STEPPING UP THE RESPONSE

Roxana Rogers

Acting, Deputy Office of HIV/AIDS

Bureau for Global Health

U.S. Agency for International Development

Evolution of the Expanded Response

• LIFE Initiative (2000) – 14 countries and 1 regional program

• Expanded Response (2001) – 17 priority countries and 3 regional programs

• Stepping up the Response (2002)– 23 priority countries and 8 regional programs

Targets for 2007, in concert with other donors:Targets for 2007, in concert with other donors:

• Reduce HIV prevalence by 50% in 15-24 yo’s in Reduce HIV prevalence by 50% in 15-24 yo’s in high prevalence countrieshigh prevalence countries• Maintain HIV prevalence <1% in 15-49 yo’s in low Maintain HIV prevalence <1% in 15-49 yo’s in low prevalence countriesprevalence countries• Care to 25% of HIV +& basic services to 25% Care to 25% of HIV +& basic services to 25% OVCOVC• MTCT services to 25% HIV + womenMTCT services to 25% HIV + women

Expanded Response: Key Elements

Expanded Response: Key Elements

• Resources focused • M&E strengthened• Technical areas:

– Prevention– Care & Treatment– OVC– MTCT– Capacity building– Multisectoral (as outlined in Child Survival Guidance)

Stepping up the Response:New Elements

1.1. Focus resources on more priority Focus resources on more priority countries.countries.

Rapid Scale-Up Countries

• Four countries

• Increased budget and support to achieve measurable impact within 1-2 years

• Ensure that at least 80% of population receives a comprehensive package of prevention & care services within 3-5 years

More Priority Countries (Rapid Scale Up)

• Cambodia

• Kenya

• Uganda

• Zambia

Intensive Focus Countries

• 19 countries

• Increased budget and support to achieve measurable impact within 3-5 years

• Achieve exapanded response targets by 2007

More Priority Countries (Intensive focus)

• AFRICA (10): Ethiopia, Ghana, Malawi, Mozambique, Nigeria, Rwanda, Senegal, South Africa, Tanzania, Zimbabwe

• LAC (4): Brazil, DR, Haiti, Honduras

• ANE (3): India, Indonesia, Nepal

• E&E (2): Russia, Ukraine

Maintain Support for Non Priority Countries (Basic)

• Countries in every region– 8 in Africa– 4 in Asia– 8 in Latin America– in E&E

Stepping up the War:New Elements

1. Focus resources on more priority countries.

2. Strengthen regional offices.2. Strengthen regional offices.

Strengthen Regional Programs

• The regional offices will: – analyze the epidemic regionally;– assist basic and priority co’s develop sound

programs; – develop regional programs; – partner with other donors and help

countries develop proposals; and– support non-presence countries as needed.

Stepping up the War:New Elements

1. Focus resources on more priority countries.

2. Strengthen regional offices.

3. Provide support for basic 3. Provide support for basic countries.countries.

Basic Countries

• in basic countries, we maintain: – technical assistance – training – commodity support, and– M & E.

More Money to the Field• Resources for field: Increase

– FY 2001 $192 million (61%)

– FY 2003 $389 million (78%)

• Resources for AID/W: Decline

– FY 2001 $71 million (23%)

– FY 2003 $68 million (14%)

USAID CSH/HIV Funding by Region FY 02

AFR52%

ANE15%

AID/W18%

CONDOM & COMMODITY FUND

8%

LAC7%

AFR

ANE

E & E

LAC

AID/W

CONDOM FUND

Stepping up the War:New Elements

1. Focus resources on more priority countries.

2. Strengthen regional offices.

3. Provide support for basic countries.

4. Increase staff where 4. Increase staff where needed.needed.

Increase Staff

• New Foreign Service Officers

• New HIVAdvisors

• More TCNs

• More FSNs

Stepping up the War:New Elements

1. Focus resources on more priority countries.

2. Strengthen regional offices.

3. Provide support for basic countries.

4. Increase staff rapidly where needed.

5. Strengthen management and 5. Strengthen management and trackingtracking..

Strengthen Management

• Implementation guidelines

• Technical review for new strategies

• Biannual review for all priority programs

• Better M&E

Stepping up the War:New Elements

1. Focus resources on more priority countries.

2. Strengthen regional offices. 3. Provide support for basic countries. 4. Increase staff rapidly where needed.5. Strengthen management and tracking.

6.6. Establish a central Condom & Establish a central Condom & Commodity Fund for HIV/AIDSCommodity Fund for HIV/AIDS

Stepping up the War:New Elements

1. Focus resources on more priority countries.

2. Strengthen regional offices. 3. Provide support for basic countries. 4. Increase staff rapidly where needed.5. Strengthen management and tracking.

6.6. Establish a central Condom & Establish a central Condom & Commodity Fund for HIV/AIDSCommodity Fund for HIV/AIDS