HIV Epidemic and SGBV* in DRCFAST-TRACK

Dr Mamadou SAKHOUNAIDS Country Director

• HIV epidemic • SGBV & human rigths violations reporting: example of 2nd quater• Fast-track: trends and programmatic progress• Leadership, funding and partners with FBO• Challenges• Recommandations (Fast- track window 2016/2021)

KNOW YOUR EPIDEMIC, KNOW YOUR RESPONSE

HIV among groups: Women (1.6%), Men (0.6%), Youth (0.8%) , Female sex workers (6.9%) , MSM (16.9%)

HIV PREVALENCE (DHS 2013- 2014)NUMBER OF PEOPLE LIVING WITH HIV PER PROVINCE (PVVIH) 2015

SGBV AND HUMAN RIGHTS VIOLATIONS REPORTED

Example of second quarter 2015• 280 violations were reported last quarter • 155 victims including 31 adult victims of rape• Types of violations: physical integrity- liberty and security of the person- life• SGBV is reported in all provinces • The most affected provinces remains the eastern provinces of the DRC, namely the

provinces of North Kivu (132), Orientale (69) and South Kivu (26)• Stigmatization and discrimination persist limiting accessing key and affected populations

HIV & SGBV strong linkage appears: HIV new infections and prevalence in the East are higher( varies 1.5% to 4%) compared to

DRC (1.2%)

1,990 1,991 1,992 1,993 1,994 1,995 1,996 1,997 1,998 1,999 2,000 2,001 2,002 2,003 2,004 2,005 2,006 2,007 2,008 2,009 2,010 2,011 2,012 2,013 2,0140

20,000

40,000

60,000

80,000

100,000

120,000

Number of new infections VIH

19 327

101 324Number of adults and infants receiving ART

Number of AIDS related deaths

25 505

FAST- TRACKING : CONCRETE RESULTS AND IMPACT

RÉDUCTION DE LA TRANSMISSION DU VIH PAR LA VOIE SEXUELLE

• UNAIDS, MONUSCO, civil society including FBO have targeted

- women and girls, youth, - key populations - people in conflicts and humanitarian areas

• Anglican, Protestants, the Catholic Church and many others religious groups have been highly involved in the HIV national response in DRC

2011 20140%

10%

20%

30%

40%

50%

60%

70%

80%

% Youth with accurate Knowledge on HIV/AIDS

% female sexe workers with Knowledge on HIV/AIDS among

% Female sexe workers using condoms

2006 2007 2008 2009 2010 2011 2012 2013 2014

1,916 1,6412,492 2,327

3,6432,584

3,738

7,802

12,294

23677

ELIMINATION OF NEW INFECTIONS AMONG CHILDREN AND REDUCING MATERNAL MORTALITY

Nombre de femmes encientes positives ayant reçu ARV pour PTMENombre de femmes encientes positives ayant besoin d'ARV pour PTME

EMTCT COVERAGE= 52% en 2014

Number of HIV positive pregnant women receiving ARV for EMTCT

Number of HIV positive pregnant women who need ARV for EMTCT

•HIV Early diagnostics has been increased from 3% en 2011 à 9,8% en 2013 et 17% en 2014

• Option B+ is experienced (in Katanga and Kinshasa) : 3%(849) in 2013 to 12%(2773) in 2014.

•HIV/SR/ MNCH progresively integrated in ANC facilities

ELIMINATION OF NEW INFECTIONS AMONG CHILDREN AND REDUCING MATERNAL MORTALITY

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

9,094 17,675 21,873 24,150 34,742 43,790 53,39366,305

79,560

101,324

319777

ACCESS TO ARV TREATMENT

Nombre d'adults et d'enfants sous ARV Nombre d'adults ayant besoin ARV

ART Coverage = 32% in 2014women = 36% children = 33%

men = 25%

ACCESS ARV TREATMENT

ART- Coïnfection TB/ VIH

• The number of patients receiving ARV treatment has been almost doubled, rising from 66,305 (16%) to 101 134 (31%)

• Coinfection TB/VIH treatment improved de 19,1% in 2013 to 29,4% in 2014.

• Refuies, IDPs, Emergency and humanitaires++

LEADERSHIP, DOMESTIC FUNDING AND PARTNERSHIP WITH FAITH BASED ORGANIZATION

Continious high-level advocacy towards parliamentarians, policymakers, faith based organisations (FBO), journalists, lawyersNational ownership showed : The head of State led the campaign on “protect your goal”National Human Rigth Commission: PLHA network representative nominated by the PresidentA key result from the advocacy was that the Government committed to increase state resources to 59.8 USD (from 3 million USD) within 2015–2017 297 millions USD Grant agreement with Global Funds for TB/VIH Concept Note 2015-2017: The FBO are the key principal recipients and sub recipients

CHALLENGES

• Stigmatization and discrimination towards SGBV victims and a lack of knowledge and perception about HIV and SGBV

• Lack of high quality data collection, analysis, and use mechanism • Weak coordination and lack of synergy mainly at operational level

between actors (NGO, FBO, health system, government and development partners)

• The legal environment and the insecurity remains key barriers for targeting prisoners, female sex workers, IDU, LGBIT, young girls and women.

• Multi-sectorial funding and human resources capacity, guidelines and commodities remain insufficient

RECOMMANDATIONS

• To engage political and community leaders and law makers for non application and removal of punitive laws and integration and delivery of HIV & SGVB services to the most affected populations

• To enhance multi-sectoral coordination, harmonization at national and operational between actors (NGO, FBO, health system, government and development partners)

• To promote community-led HIV & SGBV programs on Human rights and gender equality in order to eliminate stigmatization and discrimination

• To strengthen HIV & SGVB data collection and analysis for informed planning, intelligent investment and social progress monitoring

Rapid Reduction of New HIV Infections and Mortality

through Optimization and Innovation

Geneva, 15-16 May 2014

Thank you for your attention