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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Thirty years ago, newspaper headlines were rife with news of a virus that even doctors were unfamiliar with. Little was known about a strange epidemic that later would take the lives of music legends ... Show More +such as Freddy Mercury and Héctor Lavoe and several Hollywood stars.Today we know that the disease does not distinguish by sex, race or religion. It is the same illness that has killed 25 million people worldwide. Nowadays it is an old acquaintance whose name is no longer a novelty: AIDS.The characteristics of the epidemic differ by region. 69% of people infected with HIV live in Sub-Saharan Africa, for example, and only half of them receive antiretroviral therapy. By contrast, in Asia the epidemic is concentrated among sex workers and intravenous-drug users. “In the case of Latin America, the virus is prevalent among men who have sex with men. The epidemic is kept hidden due to the stigma of people living with HIV and discrimination with respect to sexual orientation,” says Fernando Lavadenz, senior health expert at the World Bank.The Latin American and Caribbean region has substantially reduced HIV prevalence during the past decade. “It went from being the region with the worst burden of HIV-AIDS death and illness in the 2000s to being the fourth most affected region after Sub-Saharan Africa, south Asia and east and central Europe in 2010,” says Lavadenz.Access to treatment is the keyToday, the HIV epidemic in the region has stabilized: more than 1.6 million Latin Americans are affected, but according to UNAIDS data, AIDS-related deaths declined by 36 % between 2001 and 2012. The World Health Organization (WHO) reports that currently, 600,000 more people are receiving antiretroviral therapy in the region as compared with 2003.Argentina is a case in point. “The disease burden has been significantly reduced by several factors, including, and perhaps most importantly, the free, universal access to antiretroviral drugs,” explains Lavadenz.A World Bank study carried out with support from UNAIDS reported that thanks to available treatments, at least 4,300 people were saved from illness in Argentina between 2001 and 2010. The country allocates 80% of total HIV/AIDS spending to care and treatment, compared to a regional average of 75%. “It is also a question of knowing how to spend well,” says Lavadenz. The study found that despite the high cost of antiretroviral drugs in Argentina, the National AIDS program is cost beneficial. “The benefits were not only in lives saved but also in savings of over US$ 748 million in Argentina, estimating the costs saved in the complicated treatment of people with advanced disease and the transmission that was avoided,” says the expert.“This is a successful case in which HIV treatment was the best prevention and a good lesson for Latin America,” he says.Laws in favorAlong with Brazil, Argentina was one of the first countries to provide free treatment to people living with HIV. The National AIDS Law, among other mechanisms, mandated the government and all other health providers to provide medical, pharmacological and psychological treatment to people living with HIV.“In Argentina, more than 80% of reported HIV cases have received treatment, which the WHO defines as universal access,” says Lavadenz.Additionally, the equal marriage law – Argentina is the first Latin American country to support same-sex marriage – and the gender identity law – the only law in the world that upholds the rights of transsexuals– have favored HIV prevention and treatment. “These laws made the country a pioneer in reducing the stigma,” says Lavadenz. “Less stigma, less shame in going to a hospital, taking a test or receiving medical attention in a democratic, non-discriminatory way.” Show Less -
ResultsThe following results were achieved under the Jamaica Second HIV/AIDS Project.Prevention91% of female sex workers reporting condom use with their most recent client (target: maintain more than ... Show More +90%).59.2% of female sex workers who received HIV testing in the last 12 months and who know the results (target: 50%).40,445 female sex workers and 22,145 men who have sex with men reached through prevention activities (target: FSW 14,955; MSM 14,059).19% of prison inmates reached through prevention activities (target: 15%)Treatment, Care, and Support10,469 men, women and children with advanced HIV receiving antiretroviral combination therapy according to national guidelines (target: 9,000)85.8% of HIV positive pregnant women receiving a complete course of antiretroviral (ARV) prophylaxis to reduce the risk of mother-to-child transmission (target: maintain more than or equal to 80%)1.4% of infants born to HIV infected mothers who are also HIV infected (target: less than 5.0%)More than 95% of antenatal clinic clients counseled and tested for HIV (target: maintain more than 90%)Strengthening Institutional Capacity for Legislative Reform, Policy Formulation, Program Management, Monitoring and Evaluation100% of reported cases of HIV-related discrimination receiving redress (target: 70%)100% of institutions/organizations reached adopting HIV/AIDS policies (target: 93%)Bank Group ContributionThe Bank’s total investment contributions in support of Jamaica’s response to HIV/AIDS include the first loan for US$15 million, which was implemented between March 2002 and May 2008, and the follow-on Second HIV/AIDS Project for US$10 million, implemented between May 2008 and March 2013. PartnersThe project was implemented by the Ministry of Health, its four decentralized regional health authorities, four non-health line ministries, civil society organizations, and the Jamaica Business Council. The project was critical in helping the Government leverage additional donor funds, which included US$44.22 million from the Global Fund and US$26 million from the United States Agency for International Development, President’s Emergency Plan for AIDS Relieve (USAID/PEPFAR). Based on the sustainability study conducted by the Bank in collaboration with the Government and the United Nations Program on HIV/AIDS (UNAIDS), the Global Fund has provided an additional grant of approximately US$2 million to assist Jamaica during the transition from external to domestic financing of the National HIV/AIDS Program. Show Less -
Growing up in Iowa, I was often judged solely on appearance. In stores, strangers would make karate-chop gestures at me, inspired by the popular TV series “Kung Fu.” When I played quarterback for my h... Show More +igh school team, opponents were not above slamming me to the dirt and then piling on racial slurs.These incidents embarrassed me and made me self-conscious. But they are trifling indignities compared with the discrimination that many people around the world face based solely on their sex, age, race or sexual orientation.I raise this in light of the law Uganda enacted this week, which could imprison for life those convicted of homosexuality, and the increased violence against gays in Nigeria after an anti-gay law took effect there this year.These countries are in the news now, but our focus should be much broader: 81 other countries — in the Americas, Asia, Africa and the Middle East — have passed laws that make homosexuality illegal. In the United States, although Arizona’s governor vetoed a bill this week that would have allowed businesses to deny service to gay people, nine states have laws that limit how public school teachers can talk about homosexuality. More than 100 countries discriminate against women. And an even greater number of countries still have laws that discriminate against minority groups.Institutionalized discrimination is bad for people and for societies. Widespread discrimination is also bad for economies. There is clear evidence that when societies enact laws that prevent productive people from fully participating in the workforce, economies suffer.Discrimination against women is a case in point. A World Bank study last year of 143 economies found that 128 countries still have at least one legal difference in how men and women are treated, which constrains women’s economic opportunities. These barriers include laws that make it impossible for a woman to independently obtain an ID card, own or use property, access credit or get a job.In 15 economies, husbands can prevent their wives from working, although in the past two years Ivory Coast, Mali and Togo have reformed such restrictions. Show Less -