Learning Group 3 Expanding Access to Services and Protecting Human Rights CoChairs Lydia Mungherera

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Learning Group 3Expanding Access to Services
and Protecting Human RightsCo-ChairsLydia
MunghereraJim Yong KimMembersFlorence
Baingana, Rose Gahire, Andrew Kiboneka, Joan
Lombardi, Richard Marlink, Martha Mukaminega,
Paulo Teixeira, Barbara Sebalu-Sematimba, David
Serukka
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Global HIV prevalence
There are more than 500,000 newly infected
children each year.
There are 2.3 million HIV-infected
children worldwide.
Only 15 of the 780,000 children in need received
ART in 2006.
Only 4 received cotrimoxazole prophylaxis.
15.2 million children have lost parents to AIDS.
Source Worldmapper.com, 2007
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Status PMTCT coverage
In one clinic studied in Zambia, of 2257 infants
at risk. .675 received one dose of nevirapine
at birth.
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Successful PMTCT delivery integration

• Prevention
• HIV prevention services
• Access to family planning

• Diagnosis and Social Support
• Universal counseling testing
• Excellent prenatal care
• Screening for STDs, TB, malaria
• Nutritional social support

Seamless integration with family-centered HIV
services, education and social protection for
vulnerable children in the context of the HIV
epidemic

• Treatment Pre-natal
• HAART for eligible women
• Combination ART regimens
• Community health workers

• Treatment Perinatal
• Access to skilled labor delivery services
• Nevirapine-containing combination regimens

• Treatment Postnatal
• Continuation of HAART for eligible or
  breastfeeding mothers
• ART for infant
• Optimal feeding strategies

• Ongoing management
• Cotrimoxazole prophylaxis
• Continued access to quality health care
• Social and nutritional support
• Universal infant HIV testing

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Implementation bottleneck

• Vaccines
• Primary Health Care
• Drug Therapies
• Maternal and ChildHealth Care
• Basic Surgery

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Bill and Melinda Gates Foundation 6.5 BThe
Global Fund 8.6 BPresidents Emergency Plan
for AIDS 15 BInternational Finance Facility 4
BMulti-Country HIV/AIDS Program 1.1 BGlobal
Alliance 3 BPublic-private partnerships 1.2
BAnti-Malaria Initiative in Africa (proposed)
1.2 BUnited Nations Fund 360 M TOTAL 40.7 B
Funds pledged, committed, or spent. Overlap
exists between organizations (e.g., PEPFAR money
supports the Global Fund). Adapted from Jon
Cohen, The new world of global health. Science
2006311(5758)162-167.
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Implementation bottleneck

• Vaccines
• Primary Health Care
• Drug therapies
• Maternal Child Health Care
• Basic Surgery
• Gates Foundation develops
• Microbicides and other preventive tools
• New malaria and TB drugs, diagnostics
• New combination therapies
• Drugs for neglected diseases
• gt10 new vaccines