debbi birx, md pepfar/cdc workshop - mini room 7
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Getting to Six Million. PEPFAR Track 1.0 Treatment Partners & Shared Vision for Sustainability. Debbi Birx, MD PEPFAR/CDC WORKSHOP - Mini Room 7. Center for Global Health. Division of Global HIV/AIDS. 1. - PowerPoint PPT PresentationTRANSCRIPT
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Debbi Birx, MDPEPFAR/CDC
WORKSHOP - Mini Room 7
Center for Global Health
Division of Global HIV/AIDS
Getting to Six MillionPEPFAR Track 1.0 Treatment Partners
& Shared Vision for Sustainability
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1Focus on sustainability from day 1: local FBO and pubic sector partnerships with international partners
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CDC/DGHA FY 11 Funding – All SourcesMajority of funding invested in Cooperative Agreements
Cooperative Agreements
$1,284,453,152 82%
Contracts $74,955,081
5%
Technical Personnel and
all Management &Operations $204,451,274
13%
CDC Extramural & IntramuralInvestments in FY 2011
Benefits of investing in CoAgs
• Allows CDC technical experts maximum engagement & partner oversight
• Facilitates side-by-side planning and implementation, allowing for mentoring & transference of skill
• CDC experts ensure programs are of highest quality while preserving local ownership
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Investment Strategy by Partner TypeCDC/DGHA FY11 Budget
Faith-Based Organization
(FBO)/ International,
$8,708,501
Local Indigenous Faith-Based Organization
(FBO), $84,062,166
Ministry of Health (MOH), $287,720,833
Local Indigenous
Non-Governmental Organization
(NGO), $243,402,610
Local Indigenous University, $81,627,269
Multi-Lateral, $13,463,503
NGO/ International-
U.S. Based, $260,235,760
University/ International-
U.S. Based, $305,232,510 Financial Investments Reflect
DGHA Priorities
DGHA builds local capacity by investing in Ministries and indigenous partners
DGHA promotes science & innovation by investing in universities
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Scale-up of investments in MOH must be deliberate and strategic
For the past 20 years CDC has had the sole USG/MoH agreements in Sub-Saharan Africa
We have built agreements carefully and strategically over time – scaling-up slowly and pairing funding with extensive technical support to ministries
Many CDC offices are co-located with MOH to facilitate mentoring and the transference of skills
Standing up these funding mechanisms is initially very resource intensive – both at HQ and in the field – but ultimately cost effective and sustainable
Stepwise Approach to Building MOH Capacity The cornerstone to realizing country ownership
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2004 2005 2006 2007 2008 2009 2010 20110
50
100
150
200
250
300
International Indigenous
Number of CDC Cooperative Agree-ments in PEPFAR Focus Countries
(FY04-FY11)
Investing through Cooperative AgreementsCDC is scaling up the number of CoAgs with indigenous partners
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2004 2005 2006 2007 2008 2009 2010 2011$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,000
$700,000,000
$800,000,000
Indigenous International
CDC Program Funds through Cooperative Agreements with Local PartnersFY 2004 – FY 2011
In 2011, CDC invested more resources in
local/indigenous organizations than
international
Investing through Cooperative AgreementsCDC is investing more resources in CoAgs with indigenous partners
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2Saving lives together: Implementing OGAC’s vision for PEPFAR
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1980-1985
1985-1990
1990-1995
1995-2000
2000-2005
2005-2010
35
40
45
50
55
60
65
70
BotswanaSouth AfricaSwazilandZambiaZimbabwe
PEPFAR2004-present
Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm For definition of variables, check the link Glossary of Demographic Terms Saturday, May 05, 2012; 11:17:16 AM
Life Expectancy at Birth in Selected Countries Affected by HIV/AIDS
Dramatic impact of HIV on life expectancyImpact of HIV on 5 High-Burden Countries – Model Updated in 2010
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New UNAIDS Global Report : Together We Will End AIDS
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The end is in sight: Maintaining momentum is critical
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Current ART Coverage at CD4 of 350
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3Saving lives and changing the face of the epidemic : commitment of providers and patients
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Incremental Progress : Saving Lives and Changing the Epidemic
2003 2004 2005 2006 2007 2008 2009 2010 20112,200,0002,300,0002,400,0002,500,0002,600,0002,700,0002,800,0002,900,0003,000,0003,100,000
01,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,000
New HIV Infections and Number of People on ART, 2003-2011
# of New HIV Infections (Global)# of People on ART (Low and Middle Income Countries)
# of
New
HIV
Infe
ction
s
# of
Peo
ple
on A
RT
UNAIDS Global Report 2012
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4Towards virtual elimination of new HIV infections in children: PMTCT
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New Pediatric Infections from MTCT
2009 20110
10000
20000
30000
40000
50000
60000
70000
80000Nigeria
South Africa
NigeriaSouth AfricaMozambiqueTanzaniaUgandaMalawiKenyaEthiopiaZimbabweZambiaCameroonAngolaChadCote d'IvoireLesothoGhanaBurundiSwazilandNamibia
Source: UNAIDS. Together We will End AIDS, 2012.
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New Pediatric Infections from MTCTAmong Sub-Set of Countries with High Contribution to Global Burden
2009 20110
5000
10000
15000
20000
25000
30000
MozambiqueTanzaniaUgandaMalawiKenyaEthiopiaZimbabweZambiaCameroon
Source: UNAIDS. Together We will End AIDS, 2012.
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Aggressively pursuing the virtual elimination of pediatric AIDS
UNAIDS Global Report 2012
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5The end of AIDS is in sight, and our success will depend on our mutual commitment
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Programs are People
• Financial resources are important but the key to the progress to date has been the commitment of each person on the ground
• Importance of local innovation and focus on the sustainability and impact from day one
• Shared commitment to transition and quality with embedded monitoring and evaluation