Global Response to HIV/AIDSNigerian Nurses Association of USA

June 30, 2006

Carolyn M Hall, MSN/MPH, ACRNGlobal HIV/AIDS ProgramU.S. Department of Health and Human Services Health Resources and Services AdministrationHIV/AID Bureau

Global summary of the HIV and AIDS epidemic December 2005

Number of people livingwith HIV in 2005

Total 40.3 million (36.7– 45.3 million)Adults 38.0 million (34.5 – 42.6 million)Women 17.5 million (16.2 – 19.3 million)Children under 15 years 2.3 million (2.1 – 2.8 million)

People newly infectedwith HIV in 2005

Total 4.9 million (4.3 – 6.6 million)Adults 4.2 million (3.6 – 5.8 million)Children under 15 years 700,000 (630,000 – 820 000)

AIDS deaths in 2005Total 3.1 million (2.8 – 3.6 million)Adults 2.6 million (2.3 – 2.9 million)Children under 15 years 570,000 (510,000 – 670,000)

AIDS Epidemic Update: December 2005, UNAIDS, WHO http://www.who.int/hiv/epi-update2005_en.pdf

Regional HIV and AIDS statistics and features, end of 2005

3.1 million [2.8 – 3.6 million]

3600[1700 – 8200]

18 000[9 000 – 30 000]

12 000 [ <15 000]

62 000[39 000 – 91 000]

24 000[16 000 – 40 000]

66 000[52 000 – 86 000]

41 000[20 000 – 68 000]

480 000[290 000 – 740 000]

58 000[25 000 – 145 000]

2.4 million[2.1 – 2.7 million]

1.1 % [1.0 - 1.3%]

0.5 [0.2 - 0.7]

0.7 [0.4 – 1.1]

0.3 [0.2 – 0.4]

0.9 [0.6 – 1.3]

1.6 [1.1 – 2.7]

0.6 [0.5 – 0.8]

0.1 [0.05 – 0.2]

0.7 [0.4 – 1.0]

0.2 [0.1 – 0.7]

7.2 [6.6 – 8.0]

4.9 million [4.3 – 6.6 million]

8 200[2 400 – 25 000]

43 000[15 000 – 120 000]

22 000[15 000 – 39 000]

270 000[140 000 – 610 000]

30 000[17 000 – 71 000]

200 000[130 000 – 360 000]

140 000[42 000 – 390 000]

990 000[480 000 – 2.4 million]

67 000[35 000 – 200 000]

3.2 million[2.8 – 3.9 million]

40.3 million [36.7 – 45.3 million]

74 000[45 000 – 120 000]

1.2 million[650 000 – 1.8 million]

720 000[570 000 – 890 000]

1.6 million [990 000 – 2.3 million]

300 000[200 000 – 510 000]

1.8 million [1.4 – 2.4 million]

870 000[440 000 – 1.4 million]

7.4 million[4.5 – 11.0 million]

510 000[230 000 – 1.4 million]

25.8 million[23.8 – 28.9 million]

TOTAL

Oceania

North America

Western & Central Europe

Eastern Europe & Central Asia

Caribbean

Latin America

East Asia

South and South-East Asia

North Africa & Middle East

Sub-Saharan Africa

Adult & child deaths due to AIDS

Adult prevalence

[%] *

Adults & children newly infected

with HIV

Adults & children living with HIV

Adults and children estimated to be living Adults and children estimated to be living

with HIV as of end 2005with HIV as of end 2005

Total: 40.3 (36.7 – 45.3) million

Western & Central Europe

720 000720 000[570 000 – 890 000][570 000 – 890 000]

North Africa & Middle East510 000510 000

[230 000 – 1.4 million][230 000 – 1.4 million]

Sub-Saharan Africa25.8 million25.8 million

[23.8 – 28.9 million][23.8 – 28.9 million]

Eastern Europe & Central Asia1.6 million 1.6 million

[990 000 – 2.3 million][990 000 – 2.3 million]

South & South-East Asia7.4 million7.4 million[4.5 – 11.0 million][4.5 – 11.0 million]

Oceania74 00074 000

[45 000 – 120 000][45 000 – 120 000]

North America1.2 million1.2 million

[650 000 – 1.8 million][650 000 – 1.8 million]

Caribbean300 000300 000

[200 000 – 510 000][200 000 – 510 000]

Latin America1.8 million1.8 million

[1.4 – 2.4 million][1.4 – 2.4 million]

East Asia870 000870 000

[440 000 – 1.4 million][440 000 – 1.4 million]

Antiretroviral therapy coverage in low- and middle-income countries,

December 2005Geographical Region Number of people receiving ARV therapy

Estimated need

Coverage

     (low estimate – high estimate)

   

Sub-Saharan Africa 810 000 (730 000 –

890 000)4 700 000 17%

Latin America and the Caribbean

315 000 (295 000 –

335 000)465 000 68%

East, South and South-East Asia

180 000(150 000 –

210 000)1 100 000 16%

Europe and Central Asia

21 000 (20 000 –

22 000)160 000 13%

North Africa and the Middle East

4 000(3 000 –

5 000)75 000 5%

Total 1 330 000(1 200 000 –

1 460 000)6.5 million 20%

Number of people receiving ARV therapy in low and middle

income countries, 2002—2005

end2002

mid-2003

end2003

mid-2004

end2004

mid-2005

end2005

0

100

200

300

400

500

600

700

800

900

1 000

1 100

1 200

1 300

1 400

Pe

op

le r

ec

eiv

ing

AR

V t

he

rap

y (

in t

ho

us

an

ds

)

North Africa and the Middle East

Europe and Central Asia

East, South and South-East Asia

Latin America and the Caribbean

Sub-Saharan Africa

Percentage of people on antiretroviral therapy among

those in need, December 2005

Percentage of people in sub-Saharan Africa on antiretroviral therapy among those in need

Percentage of women among all adults receiving antiretroviral

therapy, 2005

Global HIV/AIDS spending in millions of US dollars, 1996—

2004

0

1 000

2 000

3 000

4 000

5 000

6 000

7 000

Mil

lio

ns o

f U

S d

oll

ars

1996 2000 2001 2002 2003 2004

Year

Domestic

Private

Multilateral

Bilateral

International HIV/AIDS Funders

• World Health Organization (WHO)

• United Nations (UNAIDS)

• Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria

• President’s Emergency Plan for AIDS Relief (Emergency Plan)

• Department for International Development (DFID)

• The Gates Foundation

The President’s Emergency Plan for AIDS Relief

• Goals:

– Treat 2 million HIV-infected people

– Prevent 7 million new infections

– Care for 10 million HIV-infected individuals and AIDS orphans

The President’s Emergency Plan for AIDS Relief

• $15 billion in 5 years

• 15 focus countries:– Africa (12)– Caribbean (2)– Asia (1)

• 30+ other countries

US Government Partners• HRSA• CDC• USAID• DoS (OGAC,

Embassies)• Peace Corps• US Census Bureau• DoD

HRSA/HAB Ryan White CARE Act

• Work in partnership with US (Domestic) Federal, State and local government organizations as the largest provider of HIV/AIDS health care, training and technical assistance in the world.

• Provide grants to thousands of community, faith-based & non-governmental organizations.

• Support and develop culturally appropriate HIV/AIDS health care services in underserved and low resource areas around the country by: – Supporting local community planning – Expanding health care capacity and infrastructure – Targeting services to special populations – Training providers to help prevent high risk behaviors

that lead to HIV transmission

HRSA/HAB Global HIV/AIDS Program

• History • Objectives

– Care and Treatment– Education and Training– Technical Assistance– System Strengthening

Global HIV/AIDS Program Achievements

• Twinning Center• I-AETC• HMIS• Track 1.0• Monitoring and evaluation systems

Global HIV/AIDS Nursing ProgramAchievements

• Curricula Development

• Nurse Training

• Collaboration with ANAC

• Program Implementation

Next Steps – Current Work

• Monograph & Brochure• Nurse Registry - Uganda• Pre-service Training -Tanzania• Core Team Member – Namibia, Zambia• HCD TWG – Retention subcommittee, Extranet• I-AETC Advisor• Nurse Capacity Building Grant

– $500,000 x 3 years– Georgetown University

Strength does not come Strength does not come from physical capacity. It from physical capacity. It comes from an indomitable comes from an indomitable will.will.

Mahatma Gandhi, Mahatma Gandhi, August 11, 1920August 11, 1920

HRSA/Global HIV/AIDS Program

Carolyn M Hall, MSN/MPH, ACRN

5600 Fishers Lane, Suite 7-05

Rockville, MD 20857

301-443-5647

chall@hrsa.gov