Excellent healthcare – locally delivered

How far away are we from 20 million on ART

by 2020?

Meg Doherty, MD, MPH, PhDCoordinator Treatment and Care

WHO HIV Department, HQ

Global Access to Treatment

WHO, Global Treatment Report 2013

2012 20130

5

10

15

20

25

30

35

40

19%23%31%

37%

Children

Adult

14%

740,000 children on ART – widening gaps in coverage

13 million on ART, end 20132m in last year; 20m X 20 within reach

12%

Close to 1 million pregnant women received ARVs, 500,000 still being missed

2005 2006 2007 2008 2009 2010 2011 2012 2013 0

200 000

400 000

600 000

800 000

1 000 000

1 200 000

1 400 000

1 600 000

1 800 000

2 000 000

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 640 0001 540 000

1 450 000

220 000

730 000

966 000

13%

47%

67%

Number of pregnant women living with HIV needing ARV medicines for PMTCTRangesSeries3Number of pregnant women living with HIV receiving any ARV medicines for PMTCTPercentage coverage

20%

Threshold for ART initiation

37%

63%

30%

%

%

CD4 <500

CD4 <350

% Regardless of CD4

80%

83%

17%

20%

80%

Uptake of 2013 recommendations as of July 2014

38%

60%

Uptake based on 58 WHO focus countries, by region

10%

12% 50%Total43%

Total54%

Total3%

20%

Paediatric ART Age Initiation

12%

67%

38%

%

%

Age < 5 yrs

Age < 2 yrs

% Other

40%

33%

17%

20%

80%

Uptake of 2013 recommendations as of July 2014

40%

38%

Uptake based on 58 WHO focus countries, by region

25%

20% 40%Total22%

21%

50%

40%

20%

Total21%

Total48%

Option B / B +

%

%

Option B

Option A

% Option B+14%

57%

Uptake of 2013 recommendations as of July 2014

25%

Uptake based on 58 WHO focus countries, by region

20%

63%

80%

13%

25%

75%

13%100%

40%

40%

20%

Total33%

Total58%

Total9%

WHO Innovations in HIV Testing• Self testing• Test for triage• Birth testing and integrated HIV testing for kids

Innovations in Drugs• FDC 2nd and 3rd line

• Pellets and 4 in 1 for children• Integrase inhibitors in for both 1st and second line

Innovations in Diagnostics• Increase options & platforms

• Maintain quality

Innovations in Service delivery• Community delivery ARV• Integration (Double Dividend for children, UHC)• Learn from implementation science research

AcknowledgementsWHO HIV/AIDS Department• Gottfried Hirnschall• Jhoney Barcarolo• Michel Beusenberg• Nathan Ford• Cadi Irvine• Eyerusalem Negussie• Lisa Nelson• Martina Penazzato• Fintan Thompson• Marco Vitoria• Mayada Yousseffox• Gundo Weiler

WHO Regions• Emil Asamoah-Odei• Martin Donoghoe• Irina Eramova• Massimo Ghidinelli• Ying-Ru Lo• Frank Lule• Amaya Maw-Naing• Gabriele Riedner• Razia Pendse