help the estimated 240,000 Americans living with HIV who are not aware that they are infected.  For example, CDC has launched a new campaign to encourage testing among one of the hardest hit populations in the United States, black men who have sex with men.  Testing Makes Us Stronger is part of Act Against AIDS, CDC’s national campaign to bring attention to the importance of HIV prevention and testing.  In 2012, CDC will also be working with partners to expand its successful campaign for African American women.

Recognizing that the federal government’s efforts are only part of the solution, President Obama also applauded commitments by other public and private sector partners to expand and improve HIV/AIDS care services.  The National Alliance of State and Territorial AIDS Directors announced a new agreement with Gilead Sciences to extend additional voluntary discounts and rebates for most Gilead medications purchased by state AIDS Drug Assistance Programs, as well as a continued price freeze through 2013.

To learn more about World AIDS Day activities, visit AIDS.gov.

Contact: HHS Press Office
(202) 690-6343s

The Report on the Global AIDS Epidemic 2011

21 November 2011.UN.News. Global efforts to prevent and treat HIV/AIDS are showing optimistic results, but transformative efforts are needed to accelerate progress, according to the latest report released today by the United Nations agency leading the fight against the disease.

The Report on the Global AIDS Epidemic 2011, produced by the Joint UN Programme on HIV/AIDS (UNAIDS), shows there has been a significant decrease in infection rates and HIV-related deaths, as well as an increase in the number of people who have access to treatment.

HIV infections rates are at their lowest since the peak of the epidemic in 1997, with 2.7 million new infections in 2010, mainly due to changes in young people’s sexual behaviour, particularly in sub-Saharan Africa.

Twenty-one high-prevalence countries reported declines in HIV occurrence among people aged 15 to 24 last year, as opposed to 16 countries in 2009. The most pronounced falls happened in countries in sub-Saharan Africa such as Botswana, Burkina Faso, Ethiopia, Ghana, Kenya, Malawi, Namibia, Nigeria, Tanzania, Togo and Zimbabwe.

34 million people worldwide are currently living with HIV/AIDS

UNAIDS Deputy Executive Director Paul De Lay told the UN News Centre that behavioural changes – which include the use of condoms, having fewer sexual partners, and young people waiting longer before becoming sexually active – were the main causes for progress in Africa. The region, however, continues to be the most heavily affected, with 68 per cent of people living with HIV residing in sub-Saharan Africa.

The report also shows an increase in the number of people living with HIV worldwide – now at an estimated 34 million, up 17 per cent from 2001. Although the rise in this figure partly reflects new HIV infections, it is also a result of increased access to antiretroviral therapy, which has helped reduce AIDS-related deaths. Presently, 6.6 million people in low- and middle-income countries – almost half of the people eligible for treatment – have access to antiretroviral therapy.

The report also estimates that a total of 2.5 million deaths have been averted in low and middle-income countries since 1995 due to antiretroviral therapy, with 700,000 AIDS-related deaths averted in 2010 alone.

HIV infections rates are at their lowest since the peak of the epidemic in 1997

Mr. De Lay added that scientific breakthroughs have shown how people receiving treatment also become less infectious with time, decreasing the risk of infection for their partners and lowering the chances of transmission from mothers to newborns.

Mr. De Lay said the progress in recent years is notable since it has occurred in spite of funding cuts due to the global economic crisis. Last year, funding from donor countries went from $7.6 billion to $6.9 billion, representing a 10 per cent reduction.

“One of the things that the report focuses on is how countries can spend the amount they have now in a much smarter way so they get more impact,” Mr. De Lay said, expressing concern for the decrease in funding not only from international donors but from foundations and internal institutions in countries with high infection rates.

In addition, UNAIDS stressed in its report that although the data points to incremental progress, a transformative response is needed to meet the 2015 targets set by Member States in June through the Political Declaration on HIV/AIDS, and to support the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths in the near future.

“We need to move from a short-term, piecemeal approach to a long-term strategic response with matching investment,” said Michel Sidibé, Executive Director of UNAIDS.

“The world faces a clear choice: maintain current efforts and make incremental progress, or invest smartly and achieve rapid success in the AIDS response,” says the UNAIDS report, calling for an increase in smart strategies and commitment from countries.

The report also maps a new framework for AIDS investments, which focuses on getting high impact and high-value strategies. The framework is based on several elements, including focusing interventions for populations at higher risk such as sex workers and people who inject drugs; promoting behavioural change programmes; and increasing treatment and care for people living with HIV.

The Report on the Global AIDS Epidemic 2011