the role of the hiv

1. The Role of the HIV/AIDS Bureau in Support of the President’s Emergency Plan for AIDS Relief

2. Presentation Outline Provide a background of the HIV Pandemic and the Emergency Plan Explain HRSA’s background in providing HIV/AIDS Services Explain the different international HIV/AIDS programs administrated by HRSA Summarize outcomes and accomplishments

3. Background There are now over 44 million people infected with HIV/AIDS worldwide Over 90% live in sub-Saharan Africa, the Caribbean and Southeast Asia In response, the President’s Emergency Plan for AIDS Relief (PEPFAR) made an unprecedented commitment of resources ($15 Billion over a 5 year period) to the prevention, care and treatment of people with HIV/AIDS globally. You may be well aware of the global statistics on HIV but would like to share with you so we can be on the same page.You may be well aware of the global statistics on HIV but would like to share with you so we can be on the same page.

4. Adults and children estimated to be living with HIV, 2005 Map showing the distribution of HIV/AIDS globally. Sub-Saharan Africa has the vast majority, followed by South and Southeast Asia. This is because health care services in these regions are dilapidated/lack capacity.Map showing the distribution of HIV/AIDS globally. Sub-Saharan Africa has the vast majority, followed by South and Southeast Asia. This is because health care services in these regions are dilapidated/lack capacity.

5. US Commitment President George W. Bush announced the Emergency Plan in his 2003 State of the Union address At the inception of the Emergency Plan, the U.S. developed a five-year strategy that devoted $15 billion to programs in the following way: $10 billion for the 15 focus countries; $4 billion for other Emergency Plan countries and for additional activities including HIV/AIDS research; $1 billion over five years for the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The U.S. is on track to meet this commitment and has already exceeded its contribution to the Global Fund.

6. The Goal of Emergency Plan The goal of the Emergency Plan is to: Treat 2 million HIV infected people Prevent 7 million infections Provide care to 10 million people infected and affected by HIV/AIDS 15 Focus Countries: Botswana, Cote d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, Zambia However, current capacity of existing health care systems within focus countries delivering vital services is limited. This is where you come in.This is where you come in.

7. Emergency Plan To help in achieving the Emergency Plan’s goals, the President wanted to bring as many resources to bear, including HRSA And especially the experience and lessons learned from RWCA Grantees Before this, from the U.S. Government, it was primarily CDC and USAID. HRSA was chosen to bring in domestic grantees’ experience and lessons learned.Before this, from the U.S. Government, it was primarily CDC and USAID. HRSA was chosen to bring in domestic grantees’ experience and lessons learned.

8. Applying HAB’s Experience Globally 35 years of experience partnering with Community Based Organizations and governments to build a primary care infrastructure. 10+ years of experience in designing, implementing and managing systems of care for PLWHA and their families; Our involvement in caring for PLWHA started early, when there was no infrastructure, and no medications. We are able to share our experiences, including our lessons learned. Or, perhaps I should rephrase: YOUR experiences and YOUR lessons learnedOr, perhaps I should rephrase: YOUR experiences and YOUR lessons learned

9. HRSA’s Primary Areas of Assistance Track I Anti Retroviral Therapy Capacity Building Training Infrastructure Health Management and Information Systems (HMIS) Quality Improvement (QI) Sustainability

10. Programs Track I ART (Anti-Retroviral Therapy) HMIS US-Caribbean Twinning Program QI IAETC (International AIDS Education and Training Center) Twinning Center Nursing Initiative

11. The Emergency Plan Process USG Teams in-country typically include: CDC, USAID, State Department, Department of Defense, Peace Corps, FDA All HRSA activities under the Emergency Plan are approved in collaboration with U.S. Government teams in-country through their annual Plans

12. Outcomes In the US, some prevention activities are taken for granted: Specifically, Injection & Blood safety. Not so in other countries.In the US, some prevention activities are taken for granted: Specifically, Injection & Blood safety. Not so in other countries.

13. USG Contributions

14. Prevention: Progress Achieved By the Emergency Plan as of September 30, 2005 Supported counseling and testing for over 9.4 million people Supported community outreach activities to over 42 million people to prevent sexual transmission Supported PMTCT for over 1.9 million women ARV prophylaxis for 248,100 women Prevented 47,100 infant HIV infections for 2004-2005 Supported training and retraining for over 316,000 people in provision of prevention services Supported 3,100 service sites for PMTCT and blood safety

15. Care & Treatment SummaryProgress Achieved through September 30, 2005 Supported ART for approximately 401,000 people in the 15 focus countries Supported approximately 800 ART sites Approximately 7% of those receiving ART were children & 60% were women Care for over 1.2 million orphans and vulnerable children Care for over 1.7 million people living with HIV/AIDS, including over 368,000 who received care and treatment for tuberculosis

16. Emergency Plan Challenges USG “buy-in” CDC, USAID, State Dept., Dept. of Defense, others Meeting the Emergency Plan goals Each country has specific targets Country Operational Plan Review Ceilings for partners’ funding levels Developing indicators for each activity Many federal agencies at the same table, possibly for the first time in history. Populations at risk are distributed differently. Each country has a unique cultural and social context that must be tailored to for affective interventions. Indictor development: more than identifying the number of people trained. The annual and semi annual reports go into much more detail. Many of these challenges have been experienced by you and your organizations domestically. Your lessons learned can clearly provide insight into these and other challenges.Many federal agencies at the same table, possibly for the first time in history. Populations at risk are distributed differently. Each country has a unique cultural and social context that must be tailored to for affective interventions. Indictor development: more than identifying the number of people trained. The annual and semi annual reports go into much more detail. Many of these challenges have been experienced by you and your organizations domestically. Your lessons learned can clearly provide insight into these and other challenges.

17. For more informationhttp://www.hab.hrsa.gov Any Questions?Any Questions?