The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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ChallengeAt the project’s original appraisal in 2000, CAR suffered from political instability, armed conflict, and a poverty rate of 67 percent as recurrent conflicts had pushed CAR to 165 out of 173 countries... Show More + in the Human Development Report, with life expectancy an estimated 44.3 years. Periodic mutinies and coup attempts destroyed infrastructure and social services, delaying project implementation until 2007, when national elections and peace agreements with key rebel groups had been achieved. Sporadic violence persisted as IDA re-engagement focused on improving delivery of basic social services and HIV/AIDS prevention and control. In 2001, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated 10.7 percent of the population aged 15-49 was living with HIV/AIDS, 13,000 to 23,000 of whom were killed by the disease each year. Basic healthcare, primary education and access to water and sanitation are often inaccessible. This situation drove infant mortality to 106 per 1,000 li Show Less -
ChallengeAs of 2007, an estimated 1.32 million Ethiopians were infected with HIV, with over 130,000 new infections each year. An epidemic of HIV transmission was taking place in most at-risk populations,... Show More + particularly sex workers and their clients. As a result, life expectancy was falling and expected to drop from 59 to 50 years by 2010. In 2005, 80% of the 60 million Ethiopians lived rurally, and 39% lived below the poverty line. AIDS had become the leading killer of 15-49 year olds, causing 43% of all adult deaths, severely damaging economic growth and slowing poverty alleviation. Poverty, illiteracy, widespread transactional sex, gender disparity, population movement, and traditional practices such as female genital mutilation all contributed to the epidemic.SolutionThe first Ethiopian Multisectoral HIV/AIDS Project (EMSAP1), closed in 2006, supported general awareness of HIV and AIDS, as well as increased condom use, but not at a sufficiently high level. This project, EMSAP2, set ou Show Less -
ChallengeWith a per capita gross income of $380, Burundi is one of the poorest countries in the world, with individuals spending less than $49 on health per year. A 2007 survey showed HIV presence in the... Show More + general population at 3 percent and among commercial sex workers at 38 percent, as well as a rapid increase in prevalence in rural areas. Causes of the epidemic include commercial sex work, widespread presence of multiple concurrent partnerships, and low rates of male circumcision. Implementation of Burundi’s 2002-2006 National HIV/AIDs Strategy (NHAS) was constrained by a host of institutional, technical, financial, and capacity-related issues, the lessons of which were used to develop a second NHAS. IDA was needed to provide strategic guidance, lessons learned, and technical assistance to the second NHAS, and to ensure synergy between health system strengthening and HIV/AIDS interventions. Finally, the government has advocated the importance of IDA’s continued support to civil societ Show Less -