the hiv investment case -- uganda · 2020-02-03 · achieving global targets 0 10,000 20,000 30,000...
TRANSCRIPT
SENSITIVE BUT UNCLASSIFIED
The HIV Investment Case -- Uganda
Presented by
Karusa Kiragu, UNAIDS Country Director, Uganda
and
John Stover, Avenir Health, USA
Tuesday January 28, 2020
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What is an HIV Investment Case?
• The HIV Investment Case is a value proposition which describes how the Uganda government, working together with its partners and stakeholders, will help to improve the HIV response over the next 10 years.
• It describes how a stronger, more efficient and results-oriented government will serve the people of Uganda to achieve established targets.
• It makes the argument why the solutions Uganda proposes, will be able to solve the problem based on:• Understanding the HIV situation• ‘Designing efficient programs• Delivering at scale and• Sustaining for impact with adequate funding.
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How is it being done?
• Leadership: Uganda AIDS Commission and the AIDS Control Program
• Advisors: Technical working group comprised of several thematic areas (HIV Prevention; Care and Treatment; Social Support; Systems Strengthening); guided by a steering committee
• Expertise: Will be prepared by the same team that did the last HIV Investment Case for Uganda
• Consultations: Participatory consultations with stakeholders
• Process: Modelling various intervention scenarios and projecting HIV outcomes to find the most optimal for the investment
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What will be the product?
The final product is a document which explains:
1. What are the results of the current investments?
2. How much should Uganda spend in the future and what will Uganda get?
3. What needs to be improved?
4. Where will the money come from?
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How will it be used?
1. To inform the HIV National Strategic Plan
2. To inform the Global Fund application
3. To support other financing dialogues
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Modeling to Support the Development of the NSP and
the Investment Case28 January 2020
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National HIV and AIDS Strategic Plan 2015/16 – 2019/20
Zero new HIV infections, zero HIV-related mortality, zero stigma
Prevention Care and treatmentSocial support and
protectionSystems
strengthening
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Modeling for the NSP
Inputs• Pop data• Surveys• Program data• Unit costs
Targets• Prevention• Tx cascade• Social enablers• Efficiencies
Model calculations• Need for services• Behaviors• Transmission• Progression• Mortality
Services provided • Intervention• Population group
Outputs• New infections• AIDS deaths• Cost• Cost-
effectiveness
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Constant Coverage
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030
New HIV Infections
Constant
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030
AIDS-Related Deaths
Constant
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Achieving global targets
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030
New HIV Infections
Constant Targets
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030
AIDS-Related Deaths
Constant Targets
Target scenario achieves UNAIDS updated Fast-Track targets. Stars represent 75%/90% reduction from 2010 to 2020/2030.
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Epidemic transition: Targets achieved
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
2010 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030
Incidence – Mortality Ratio
Ratio Target
0
0.01
0.02
0.03
0.04
0.05
0.06
0.07
0.08
0.09
2010 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030
Incidence – Prevalence Ratio
Ratio Target
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Importance of addressing social enablers
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030
New HIV Infections
Constant Targets No Social Enablers
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030
AIDS-Related Deaths
Constant Targets No Social Enablers
Social enablers: Programs to address stigma, gender-based violence, decriminalization, human rights
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Resources Needed
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Mill
ion
s
Base Targets
Funding gap
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Closing the funding gap: optimizing allocation and improving implementation efficiency
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
New HIV Infections
Optimized = Current spending optimized for maximum preventionImplementation efficiencies = Optimized plus implementation changes to reduce costs
Constant coverage
Constant expenditures (optimized)Implementation efficiencies
Targets achieved
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NSP Components
Prevention• Condoms• VMMC• PMTCT• PrEP• PEP• Combination
prevention for key populations
• Combination prevention for AGYW
• Services for priority populations
Treatment• HIV testing services• Linkage to care• ART delivery• Adherence support
Social enablers• Reduce stigma • Prevent gender-based
violence• Decriminalize behaviors
Social protection and support• Human rights• OVC
System strengthening• Governance• Financial sustainability• Human resources• Service delivery• Research