Leadership in the AIDS Response:Changing the Course for Women

Dr. Debrework Zewdie

Deputy General Manager and

Head of Strategy, Investment and Impact Division

The Global Fund

Outline1. The burden of HIV among women

2. What has been done

3. What needs to happen to transform the AIDS response for women?

4. How do we make it happen?

5. Leadership for AIDS in the response for women

2

The burden of HIV among women

1.3 million women and girls were newly infected with HIV in 2011

63% of all young people (15-24) living with HIV are young women

In sub-Saharan Africa, women and girls comprise 60% of people living with HIV

Every minute a young woman acquires HIV infection

Sources: Demographic and Health Surveys and other, national population-based surveys with HIV testing.

HIV prevalence among female sex workers in low and middle income countries

• Source: S. Baral et al., Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis (Lancet Infect Dis 2012; 12: 538-49)

Women who use drugs

An estimated 35% of women in EECA acquire HIV through injecting drug use

An additional 50% of women living with HIV infected by partners who inject drugs

Behavioural Intervention

HIV Counselling and Testing

Coates T, Lancet 2000

Structural / legal

Male & female condoms

Treatment of STIs

Grosskurth H, Lancet 2000

Male circumcision

Auvert B, PloS Med 2005 Gray R, Lancet 2007 Bailey R, Lancet 2007

Treatment for preventionDonnell D, Lancet 2010Cohen M, NEJM 2011

Microbicidesfor women

Abdool Karim Q, Science 2010

Grant R, NEJM 2010 (MSM)Baeten J , NEJM 2012 (couples)Thigpen, NEJM, 2012 (Heterosexuals)

Oral pre-exposure prophylaxis

Post Exposure prophylaxis (PEP)

Scheckter M, 2002

HIV

PREVENTION combined

interventions

What has been done?

What needs to happenAccess to ART for all eligible women

In 2011 - 620,000 pregnant women were

eligible for ART for their own health,

Only 190,000 pregnant women living with HIV with a CD4 count less than or equal to 350 received ART.

Fewer than 45% of women known to be living with HIV in low- and middle-income countries were even assessed for their eligibility!

How do we make it happen

The money

Strategic investment

Costed care programs for women

Now on Leadership

11

“Do not mainstream us…meet all of our needs…. We do not want to be 10 percent of what you do….. We need to change the game, because the game is broken…We don’t have another 30 years, we need to do it NOW”

Linda ScruggsMaking Women Count: A Comprehensive Agenda

XIX International AIDS Conference

Acknowledgement Dr Jacqueline Bataringaya

Dr Ade Fakoya

Ms Motoko Seko