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As Fight Against AIDS Intensifies, World Bank Reaffirms Role in Global Response

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  • World Bank appoints renowned expert David Wilson as new Global HIV/AIDS Program Director.
  • In the past year, the Bank provided $630 million in funding and new commitments to help poor countries prevent, treat and mitigate HIV/AIDS.
  • As International AIDS Conference begins in Vienna, global donors measure progress against 2015 Millennium Development Goals deadline.

July 15, 2010—Five years before the Millennium Development Goals (MDGs) deadline, and as the XVII International AIDS Conference—the world’s largest gathering to track progress against the epidemic—kicks off next week in Vienna, the World Bank is sharpening its focus on halting and reversing the spread of HIV and AIDS.

For the Bank and its global development partners, the MDGs countdown and Vienna conference are footholds in an ongoing tug-of-war to save lives and improve global health; more than 22 million people are currently living with HIV, and 2 million will lose their lives to AIDS this year.

The Bank has been at the forefront in shaping the global response to HIV/AIDS since the epidemic’s emergence; its programs continue to recognize AIDS as a unique health and development challenge. During the last two decades, globally, the Bank has provided $4.5 billion for HIV prevention, treatment, care and support programs in developing countries.

Since 2006, 4.3 million people have received counseling and testing through Bank-supported projects focused on HIV prevention. During the past year alone, the Bank provided $630 million in funding disbursements and new commitments for HIV and AIDS programs, helping poor countries fill critical gaps in AIDS prevention, treatment and mitigation. The Bank also helped 65 countries improve their national HIV/AIDS responses via the AIDS Strategy & Action Plan.

Reaffirming the Bank’s leadership on global AIDS, on July 8 the Bank appointed internationally renowned AIDS expert Dr. David Wilson as its new Global HIV/AIDS Program Director.

Wilson will guide and implement the Bank’s global HIV/AIDS strategy, focusing on four key areas: promoting effective HIV prevention strategies; helping countries strengthen their public health systems to ensure that antiretroviral treatment is reliable and can be sustained; integrating HIV response into the Bank’s broader work on social safety nets and other development interventions, with a special focus on AIDS widows, orphans and other marginalized populations; and helping countries better target their responses through economic analysis of the determinants and impacts of HIV.

Prevention is Key

More needs to be done to lower infection rates, because for every 100 people on treatment, 250 are infected. This week, UNAIDS said the prevalence of HIV has dropped among youth in 15 of the worst-affected countries. In a dozen of these countries, HIV levels decreased by 25% among 15- to 24-year-olds. UNAIDS attributed the decrease to prevention campaigns and behavior change.

Experience shows that prevention efforts can work. Along West Africa’s main highway, the Abidjan-Lagos Transport Corridor, where long-range ground transport is a major route for the spread of HIV, the Bank has helped to increase knowledge of how to prevent HIV, encourage more diagnosis and treatment of sexually transmitted infections, ensure greater condom availability and use, and significantly increase voluntary HIV counseling and testing. As a result, sexually transmitted infections have fallen sharply among key populations along the corridor.

Wilson noted that male circumcision is a key intervention that will reduce HIV infection in Africa.

“We need better prevention programs that can keep people HIV-free for the rest of their lives,” Wilson said. “One of the Bank’s most important contributions is providing countries with evidence to better understand where and how new HIV infections are occurring, and to use proven approaches to tackle these infections. With better evidence we can make prevention services succeed and make AIDS treatment more sustainable.”

On July 18 in Vienna, Bank researchers will present promising findings from Malawi and Tanzania on conditional economic incentives for the prevention of HIV and other sexually transmitted infections.

Systems Matter

To ensure that HIV and AIDS programs are more effective, efficient and sustainable, the Bank must integrate its HIV response with its broader work to help developing countries strengthen their overall health systems, Wilson said.

One of the Bank’s most important contributions is providing countries with evidence to better understand where and how new HIV infections are occurring.

—David Wilson, World Bank Global HIV/AIDS Program Director

“We must integrate AIDS treatment from an emergency response to a sustainable effort by integrating AIDS treatment and other health-related HIV services into national health systems and ensure that each HIV and wider health dollar work reciprocally together for maximum effect,” Wilson said.

The Bank’s record year in lending for health—about $4 billion in FY2010, up from $2.9 billion in FY2009—reflects strong demand from countries for Bank support.

The Bank is helping countries put systems in place to ensure that money and services reach people whose health is most at risk, and to make sure that development investments in other sectors—infrastructure, transport and education—also benefit AIDS response.

In Rwanda, efforts by the Bank and development partners to strengthen the public health system have accompanied significant reductions in HIV prevalence among young, pregnant urban women, by more than one-third over 5 years.

Drumbeat for Millennium Development Goals

Yet the global response to MDG 6 on AIDS is still falling short. Although 4 million people receive antiretroviral therapy treatment, more than 5 million are still waiting for treatment. Prevention is not yet halting the global epidemic in a decisive way. Southern Africa—with about 2% of the world’s population and about one-third of global HIV infections—is the epicenter of the epidemic today. But aid donors and poor countries alike are seeing flat-lining or shrinking budgets for HIV/AIDS programs after a period of tremendous growth in global health financing.

The good news? Research, analysis and tools now exist to address the problem, and ongoing public campaigns to promote safe sex could greatly disrupt HIV infection rates in many countries.




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