06/06 e 2006 Report on the
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25 years of AIDS25 years of AIDS
9 In 1991-1993, HIV prevalence in young pregnant women in Uganda and in young men in Thailand begins to decrease, the first major downturns in the epidemic in developing countries
10 Highly Active Antiretroviral Treatment launched
11 Scientists develop the first treatment regimen to reduce mother-to-child transmission of HIV
12 UNAIDS is created13 Brazil becomes the first developing
country to provide antiretroviral therapy through its public health system
14 The UN General Assembly Special Session on HIV/AIDS. Global Fund to fight AIDS, Tuberculosis and Malaria launched
15 WHO and UNAIDS launch the "3 x 5" initiative with the goal of reaching 3 million people in developing world with ART by 2005
16 Global Coalition on Women and AIDS launched
40
30
20
10
0
50
35
25
15
5
45
Mill
ion
1980 1985 1990 1995 2000 2005
1 2 3 45 6
8
9
11
12
13
1415
16
7
10
1 First cases of unusual immune deficiency are identified among gay men in USA, and a new deadly disease noticed
2 Acquired Immune Deficiency Syndrome (AIDS) is defined for the first time
3 The Human Immune Deficiency Virus (HIV) is identified as the cause of AIDS
4 In Africa, a heterosexual AIDS epidemic is revealed
5 The first HIV antibody test becomes available6 Global Network of People living with HIV/AIDS
(GNP+) (then International Steering Committee of People Living with HIV/AIDS) founded
7 The World Health Organisation launches the Global Programme on AIDS
8 The first therapy for AIDS – zidovudine, or AZT -- is approved for use in the USA
People People living living with HIVwith HIV
Children Children orphaned orphaned by AIDS in by AIDS in sub-Saharan sub-Saharan AfricaAfrica
1.1
06/06 e 2006 Report on the
global AIDS epidemicFig
Adult (aged 15‒49 years) HIV prevalence (%) in countries in sub-Saharan Africa Adult (aged 15‒49 years) HIV prevalence (%) in countries in sub-Saharan Africa which have conducted population-based HIV surveys in recent yearswhich have conducted population-based HIV surveys in recent years
Median HIV prevalence (%) among women
attending antenatal clinics
2003‒2004*
Population-based survey prevalence (%)
(year)
2003 HIV prevalence
(%) reported in 2004 Report on the global
epidemic
Adjusted 2003 HIV
prevalence (%) in current
report
2005 HIV prevalence
(%) in current report
Trend in prevalence
Botswana Stable38.5 25.2 (2004) 38.0 24.0 24.1Burkina Faso Decline in urban areas2.5 1.8 (2003) 4.2 2.1 2.0Burundi Decline in capital city4.8 3.6 (2002) 6.0 3.3 3.3Cameroon Stable7.3† 5.5 (2004) 7.0 5.5 5.4Ethiopia Decline in urban areas8.5 1.6 (2005)§ 4.4 (1.0‒3.5) (0.9‒3.5)Ghana Stable3.1 2.2 (2003) 3.1 2.3 2.3Guinea Stable4.2 1.5 (2005) 2.8 1.6 1.5Lesotho Stable28.4 23.5 (2004) 29.3 23.7 23.2
Sierra Leone Stable3.0 1.5 (2005) - 1.6 1.6
Rwanda Decline in urban areas4.6 3.0 (2005) 5.1 3.8 3.1Senegal Stable1.9 0.7 (2005) 0.8 0.9 0.9
South Africa Increasing29.5 16.2 (2005) 20.9 18.6 18.8UR Tanzania Stable7.0 7.0 (2004) 9.0 6.6 6.5Uganda Stable6.2‡ 7.1 (2004‒5) 4.1 6.8 6.7
* WHO Africa (2005). HIV/AIDS epidemiological surveillance report for the WHO African region, 2005 Update. Harare† Estimate based on country report for 2002 (2003). Ministry of Public Health Cameroon. National HIV sentinel surveillance report 2002.‡ Estimate based on country report for 2002 (2003). Ministry of Health Uganda. STD/HIV/AIDS surveillance report. STD/AIDS control programme. Kampala§ Preliminary result. Additional analysis is ongoing.
2.1
06/06 e 2006 Report on the
global AIDS epidemicFig
Global HIV epidemic, 1990‒2005* HIV epidemic in sub-Saharan Africa, 1985‒2005*
Number of people living with HIV% HIV prevalence, adult (15-49)
% HIV prevalence, adult (15‒49)
Number of peopleliving with HIV (millions)
0
10
20
30
40
50
1990 1995 2000 20050.0
1.0
2.0
3.0
4.0
5.0
1985 1990 1995 2000 20050
5
10
15
20
25
30
0.0
2.5
5.0
7.5
12.5
15.0
% HIV prevalence, adult (15‒49)
Number of peopleliving with HIV (millions)
Estimated number of people living with HIV and adult HIV prevalenceEstimated number of people living with HIV and adult HIV prevalence
This bar indicates the range around the estimate
*Even though the HIV prevalence rates have stabilized in sub-Saharan Africa, the actual number of people infected continues to grow because of population growth. Applying the same prevalence rate to a growing population will result in increasing numbers of people living with HIV.
10.0
2.2
06/06 e 2006 Report on the
global AIDS epidemicFig
Regional HIV and AIDS statistics and features, 2003 and 2005Regional HIV and AIDS statistics and features, 2003 and 2005
2.7 million[2.3‒3.1 million]
64 000[38 000‒210 000
930 000[620 000‒2.4 million]
7200[3500‒55 000]
140 000[100 000‒420 000]
37 000[26 000‒54 000]
220 000[150 000‒650 000]
65 000[52 000‒98 000]
2.0 million[1.7‒2.3 million]
37 000[20 000‒62 000]
600 000[400 000‒850 000]
3400[1900‒5500]
59 000[47 000‒76 000]
27 000[19 000‒36 000]
53 000[36 000‒75 000]
30 000[24 000‒45 000]
24.5 million[21.6‒27.4 million]
440 000[250 000‒720 000]
8.3 million[5.7‒12.5 million]
78 000[48 000‒170 000]
1.6 million[1.2‒2.4 million]
330 000[240 000‒420 000]
1.5 million[1.0‒2.3 million]
2.0 million[1.4‒2.9 million]
23.5 million[20.8‒26.3 million]
380 000[220 000‒620 000]
7.6 million[5.2‒11.3 million]
66 000[41 000‒140 000]
1.4 million[1.1‒2.0 million]
310 000[230 000‒400 000]
1.1 million[790 000‒1.7 million]
1.8 million[1.3‒2.7 million]
2.6 million[2.3‒3.0 million]
54 000[31 000‒150 000
860 000[560 000‒2.3 million]
9000[4300-69 000]
130 000[95 000‒310 000]
34 000[24 000‒47 000]
160 000[110 000‒440 000]
65 000[52 000‒98 000]
6.1[5.4‒6.8]
0.2[0.1‒0.4]
0.4[0.3‒0.6]
0.3[0.2‒0.8]
0.5[0.4‒1.2]
1.6[1.1‒2.2]
0.8[0.6‒1.4]
0.5[0.4‒0.7]
6.2[5.5‒7.0]
0.2[0.1‒0.3]
0.4[0.2‒0.6]
0.3[0.2‒0.7]
0.5[0.4‒0.7]
1.5[1.1‒2.0]
0.6[0.4‒1.0]
0.5[0.3‒0.6]
1.9 million[1.7‒2.3 million]
34 000[18 000‒57 000]
500 000[340 000‒710 000]
2300[1300‒3600]
51 000[40 000‒67 000]
28 000[19 000‒38 000]
28 000[19 000‒39 000]
30 000[24 000‒45 000]
Sub-Saharan Africa
North Africa and Middle East
Asia
Oceania
Latin America
Caribbean
Eastern Europe and Central AsiaNorth America, Western and Central Europe
4.1 million[3.4‒6.2 million]
2.8 million[2.4‒3.3 million]
38.6 million[33.4‒46.0 million]
36.2 million[31.4‒42.9 million]
3.9 million[3.3‒5.8 million]
1.0[0.9‒1.2]
1.0[0.8‒1.2]
2.6 million[2.2‒3.1 million]
TOTAL
Adults (15+) and children living with HIV
2005 2003
Adults (15+) and children newly infected with HIV
Adult (15-49) prevalence (%)
2005 2003
Adult (15+) and child deaths due to AIDS
2005 2003 2005 2003
REGION
2.3
06/06 e 2006 Report on the
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A global view of HIV infectionA global view of HIV infection38.6 million people [33.4‒46.0 million] living with HIV, 2005
2.4
06/06 e 2006 Report on the
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HIV prevalence (%) in adults in Africa, 2005HIV prevalence (%) in adults in Africa, 2005
2.5
06/06 e 2006 Report on the
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Southern Africa
HIV prevalence (%) among pregnant women attending antenatal clinics HIV prevalence (%) among pregnant women attending antenatal clinics in sub-Saharan Africa, 1997/98‒2004in sub-Saharan Africa, 1997/98‒2004
West Africa
1997‒1998
1999‒2000
2001 2002 2003 20040
5
10
15
20
Med
ian
HIV
pre
vale
nce
(%)
Burkina Faso Côte d'Ivoire
GhanaSenegal
1997‒1998
1999‒2000
2001 2002 2003 20040
10
20
30
40
Med
ian
HIV
pre
vale
nce
(%) 50
MozambiqueSouth Africa
Swaziland
Zimbabwe
Note: Analysis restricted to consistent surveillance sites for all countries except South Africa (by province) and Swaziland (by region)
Sources: Ministry of Health (Mozambique); Department of Health (South Africa); Ministry of Health and Social Welfare (Swaziland); Ministry of Health and Child Welfare (Zimbabwe); Adapted from Asamoah-Odei, et al. HIV prevalence and trends in sub-Saharan Africa: no decline and large subregional differences. Lancet, 2004 (Ethiopia); Ministry of Health—National AIDS/STD Control Programme (Kenya); Ministry of Health (United Republic of Tanzania); Conseil national de lutte contre le sida et les IST (Burkina Faso); Centers for Disease Control and Prevention (CDC)—GAP—Côte d'Ivoire (Côte d'Ivoire); Ghana Health Service (Ghana); Conseil National de Lutte Contre le SIDA (Senegal).
1997‒1998
1999‒2000
2001 2002 2003 20040
5
10
15
20
Med
ian
HIV
pre
vale
nce
(%)
Eastern Africa
EthiopiaKenya
United Republic of Tanzania
2.6
06/06 e 2006 Report on the
global AIDS epidemicFig
HIV prevalence (%) by gender and urban/rural residence, HIV prevalence (%) by gender and urban/rural residence, selected sub-Saharan African countries, 2001‒2005selected sub-Saharan African countries, 2001‒2005
0
10
20
30
%
15‒49 years old,by gender
Lesotho South Africa
Zambia Kenya Uganda URTanzania
BurkinaFaso
Ghana Guinea Senegal
Urban Rural
Women Men
Women Men
0
10
20
30
%
15‒24 years old,by gender
0
10
20
30
%
15‒49 years old,by urban/rural residence
South East West
Sources: Demographic and Health Survey reports (Lesotho, Zambia, Kenya, Burkina Faso, Ghana, Guinea and Senegal) (2001–2005). Nelson Mandela Foundation (South Africa) (2005). Ministry of Health (Uganda). Tanzania Commission for AIDS (UR Tanzania) (2005). 2.7
06/06 e 2006 Report on the
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HIV prevalence (%) in adults in Asia and Oceania, 2005HIV prevalence (%) in adults in Asia and Oceania, 2005
2.8
06/06 e 2006 Report on the
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HIV prevalence (%) trends in India among injecting drug users HIV prevalence (%) trends in India among injecting drug users and pregnant women, selected areas, India, 1998–2004*and pregnant women, selected areas, India, 1998–2004*
AntenatalClinic attendees
Antenatalclinicattendees
Injectingdrugusers
1998 1999 2000 2001 2002 2003 2004
%
0.01.02.03.04.05.0
1998 1999 2000 2001 2002 2003 2004
%
0.00.30.60.91.21.5
1998 1999 2000 2001 2002 2003 2004
%
0.03.06.09.0
12.015.0
Andhra PradeshKarnatakaMaharashtraTamil Nadu
Madhya PradeshMizoramUttar PraheshWest Bengal
DelhiMizoramWest Bengal
2.9
*Data from consistent surveillance sites only.
06/06 e 2006 Report on the
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HIV prevalence trends among pregnant women in major cities HIV prevalence trends among pregnant women in major cities in Cambodia, Myanmar and Thailand, 1990–2004in Cambodia, Myanmar and Thailand, 1990–2004
Phnom Penh Mandalay and Yangon Bangkok
Sources: Cambodia National Center for HIV/AIDS, Dermatology and STDs (Phnom Penh); Myanmar Ministry of Health (Mandalay and Yangon); Thailand Ministry of Public Health (Bangkok), 2005.
19901999 2003
20040.0
1.0
2.0
3.0
4.0
5.0
19931994
19951996
19971998 2000
20012002
19911992
% HIV prevalence
2.10
06/06 e 2006 Report on the
global AIDS epidemicFig
HIV prevalence (%) trends among injecting drug users HIV prevalence (%) trends among injecting drug users in Bangladesh, Pakistan and the Philippines, 1998–2005*in Bangladesh, Pakistan and the Philippines, 1998–2005*
* Other sites in Bangladesh and Pakistan continue to show very low HIV prevalence in their latest surveillance surveys (0% in 13 sites in Bangladesh, and 0.5% in Lahore, Pakistan)
Pakistan [Karachi]
2003 20040%
10%
20%
30%
Bangladesh
1998–1999
1999–2000
2000–2001
2002 2003–2004
2004–2005
0%
2%
4%
6%
Northwest F1
Central A
Southeast D
Philippines [Cebu City]
2002 2003 2004 20050%
2%
4%
6%
0.0 0.0
Sources: 2005 Integrated HIV Behavioral and Serologic Surveillance Findings, Summary Report. National Epidemiology Center, Department of Health (Philippines); National HIV Serological Surveillance, 2004-2005, 6th Round Technical Report. Natonal AIDS/STD Programme, Ministry of Health and Family Welfare (Bangladesh); National Study of Reproductive Tract and Sexually Transmitted Infections, Survey of High Risk Groups in Lahore and Karachi, 2005. National AIDS Control Program, Ministry of Health (Pakistan) 2.11
06/06 e 2006 Report on the
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Increase in reported HIV cases in the Russian Federation Increase in reported HIV cases in the Russian Federation and Ukraine, 1987–2005and Ukraine, 1987–2005
1987 1989 1991 1993 1995 1997 1999 2001 2003 20050
50 000
100 000
150 000
200 000
250 000
300 000
350 000
400 000
30 000
45 000
60 000
75 000
90 000
105 000
120 000
15 000
0
Reported HIV cases in the Russian Federation
Reported HIV cases in Ukraine
Russian Federation
Newly reported cases
Cumulative (previous years)
Ukraine
Newly reported cases
Cumulative (previous years)
2.12Sources: Russian Federal AIDS Centre; Ukranian AIDS Centre and Ministry of Health of Ukraine
06/06 e 2006 Report on the
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HIV prevalence (%) in adults in Latin America and the Caribbean, 2005
2.13
06/06 e 2006 Report on the
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HIV prevalence (%) among female sex workers HIV prevalence (%) among female sex workers and men who have sex with men in Latin America, 1999–2002and men who have sex with men in Latin America, 1999–2002
Provinces (7 cities)
La Paz
Santa CruzBorder cities
with Argentina
Santiago
Bogotá
Argentina
Bolivia
Chile
Colombia
0.0
% HIV prevalence
0 5 10 15 20 25 30
Buenos Aires Quito
Guayaquil
Other city ports (4)
Asunción and 4 other cities
Lima
Provinces
Montevideo
Border citieswith Brazil
Isla Margarita
Ecuador
Paraguay
Peru
Uruguay
Venezuela 0.0
% HIV prevalence
0 5 10 15 20 25 30
Female sex workers Men who have sex with men
2.14Source: Montano SM et al., JAIDS (2005).
06/06 e 2006 Report on the
global AIDS epidemicFig
50% coverage (3 million people on treatment)
21 countries achieved this Global target not achieved
Percentage of people with advanced HIV infection receiving antiretroviral therapy****
9% (Country range: 1%‒59% coverage), (n=41)
Percentage of youth aged 15‒24 who correctly identify ways of preventing HIV transmission and who reject major misconceptions about HIV transmission**
US$ 7.0 billion‒US$ 10.0 billionGlobal target achieved
US$ 8 297 000 000Estimated range: US$ 7.5 billion‒US$ 8.5 billion
MALE: 33% (Country range: 7%‒50% coverage), (n=16)FEMALE: 20% (Country range: 8%‒44% coverage), (n=17)
Total annual expenditure*
Percentage of HIV-positive pregnant women receiving antiretroviral prophylaxis***
2005 Country progress towards 2001 Declaration of Commitment 2005 Country progress towards 2001 Declaration of Commitment on HIV/AIDS—Global targets (low- and middle-income countries)on HIV/AIDS—Global targets (low- and middle-income countries) [First of 2 slides]
90% coverage No country achieved this
80% coverage No country achieved this
20% (Country range: 1%‒100% coverage), (n=116) 1 300 000 people on treatment
GLOBAL RESULTS 2005 GLOBAL TARGETS 2005
* See ‘Financing’ chapter** Demographic and Health Survey/AIDS Indicator Survey, 2001‒2005 (MEASURE DHS, 2006)*** Stover et al. (2006)**** “3 by 5” Report (WHO/UNAIDS, 2006) 3.1a
06/06 e 2006 Report on the
global AIDS epidemicFig
2005 Country progress towards 2001 Declaration of Commitment 2005 Country progress towards 2001 Declaration of Commitment on HIV/AIDSon HIV/AIDS——Global targets (low- and middle-income countries)Global targets (low- and middle-income countries) [Last of 2 slides]
GLOBAL RESULTS 2005 GLOBAL TARGETS 2005
26% of infants born to HIV-infected mothers were also infected (n=33 most affected countries)In 2001, approximately 30% of infants were infected. There has been an estimated 10% reduction in HIV transmission between 2001 and 2005.
Estimated percentage of infants born to HIV-infected mothers who are infected in 2005******
20% reduction 11 of the most affected countries
achieved this
25% reduction in most affected countries
6 of the most affected countries achieved this
MALES: 1.4% (Measure of uncertainty: 1.1%‒1.8%), (n=54) FEMALES: 3.8% (Measure of uncertainty: 3.0%‒4.7%), (n=54)No comparable global data on this age cohort is available from 2001. Progress towards target can only be measured in individual countries.
Percentage of young males and females, aged 15‒24, who are HIV infected*****
***** UNAIDS/WHO 2005 Estimates for countries with generalized epidemics****** UNAIDS/WHO 2005 Estimates 3.1b
06/06 e 2006 Report on the
global AIDS epidemicFig
Access to mother-to-child prevention services (all pregnant
women)
Comparison of 2003 and 2005 data on the coverage Comparison of 2003 and 2005 data on the coverage of antiretroviral therapy, access to mother-to-child prevention services of antiretroviral therapy, access to mother-to-child prevention services
and coverage of HIV-infected mothers who received antiretroviral prophylaxis and coverage of HIV-infected mothers who received antiretroviral prophylaxis to prevent mother-to-child transmissionto prevent mother-to-child transmission
Coverage of antiretroviral therapy
7.0
20.0
0
5
10
15
20
25
2003 2005
%7.6
9.0
0
5
10
15
20
25
2003 2005
%
Coverage of HIV-infected mothers who received antiretroviral prophylaxis
3.3
9.2
0
5
10
15
20
25
2003 2005
%
Sources: WHO/UNAIDS (2006). Progress on global access to HIV antiretroviral therapy: a report on “3 by 5” and beyond; USAID et al. (2006). Coverage of selected services for HIV/AIDS prevention, care and support in low and middle income countries in 2003 and 2005. 3.2
06/06 e 2006 Report on the
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Coverage of HIV-infected mothers who received antiretroviral prophylaxis
Comparison of 2003 and 2005 data on the expansion of antiretroviral therapy Comparison of 2003 and 2005 data on the expansion of antiretroviral therapy and coverage of HIV-infected mothers who received antiretroviral prophylaxis and coverage of HIV-infected mothers who received antiretroviral prophylaxis
in three sub-Saharan African countriesin three sub-Saharan African countries
Coverage of antiretroviral therapy
30
40
50
60
%
20
10
0Kenya UgandaNamibia
1.07.0 4.6
9.3
25.0
12.0
30
40
50
60
%
20
10
0Kenya UgandaNamibia
3.00.0
6.3
19.7
35.0
56.0
2003 2005
3.3Sources: Individual country reports (2005).
06/06 e 2006 Report on the
global AIDS epidemicFig
Comprehensive knowledge about HIV and AIDS Comprehensive knowledge about HIV and AIDS among young males aged 15–24, by level of education, among young males aged 15–24, by level of education,
in 11 sub-Saharan African countries, 2000–2004in 11 sub-Saharan African countries, 2000–2004
Sources: Demographic and Health Surveys; HIV/AIDS Indicator Surveys (2000–2004).
01020304050607080
BurkinaFaso Cameroon
GhanaKenya
MaliMozambique
NamibiaNigeria
RwandaUganda
Zambia
%
No education Primary education Secondary education and beyond
3.4
06/06 e 2006 Report on the
global AIDS epidemicFig
Comprehensive knowledge about HIV and AIDS Comprehensive knowledge about HIV and AIDS among young females aged 15–24, by level of education, among young females aged 15–24, by level of education,
in 11 sub-Saharan African countries, 2000–2004in 11 sub-Saharan African countries, 2000–2004
Sources: Demographic and Health Surveys; HIV/AIDS Indicator Surveys (2000–2004).
01020304050607080
BurkinaFaso Cameroon
GhanaKenya
MaliMozambique
NamibiaNigeria
RwandaUganda
Zambia
%
No education Primary education Secondary education and beyond
:
3.5
06/06 e 2006 Report on the
global AIDS epidemicFig
Percentage of young people aged 15–24 reporting the use of a condom during Percentage of young people aged 15–24 reporting the use of a condom during sexual intercourse with a non-regular partnersexual intercourse with a non-regular partner, , Sub-Saharan Africa, 2001–2005Sub-Saharan Africa, 2001–2005
MaleFemale
Countries with date of survey indicated
1000 10 20 30 40 50 60 70 80 90
%
Benin 2001Botswana 2001
Burkina Faso 2003Cameroon 2004
Chad 2004Ghana 2003Guinea 2005Kenya 2003
Lesotho 2004Madagascar 2003
Malawi 2004Mali 2001
Mozambique 2003Nigeria 2003
Rwanda 2004Senegal 2005
United Republic of Tanzania 2003Uganda 2004Zambia 2003
Sources: Demographic Health Surveys; HIV/AIDS Indicator Surveys (2001-2005).3.6
06/06 e 2006 Report on the
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Median percentage of most-at-risk populations reached Median percentage of most-at-risk populations reached with prevention programmes and those who received HIV testing with prevention programmes and those who received HIV testing
in the last 12 months and who knew their resultsin the last 12 months and who knew their results
Sex workers Men who have sex with men Injecting drug users
0
10
20
30
40
50
Percentage who received HIV testing and who knew their results
Percentage reached with prevention programmes
%
42% (n=13)
19% (n=10)23% (n=10)
17% (n=10)
38% (n=9)
28% (n=10)
3.7
06/06 e 2006 Report on the
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Estimated total annual resources available for AIDS, 1996‒2005Estimated total annual resources available for AIDS, 1996‒2005
2921623
8297*
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
US$
mill
ion
Signing of Declaration of Commitment on HIV/AIDS
Data include:
• International donors, domestic spending (including public spending and out-of-pocket expenditures)
• International Foundations and Global Fund included from 2003 onwards, PEPFAR included from 2004 onwards
* Projections based on previous pledges and commitments (range of the estimation: US$7.5 to US$8.5 billion).
3.8
06/06 e 2006 Report on the
global AIDS epidemicFig
Per capita HIV and AIDS expenditures by country income level*Per capita HIV and AIDS expenditures by country income level*
0.0
0.5
1.0
1.5
2.0
2.5
2000 2001 2002 2003 2004 2005
US$ per capita
Low income
Lower middle
Higher middle
Low income SSA
• Trends based on a sample of 25 countries from sub-Saharan Africa and 57 countries from other regions
3.9
06/06 e 2006 Report on the
global AIDS epidemicFig
Progress towards achieving the “Three Ones”: Percentage of countries with Progress towards achieving the “Three Ones”: Percentage of countries with one national coordinating body, one national HIV/AIDS strategy or framework one national coordinating body, one national HIV/AIDS strategy or framework
and one national monitoring and evaluation planand one national monitoring and evaluation plan
50
9085
0
20
40
60
80
100
National body National framework National monitoringand evaluation plan
%
3.10
06/06 e 2006 Report on the
global AIDS epidemicFig
Impact of AIDS on life expectancy in five African countries, 1970–2010Impact of AIDS on life expectancy in five African countries, 1970–2010
Life expectancy at birth (years)
Source: United Nations Population Division (2004). World Population Prospects: The 2004 Revision, database.
Botswana
South Africa
Swaziland
Zambia
Zimbabwe
1970–1975 1975–1980
1980–19851985–1990
1990–19951995–2000
2000–20052005–2010
7065
60
55
50
45
4035
30
25
20
4.1
06/06 e 2006 Report on the
global AIDS epidemicFig
Percentage of distribution of deaths by age in southern Africa, Percentage of distribution of deaths by age in southern Africa, 1985–1990 and 2000–20051985–1990 and 2000–2005
0–4 5–19 20–29 30–39 40–49 50–59 60+
40
35
30
25
20
15
10
5
0
1985-1990 2000-2005
Percentage of total deaths
Age-groups:
Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat (2005). World Population Prospects: The 2004 Revision. Highlights. New York: United Nations. 4.2
06/06 e 2006 Report on the
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Wealth, poverty and HIV: Wealth, poverty and HIV: countries grouped by region and HIV prevalencecountries grouped by region and HIV prevalence
01020304050607080
over 20
%
10-205-101-5LatinAmerica
andCaribbean
Asia*AfricaAll (48)
% of population living on less that $1 per day
Relative income of richest 10% to poorest 10% *except Japan
Industrializedcountries
Countries with HIV prevalenceover 1.9% in 2002
Countries according to level ofHIV prevalence in 2001 (%)
Source: UN Population Division( 2005a). Most figures relate to 2002, or earlier.4.3
06/06 e 2006 Report on the
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Violations of reproductive rights—Violations of reproductive rights—women surveyed in four Asian countrieswomen surveyed in four Asian countries
India Indonesia Philippines Thailand Total
70
60
50
40
30
20
10
0
%
Mandatory HIV testing during pregnancy or due to illness of childCoerced into abortion due to HIV statusAdvised not to have a child since HIV-positive diagnosis
Source: Paxton S, et al. (2005) AIDS-related discrimination in Asia. 4.4
06/06 e 2006 Report on the
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TB notification rate in 20 African countries* versus HIV prevalence TB notification rate in 20 African countries* versus HIV prevalence in sub-Saharan Africa, 1990–2004in sub-Saharan Africa, 1990–2004
Sources: World Health Organization (2006), Global TB database; UNAIDS (2006)
• Consistently reporting each year: Algeria, Angola, Botswana, Cameroon, Comoros, Congo, Côte d'Ivoire, Democratic Republic of Congo, Ghana, Guinea, Kenya, Malawi, Mauritius, Mozambique, Nigeria, Senegal, South Africa, Uganda, United Republic of Tanzania, Zimbabwe
020406080
100120140160180200
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 20040
1
2
3
4
5
6
7
8
TB notification rate
TB notification rate per 100,000 population
% Adult HIV prevalence (15-49)
HIV prevalence
4.5
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Estimated impact of AIDS on under-five mortality rates 2002–2005, Estimated impact of AIDS on under-five mortality rates 2002–2005, selected countries in sub-Saharan Africaselected countries in sub-Saharan Africa
Without AIDS With AIDS
Sources: UNICEF (2005); United Nations Population Division, World Population Prospects: The 2004 Revision, database.
Deaths per 1,000 live births
117
173
143
74
78
123
118
106
78
142
73
43
43
71
98
42
0 20 40 60 80 100 120 140 160 180 200
Botswana
Kenya
Lesotho
Namibia
South Africa
Swaziland
Zambia
Zimbabwe
4.6
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Source: Roeland Monasch and J. Ties Boerma, Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries. AIDS 2004, 18 (suppl 2): S55-S65.
Impact of orphanhood on school attendance Impact of orphanhood on school attendance among 10–14-year-olds (%)among 10–14-year-olds (%)
West
(9 countries)Central
(6 countries)Eastern
(9 countries)Southern
(10 countries)All
(34 countries)
Percentage in school Non-orphans Orphans Double orphans
675857
756958
705449
888480
746964
Ratios Double vs. non-orphans Boys Girls
0.860.960.91
0.940.960.94
0.720.820.88
0.900.930.96
0.870.940.93
4.7
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Projected reduction in African agricultural labour force Projected reduction in African agricultural labour force due to HIV and AIDS by 2020due to HIV and AIDS by 2020
Sources: ILO (2004). HIV/AIDS and work: global estimates, impact and responses
Projected labor force loss (%) by year
NamibiaBotswanaZimbabwe
MozambiqueSouth Africa
KenyaMalawi
UgandaUR Tanzania
Central African RepublicCôte d’Ivoire
Cameroon
0 5 10 15 20 25 30
2020 2000
4.8
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Impact of three scenarios on HIV infection Impact of three scenarios on HIV infection in sub-Saharan Africa, 2003–2020in sub-Saharan Africa, 2003–2020
0.0
1.0
2.0
3.0
4.0
5.0
2003 2005 2010 2015 2020
Year
Treatment-centeredPrevention-centeredBaseline
Comprehensive response
Number of new HIV infections (millions)
Source: Salomon JA et al. (2005). Integrating HIV prevention and treatment: from slogans to impact6.1
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Impact of AIDS-related deaths in sub-Saharan Africa, 2003–2020Impact of AIDS-related deaths in sub-Saharan Africa, 2003–2020
2003 2005 2010 2015 2020
Year
Treatment-centeredPrevention-centeredBaseline
Comprehensive response
0.0
0.5
1.0
1.5
2.0
2.5
3.0
Number of AIDS- relateddeaths (millions)
Source: Salomon JA et al. (2005). Integrating HIV prevention and treatment: from slogans to impact6.2
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Number of people on antiretroviral therapy Number of people on antiretroviral therapy in low- and middle-income countries, 2002–2005in low- and middle-income countries, 2002–2005
North Africa and the Middle East
Europe and Central Asia
East, South and South-East Asia
Latin America and the Caribbean
Sub-Saharan Africa
Source: WHO/UNAIDS (2005). Progress on global access to HIV antiretroviral therapy: An update on “3 by 5.”
0
200
400
600
800
1000
1200
1400
End 2002
Mid-2003
End 2003
Mid-2004
End 2004
Mid-2005
End 2005
People receiving therapy (thousands)
7.1
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People in sub-Saharan Africa on antiretroviral treatment People in sub-Saharan Africa on antiretroviral treatment as percentage of those in need, 2002–2005as percentage of those in need, 2002–2005
20022003
2004
2005
7.2Source: WHO/UNAIDS (2005). Progress on global access to HIV antiretroviral therapy: An update on “3 by 5.”
06/06 e 2006 Report on the
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Percentage of people on treatment who are children, Percentage of people on treatment who are children, by country, 2005by country, 2005
Zambia
0% 2% 4% 6% 8% 10% 12% 14% 16%
AfricaAfrica [Median: 7%] UR Tanzania
UgandaCentral African Republic
South AfricaKenya
ZimbabweNamibiaRwanda
MozambiqueMalawi
Côte d'IvoireNigeriaGhana
Haiti
Latin America and CaribbeanLatin America and Caribbean [Median: 8%] Panama
HondurasArgentina
GuyanaBrazil
El SalvadorVenezuela
Peru
0% 2% 4% 6% 8% 10% 12% 14% 16%
0% 2% 4% 6% 8% 10% 12% 14% 16%
CambodiaViet Nam
IndiaChina
AsiaAsia [Median: 4%]
Source: WHO/UNAIDS (2005). Progress on global access to HIV antiretroviral therapy: An update on “3 by 5.”7.3
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Women as a percentage of all adults receiving antiretroviral therapy Women as a percentage of all adults receiving antiretroviral therapy in 30 countries: actual versus expected percentages, 2005in 30 countries: actual versus expected percentages, 2005aa
Latin America and CaribbeanLatin America and Caribbean
Guyana
ArgentinaBrazil
El Salvador
HaitiHonduras
PanamaPeru
Venezuela
0% 20% 40% 60% 80%
0% 20% 40% 60% 80%
CambodiaChinaIndia
Viet Nam
AsiaAsia
Sub-Saharan AfricaSub-Saharan Africa
Kenya
0% 20% 40% 60% 80%
MalawiMozambique
NamibiaNigeria
RwandaSouth AfricaUR Tanzania
UgandaZambia
Zimbabwe
Côte d'Ivoire Ethiopia
Ghana
BotswanaBurundi
Central African Republic
Expected percentage of women receiving ARV therapy
7.4Source: WHO/UNAIDS (2006). Progress on global access to HIV antiretroviral therapy. A report on “3 by 5” and beyond.
a The expected percentage of women receiving ARV therapy is based on the percentage of people living with HIV/AIDS who are women
06/06 e 2006 Report on the
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Country Coordinating Mechanisms (CCMs): Entities participating in preparation Country Coordinating Mechanisms (CCMs): Entities participating in preparation of Round Four proposals, 100% = all representatives of all 78 surveyed CCMsof Round Four proposals, 100% = all representatives of all 78 surveyed CCMs
Source: The Global Fund to Fight AIDS, Tuberculosis and Malaria
20% Government health ministry
19% Government other ministries
15% UN/Multilateral agencies
Religious/faith-based groups 5%
Private sector 7%People living with the disease 4%
Academic/educational 4% organizations
International NGOs 3%
Bilateral agencies 6%
NGO/community-based 17%organizations
Public sectorNon-public sector
9.1
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Sector of recipientsSector of recipients
25% Non-governmental andcommunity-based organizations
4% People living with HIV, Tuberculosis or Malaria
5% Academic institutions
5% Faith-based organizations5% Private sector
5% Other
51% Government
Source: The Global Fund to Fight AIDS, Tuberculosis and Malaria. Rounds 2‒4 only. Information not available for Round 1.9.2
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AIDS funding requirements for low- and middle-income countriesAIDS funding requirements for low- and middle-income countries
Prevention 8.4 10.0 11.4 29.8
Care and treatment 3.0 4.0 5.3 12.3
Support for orphans and vulnerable children 1.6 2.1 2.7 6.4
Programme costs 1.5 1.4 1.8 4.6
Human resources 0.4 0.6 0.9 1.9
TOTAL 14.9 22.1 55.118.1
2006 2007 2008 2006‒2008US$ billion
Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.10.1
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PREVENTION ACTIVITIES (US$ million) 2006 2007 2008 2006–08Mass media 91 100 109 299Community mobilization 449 608 772 1830Voluntary counselling and testing 451 569 690 1710
Youth in school 101 104 108 313Youth out of school 768 945 1126 2838
Programmes focused on sex workers and their clients 429 552 682 1663
Programmes focused on men who have sex with men 312 407 499 1218
Harm reduction programmes for injecting drug users 114 149 180 443Workplace 421 523 628 1573Prevention programmes for people living with HIV 22 33 48 103Special populations 151 252 252 654Condom social marketing 159 175 190 525Public and commercial sector condom provision 1381 1501 1625 4506
Improving management of sexually transmitted infections 672 718 764 2154
Prevention of mother-to-child transmission 206 264 324 794Blood safety 226 228 231 685Post-exposure prophylaxis (health care setting, rape) 1 2 2 5Safe medical injections 897 897 897 2690Universal precautions 1590 1944 2303 5838
TOTAL 8441 9969 11 430 29 840
Funding required for preventionFunding required for prevention
10.2Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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Distribution by region of the funding required for preventionDistribution by region of the funding required for prevention
Latin America/Caribbean: 9%Eastern Europe: 12%North Africa/Middle East: 3%
Africa: 29%
South/South-East Asia: 21%
East Asia/Pacific: 26%
Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.10.3
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Year People on ART (million)
ART coverage of urgent cases
Total Funding(US$ million)
2006 3.0 55% 2986
2007 4.8 67% 4029
2008 6.6 75% 5250
2009 8.3 79% -
2010 9.8 80% -
Funding required for treatment and care, Funding required for treatment and care, including antiretroviral therapy (ART), including antiretroviral therapy (ART),
in order to achieve the coverage targets shownin order to achieve the coverage targets shown
10.4Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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TREATMENT AND CARE ACTIVITIES (US$ million) 2006 2007 2008 2006–08
Palliative care 308 302 295 905
Provider initiated testing 66 79 109 254
Opportunistic infections treatment 686 703 707 2096
Opportunistic infections prophylaxis 287 403 510 1200
Antiretroviral therapy, including nutritional support 1642 2482 3624 7748
Laboratory testing 54 79 104 237
TOTAL 3043 4048 5349 12 440
Distribution by activity of the funding required Distribution by activity of the funding required for treatment and carefor treatment and care
10.5Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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Distribution by region of the funding required for treatment and careDistribution by region of the funding required for treatment and care
Latin America/Caribbean: 17%Eastern Europe: 7%North Africa/Middle East: 1%
Africa: 55%
South/South-East Asia: 4%East Asia/Pacific: 16%
Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.10.6
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ORPHAN-SUPPORT ACTIVITIES (US$ million) 2006 2007 2008 2006–08
Education 193 287 443 923
Health care and support 145 174 200 519
Family/home support 971 1255 1604 3830
Community support 14 18 25 57
Organization costs 246 322 422 990
TOTAL 3043 4048 5349 12 440
Funding required for activities supporting orphans Funding required for activities supporting orphans and vulnerable childrenand vulnerable children
10.7Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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PROGRAMME ACTIVITIES (US$ million) 2006 2007 2008 2006–08
Management 485 376 390 1251
Advocacy and communications 118 111 111 340
Monitoring and Evaluation 148 138 146 432
Operations Research 11 7 7 25
Training 72 136 231 439
Logistics and suppy, including transportation 305 259 304 868
Supervision of personnel and patient tracking 97 68 92 257
Drug resistance surveillance 69 68 68 205
Construction of new health centers 60 23 167 250
Laboratory and other infrastructure upgrading 121 185 236 542
PROGRAMME AND INFRASTRUCTURE COSTS 1486 1371 1753 4610
Funding required for programme support and infrastructureFunding required for programme support and infrastructure
10.8Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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(US$ million) 2006 2007 2008 2006–2008
Education 50 89 123 262
Nurses’ wage supplements 153 261 370 784
Doctors’ wage supplements 152 258 366 776
TOTAL 355 608 859 1822
Funding required for building human resource capacityFunding required for building human resource capacity
10.9Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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Sources of the estimated and projected funding Sources of the estimated and projected funding for the AIDS response from 2005 to 2007*for the AIDS response from 2005 to 2007*
* Assuming there are no new commitments
Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
Domestic
Bilateral
Multilateral
Private Sector
2005 2006 2007
US$ billion
0
2
4
6
8
10
12
10.10
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Sources of HIV spending in three countries, 2004Sources of HIV spending in three countries, 2004
US$ 1.87
HIV and AIDS spending per capita
US$ 0.59 US$ 0.28
World Bank loan 27%
All donors 14%
Public 86%
Public 9%
Global Fund9%
Bilateral 35%
World Bankcredit 32%
Multilateral(excluding GF) 15%
Bilateral32%
Public 36%
Global Fund 2%
Multilateral(excluding GF) 3%
India Russian FederationBurkina Faso
10.11Source: UNAIDS, based on National AIDS Spending Assessments.
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HIV spending by programmatic area in four countries, 2004HIV spending by programmatic area in four countries, 2004
Thailand
Senegal
Ethiopia
Burkina Faso
PreventionTreatment and careOrphans and vulnerable childrenProgram developmentOther
US$ 1.87
US$ 0.45
US$ 1.40
US$ 1.91
Total AIDS spending per capita
0 20 40 60 80 100%
10.12Source: UNAIDS, based on National AIDS Spending Assessments.
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DAC member’s Official Development Assistance DAC member’s Official Development Assistance in 2003 and 2004in 2003 and 2004
NorwayDenmark
LuxembourgSweden
NetherlandsPortugal
FranceSwitzerland
Belgium
IrelandUnited Kingdom
FinlandGermany
CanadaAustralia
Spain
New ZealandAustriaGreece
JapanUnited States
Italy0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.020 18 16 14 12 10 8 6 4 2 0
Averagecountryeffort, 0.42%
UN target, 0.70%
20042003
20032004
Source: Organisation for Economic Co-operation and Development (2005).
ODA (US$billion) current
ODA/GNI (%)
10.13
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DAC members’ Official Development Assistance DAC members’ Official Development Assistance committed to HIV in 2004committed to HIV in 2004
Source: UNAIDS, based on data from DAC members’ reports to OECD.
CanadaSweden
NetherlandsLuxembourg
DenmarkNorway
United KingdomBelgium
United States
FinlandGermany
IrelandAustralia
SwitzerlandNew Zealand
Spain
AustriaItaly
France
GreecePortugal
Japan 30.1
1171181476
1058
15731
2626
49660
1160
373843
7286
100103108
126167172
114445781012
202 208
50 100 150 200 250 300400 300 200 100 0120011001000 900 800 700 600 5001300
Aid for HIV (US$ million) Aid for HIV per million GNI
10.14
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DAC members’ bilateral commitments DAC members’ bilateral commitments to HIV-related programmes in 2004to HIV-related programmes in 2004
France 0.9%
United Kingdom 20.5%
United States 49.6%
Other DAC country members 13.1% Italy 0.5%
European Community 4.3% Canada 4.1%
Germany 3.5% Japan 3.4%
Total: US$ 2.7 billion
10.15Source: UNAIDS (2005). Resource needs for an expanded response to AIDS in low- and middle-income countries.
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UNAIDS Unified Budget compared to resources available UNAIDS Unified Budget compared to resources available for HIV in low- and middle-income countriesfor HIV in low- and middle-income countries
Total funding for AIDS
UNAIDS Unified Budget*
2003 2004 2005
US$ million
0
2000
4000
6000
8000
10 000
12 000
2006 2007
• UNAIDS Unified Budget includes core, supplemental and agency own resources. It does not include estimates of country-level spending by Cosponsors.
Source: UNAIDS (2005). UNAIDS Unified Budget and Workplan 2006-2007.10.16
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Commitments by foundations based in the United States Commitments by foundations based in the United States to domestic and global HIV projects, 2000–2003to domestic and global HIV projects, 2000–2003
Source: Funders Concerned About AIDS (2005).
US$ million
0
100
200
300
400
500
600
10.17
2000 2001 2002 2003
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Annual public sector investment in preventive HIV vaccine research and Annual public sector investment in preventive HIV vaccine research and development between 2000 and 2005 by regiondevelopment between 2000 and 2005 by region
US$ million
0
100
200
300
400
500
600
700
US Europe Other Public Sector Multilaterals
Source: HIV Vaccines and Microbicides Resource Tracking Working Group (2005). 10.18
2000 2001 2002 2003 20052004
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2000 2001 2002 2003 2004 2005
PUBLIC SECTORUnited States 34.6 61.3 75.3 78.8 92.0 99.3
Europe 0.7 0.4 5.1 10.6 29.9 37.8
Other 0.3 <0.1 0.2 0.9 2.0 5.0
Multilaterals <0.1 0.3 0.4 <0.1 0.2 0.2
Total public 35.7 62.0 81.0 90.2 124.2 142.3
PHILANTHROPIC SECTORTotal philanthropic 29.4 3.4 24.8 16.9 18.1 21.1
NON-COMMERCIAL (PUBLIC & PHILANTHROPIC)Total non-commercial 65.1 65.4 105.8 107.1 142.3 163.4
Annual public and philanthropic sector investment in microbicide research Annual public and philanthropic sector investment in microbicide research and development between 2000 and 2005 (US$ million)and development between 2000 and 2005 (US$ million)
10.19Source: HIV Vaccines and Microbicides Resource Tracking Working Group (2005).
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Stakeholder participation in development Stakeholder participation in development of national AIDS plans in 79 countries, 2004of national AIDS plans in 79 countries, 2004
full participationinsufficient but increasing participationinsufficient participation with no signs of improvementno participation
Source: (UNAIDS 2006) From advocacy to action: A progress report on UNAIDS at country-level, UNAIDS.
UN agenciesCivil society/NGOs
People living with HIVDonors
Line ministriesMedia
District and local authoritiesFaith-based organizations
Private sectorWomen’s groups
0% 20% 40% 60% 80% 100%
11.1
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Sites Involved with Collaborative Fund Sites Involved with Collaborative Fund for HIV Treatment Preparedness, March 2006for HIV Treatment Preparedness, March 2006
Sources: The International Treatment Preparedness Coalition (2006); TIDES Foundation (2006)11.2
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Trends in HIV and AIDS per-capita expenditures in current US$, Trends in HIV and AIDS per-capita expenditures in current US$, selected sub-Saharan countriesselected sub-Saharan countries
0.22
0.65
0.31
0.15
0.49
0.0
0.10.2
0.3
0.4
0.50.6
0.7
0.80.9
1.0
2001 2002 2003 2004 2005
HIV per capita spending (US$)
Sources: Countries reporting on UNGASS on domestic public expenditure; UNAIDS estimates11.3
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Countries using the Country Response Information System Countries using the Country Response Information System (92 countries as of January 2006)(92 countries as of January 2006)
Sources: Countries reporting on UNGASS; UNAIDS (Country Coordinator Reports and Monitoring and Evaluation Officers’ personal communications) 11.4