HIV in the MDG framework and beyond

Brian Lutz10 August 2012

Objectives

Take stock of progress on MDG 6/HIV1

Look ahead to 2015 and beyond2

Framing of HIV/health post 20153

Good progress in prevention globally …..

Target 6A – halt and reverse the spread of HIV

1

…But have we hit the mark?

…but progress is not uniform1

Monumental progress in treatment globally…1

Target 6B – universal treatment access…but where

should we be?15m?

Political and financial commitments have been key1

Technical and policy changes have mattered1

Human rights-based approaches remain integral1

Opportunities to 2015 and beyond (?)2

• Treatment as prevention – scale up of ART

• Vaginal and rectal microbicides

• Pre-exposure prophylaxis

• Safe male circumcision

Incre

asin

g tim

e to

scale

up

• Structural interventions (e.g., cash transfers?)

Opportunities: male circumcision2

• ~50% reduction in HIV risk

• 80% coverage could avert 22% of new HIV infections from 2011-2025

Sustainable AIDS financing is biggest risk on horizon2

Key populations will probably suffer most2

Increasing domestication of response is one option2

• Budget re-allocation

• Technical efficiencies

• Alternative revenues

So is improving allocative efficiency2

Another risk is too much remedicalization2

Biomedical

Behavioral

Structural

Emerging issues for post 20153

• AIDS out of isolation

• Vertical versus horizontal

• Universal health access

• One, many and/or mainstreamed

• Outcomes or inputs

Thank You