Presentation outline 1. Where are we and where do we want to go? - PowerPoint PPT Presentation

Ending the AIDS epidemic as a public health threat by 2030: sustainability and universal health Amalia Del Riego Unit Chief Health Services and Access Health Systems and Services Department Pan American Heath Organization/World Health Organization III Latin American and Caribbean Forum Road to Ending AIDS in LAC – Towards Sustainable Regional Fast Track Targets Port-au-Prince, 6 -8 November 2017

Presentation outline 1. Where are we and where do we want to go? Sustainability or expanding access with sustainability? 2. Where are we coming from?: Evolution of the response to HIV and health systems evolution, intersections. 3. Current sustainability challenges. 4. Addressing the challenges: universal health 5. Conclusions and key messages 2

Where are we? An esCmated 25% in LAC do not know their serostatus. 2,500,000 Only 55% were receiving ART in 2015 140,000 2,100,000 2,000,000 120,000 The rate of reducCon of new infecCons slowed aTer 2010, and has 100,000 been stagnant. 1,500,000 80,000 1,181,000 Inequi'es persist : gay men, MSM, 1,000,000 60,000 45,000 transgender women and sex workers and other key populaCons are 40,000 disproporConally affected. 500,000 20,000 S'gma and discrimina'on persist in 0 0 society and health care se7ngs : in 2010 2011 2012 2013 2014 2015 2016 2015 almost 1/3 of newly diagnosed HIV PLWH on treatment PLWH cases had highly compromised immune AIDS deaths New HIV infecCons system. Source: UNAIDS Spectrum esCmates 2017 Source: PAHO/WHO: HIA 2017 3

Towards GPA Universal Access Ending the PEPFAR (goals) Scale-up epidemic WHO Timeline of the global response to HIV 2014 2003 2004 1996 2000 2002 2006 1981 1987 2014 1978 1989 1993 2000 2005 2002 2008 2010 Timeline of health systems development Core Structural Basic EPHF Alma Ata Health adjustment UHC pro-poor Stewardship PHC PHC PHC systems WHO Reforms packages Renewal functions WHO PAHO 4

Current sustainability challenges 2. Service delivery and model of care 1. Financing HIV expenditure from interna'onal funds 20 15 Million USD 10 5 0 2006 2007 2008 2009 2010 2012 2013 2014 2016 Source: adapted from NASA 2016 Honduras Drop in donor support Source: h[p://www.medifit.co.za/mobile-clinics-gallery/ Fragmented stand-alone services + complex fiscal outlook 3. Stewardship and governance 4. Intersectoral action Source: NGO for AIDS awareness Isolated from the rest of the health Fragmentation and weakening of system and dependent on donors national health authorities 6

Regional Strategy for Universal access to health and universal health coverage Values: ü Right to Health ü Equity ü Solidarity Universal coverage Universal access Sufficient organizational Absence of geographical, economic, sociocultural, mechanisms and financing organizational, or gender barriers that prevent all to cover the entire people from having equitable use of population comprehensive health services and healthy living to allow their development and well-being 7

2. Strengthening 1. Expanding stewardship and equitable access governance to health services 4. Strengthening intersectoral 3. Increasing and coordination to improving address SDH financing, with equity and efficiency 8

Conclusions and key messages Changing context : Convergence: evolution of the (epidemiological, technological, political, response and financial..) require changing health changing response systems paradigm Challenges: broader Universal health: than financial, there is Framework to address the need for a challenges in comprehensive and comprehensive and integrated approach integrated manner 9

Universal health and ending AIDS by 2030: access and coverage for all A moral imperaCve. An investment for healthy living, well-being and sustainable human development. Leaving no one behind! Values Right to Health ü Equity ü Solidarity