HIV/AIDs treatment – increased efforts needed to finance scale-upedit
Increasing domestic resources, innovative funding mechanisms and new efficiencies are needed to ensure confirmed scale-up in HIV treatment
Financing continued scale-up in HIV treatment: more money for years gained and more years gained for the money
Tuesday 22 – Thursday 24 February 2011 (WP1091)
Addressing one of the critical challenges facing the global community, this conference discussed the following issues:
- How can the tremendous success in gaining access to life saving antiretroviral therapy (ART) for over five million people in developing countries be maintained and expanded?
- How can more international and domestic resources be mobilised?
- What are the best ways to secure better value for money by improving the efficiency and quality of services, for the people who most need them?
Governments and other stakeholders in low and middle income countries are urged to continue to strive for greater self-reliance in their national AIDS response, and use external resources to support a transition away from external dependence. Some countries have achieved remarkable results, and more emphasis on sustainable financing models and mechanisms, embedded in legislation through the general budget; social health insurance; special funds and taxes; corporate contributions and individual payments from those who can afford them are needed.
External funders need to make greater efforts to support and leverage national financing, to focus explicitly on funding only evidence-based programmes and to support countries in driving programme efficiencies and quality, and ensuring that the most vulnerable and affected groups are inclusively engaged and have access to prevention, treatment, care and support services.
Greater quality and efficiencies in programmes are called for
These included: developing new, effective and simpler technologies for diagnosis, treatment and monitoring; further accelerating affordable access through collaborative partnerships and competition; and speeding up quality assurance, regulatory and licensing processes.
Priority areas for programming include: taking service delivery closer to, and involving, communities; scaling up integrated disease management approaches for HIV, TB, other chronic infections and non-communicable diseases, including reproductive, maternal, neonatal and child health; promoting use of standard treatment guidelines and regimens in national policy; encouraging greater take-up of HIV counselling and testing and earlier initiation of treatment; and investing further in ‘treatment as prevention’ approaches, and scaling up as appropriate. Last but by no means least, effective prevention – especially for key risk populations – continues to be essential.
The conference emphasised the tremendous achievement represented by the scale-up achieved over the last 10 years in access to treatment for HIV/AIDs, which was made possible through the combined efforts of diverse stakeholders: civil society and people living with HIV/AIDS, national and donor partner governments, private companies, the pharmaceutical industry, faith-based organisations, academia and many others.
Unprecedented levels of domestic and international resources have been mobilised. Through the pharmaceutical sector’s investment in innovation, and through generic competition and collaborative partnerships, the cost of first-line antiretroviral therapy has fallen from several thousand US dollars to under US $200 per person per year.
Accessible and affordable service delivery models are evolving
These are promoting the take-up of testing and early treatment and supporting high rates of adherence to treatment regimens. Over 30 countries have seen declines in overall HIV prevalence.
However, participants also recognised the enormous challenges in maintaining and increasing scale-up in access to treatment, calling for national efforts to be further stepped up in tandem with international mobilisation.
This conference was organised in partnership with The Global Health Group, UCSF and sponsored by Gilead Sciences.
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