Transcript 3 PCB Economic Crisis and HIV 10 Dec (v5)

The Impact of the Global Economic Crisis on HIV and AIDS
UNAIDS Program Coordinating
Board Meeting
10 December 2009
Geneva
The context
At the 24th Meeting of the UNAIDS Programme
Coordinating Board in June, the Board requested that
UNAIDS:
“report at the 25th Programme Coordinating Board
Meeting on the anticipated impact that the financial
crisis will have on countries’ ability to meet their
universal access targets and to include
recommendations and mitigation strategies.”
Monitoring system: sources of information
1. UCCs survey
a.
b.
March survey 71 responses
July survey 63 responses
2. CSOs survey
a.
b.
c.
PCB Delegates provided the list of NGOs
458 CSOs started the survey and 80 fully completed it
CSOs respondents from 75 countries
3. Country Case studies
a.
12 country case studies
4. Cosponsor’s contributions
5. Donor’s interviews
a.
Structured interviews with the top five bilateral donors plus
the Global Fund and World Bank
Reported and expected impact is getting
worse (UCCs July Survey)
Percentage of countries in each region where
funding reduction is expected to affect prevention
AP
Caribbean ESAF
ECA
LA
MENA
WCA
VCT
18%
67%
36%
20%
33%
67%
25%
Condoms
18%
67%
27%
50%
33%
67%
23%
AIDS education
18%
67%
27%
30%
33%
0%
19%
IDUs programs
18%
33%
9%
60.0
17%
67%
17%
MSM programs
36%
100%
18%
30%
50%
67%
24%
SW programs
46%
100%
36%
30%
33%
67%
28%
Human rights and
advocacy
18%
100%
18%
30%
50%
33%
24%
Reduction of stigma
and discrimination
27%
100%
18%
50%
50%
0%
27%
Violence against
women
18%
100%
9%
20%
17%
0%
15%
Empowerment of
young people
36%
67%
27%
40%
17%
33%
26%
Universal Access off-track
(Coverage of ART for illustration)
90%
80%
19 on track
70%
60%
50%
32 off-track
40%
30%
20%
12 not
available
10%
0%
2003
2004
2005
2006
2007
2008
2009
2010
II. What are the driving forces?
• Economic slowdown and external shocks
• Flat international resources
• Competing priorities for development assistance
• Growing uncertainty at the country level
Macro and Micro Impacts related to HIV/AIDS
Country Context
Macro Impacts
-Recent economic growth
-Political stability
-Health of government budget
-Degree of financial integration through trade
FDI, and remittances
- Degree of dependence on external
assistance
-Lower GDP & GDP per capita growth
-Reduced external flows (ODA, private capital
flows, remittances)
-Worsening terms of trade
-Higher unemployment
- Currency devaluation
Negative Impact on
Other Actors (NGOs,
private sector)
Government Budget
Cuts for Health and HIV
Negative Impact on
Related Sectors
(Agriculture, Public
Works)
Delivery of HIV Services
- Lower purchasing power for imported
commodities
- Decrease in health and HIV human resources
- Unplanned interruptions and eliminations of
prevention programs
- Shortages of ARTs; disorganized access to
ARTs
Lower Real Household
Income and Increase in
Poverty
Demand for HIV Services
- Higher opportunity costs (transportation, food
security and nutrition)
- Increase in OOPs
- Increase in risky behaviors?
- Increase in stigma and discrimination?
Health Status of Populations
- Increased morbidity and mortality
- Increased risk of HIV transmission
- Increased resistance to HIV/AIDS treatment
Economic Slow-Down and Shocks:
UCCs reported risk factors
Factors perceived by CSOs to affect HIV and AIDS of
the Crisis on HIV/AIDS
Impact of the Crisis on HIV/AIDS Programs:
CSOs perspective
Impact in the last 6 months
Expected Impact in the next 12 months
80%
74% 72%
68%
70%
Percentage Respondents
64%
59%
60%
53%
55%
48%
41%
30%
20%
10%
0%
61%
56%
50%
40%
65%
46%
39%
What are the countries’ needs for
technical assistance?
• Strategic planning: 20 countries
• Improved tracking, monitoring, evaluation 9 countries
• Economic analysis: of impact of crisis 8 countries
• Prioritization and efficiency: 8 countries
• Resource mobilization strategy: 7 countries
• Mitigation of the impact and Social protection package for
poor AIDS affected households (1 country)
• Capacity building and strengthening the institutional
capacity of civil society
The outlook for donors
Interviews with major donors, plus the Global Fund and
World Bank, suggest that:
•
Donors and International Financing Institutions are
striving to maintain financial support for AIDS in the
context of a very challenging environment
•
There are significant shifts towards:
–
funding for health systems and other development agendas.
–
favouring countries with a high burden of disease and lower
income status.
What are the main findings?
1.
Reported and expected impact is getting
worse with the biggest impacts experienced
by prevention programs delivered by CSOs
2.
HIV funding is leveling off
3.
Universal access goal is off track
What can be done to address the negative
effects of the economic crisis on AIDS
programs
I.
Target better existing but constrained resources to
protect priority services and populations including
those delivered by CSOs.
II.
Pursue greater efficiencies in existing programmes
III.
Develop funding diversification strategies
IV.
Increase the stability and predictability of funding
V.
Expand “safety net” services for poor and
vulnerable populations
Each and every one of us has a responsibility
to improve the picture of the response to
HIV/AIDS!