Context Most of the world’s 34 million people living with HIV/AIDS reside in developing countries. In 2010, 2.7 million people became newly infected with HIV, and 1.8 million died of HIV-related illnesses. Sub-Saharan Africa accounted for 68% of all new infections. While 6.6 million people worldwide can access treatment, nearly 8 million in need of access do not have it. Moreover, for every one person on treatment, two are infected. Without effective HIV prevention, the number of people requiring treatment will become unsustainable. Despite the increase in AIDS funding during the past decade, financing gaps persist (International assistance declined from $7.6 billion in 2009 to $6.9 billion in 2010.), and the bulk of likely available funds is unpredictable and mainly for treatment. As new infections rise, country and donor investments in prevention are not being sustained. Strategy The World Bank offers long-term financial and specialized technical support and knowledge to countries for effective prevention of new HIV infections, care and treatment for people living with HIV/AIDS, and alleviation of social and economic consequences for affected communities. The Bank plays a global leadership role in three key areas: The Bank provides sustained funding for HIV/AIDS programs and supports countries to improve the efficiency, effectiveness, and sustainability of national AIDS programs. Since 1989, Bank financing for HIV/AIDS has totaled nearly $4.6 billion; as of FY12, Bank financing for HIV/AIDS stands at $1.8 billion. The Bank works with stakeholders to improve evidence related to HIV prevention and engages in key sectors such as education, transport, energy, and infrastructure. As one of ten co-sponsors of UNAIDS, the Bank helps share the global response to HIV/AIDS, in partnership with governments, nongovernmental NGOs, other agencies and foundations, and the private sector. The co-sponsoring organizations are the International Labor Organization (ILO), Office of the United Nations High Commissioner for Refugees (UNHCR), United Nations Children's Fund (UNICEF), United Nations Development Programme (UNDP), United Nations Education, Scientific and Cultural Organization (UNESCO), United Nations Office on Drugs and Crime (UNODC), United Nations Population Fund (UNFPA), World Food Programme (WFP), World Health Organization (WHO), and World Bank. Results Through the International Development Association (IDA) the Bank’s Fund for the Poorest, the Bank has helped save lives and improve the health of millions in developing countries. Some examples of IDA results from 2000-2010: - Provided more than 47 million people with basic packages of health, nutrition, or population services;
- Delivered antiretroviral therapies to almost 2 million adults and children with HIV;
- Provided 2.5 million pregnant women with antenatal care;
- Purchased and/or distributed 813 million condoms for the prevention of HIV, sexually transmitted diseases, and unwanted pregnancies;
- Constructed, renovated, and/or equipped 23,000 health facilities to improve access to health services; and
- Trained 1.8 million health personnel to improve the quality of health services delivery.
Country and regional-level HIV/AIDS results include the following: - Over five years, four regional, HIV/AIDS projects in sub-Saharan Africa, offered services to more than 1.5 million women to prevent mother-to-child HIV transmission; established 1,500 voluntary counseling and testing sites (where 7 million people were tested for HIV); provided antiretroviral treatment for 27,000 people and treatment for HIV-related infections for nearly 300,000 more; reached more than 173 million people with information about HIV/AIDS; provided workplace HIV information, testing, counseling, and treatment programs to 2.3 million employees; mitigated the impact of AIDS for more than half a million adults and 1.8 million children through education, nutrition, and income-generating activities delivered by 38,000 grassroots initiatives; and delivered 1.3 billion male condoms and 4 million female condoms.
- With Bank support, India designed its national HIV/AIDS response to focus on high-risk groups, eventually culminating in a decline in HIV new infections by nearly 50%.
- With Bank support, Brazil’s provision of free, universal access to antiretroviral drugs led to a decline in mother-to-child HIV transmission from 16% in 1998 to around 3% in 2011. More than 80% of HIV-positive pregnant women received medication to prevent infection in their infants.
- Through a mass media campaign to promote universal and consistent condom use in commercial sex, Thailand saw visits to sex workers and infection rates among army conscripts fall by half in a few years. Nationwide, new infections have declined by more than 80% since their peak in the early 1990s.
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