Академический Документы
Профессиональный Документы
Культура Документы
Session Objectives
At the end of the module, the participants should be able to:
Gain a clear understanding of the challenges to the country response to HIV and AIDS & how these can be addressed; and Know the significance of contributing to the national effort to halt the epidemic.
Philippine National AIDS Council
Behavior-related factors
Promoting correct & consistent use of condoms & ensuring their availability
Strengthening client-initiated counseling and testing (CICT) & ensuring quality assurance in HIV testing Institutionalizing programs on HIV&AIDS in the workplace
Philippine National AIDS Council
Need for a bigger budget allocation from the national government Need for varied sources of funding to sustain the HIV & AIDS program Ensuring greater efficiency in the utilization of funds and resources
2. Lack of policy guidelines for effective implementation of STI, HIV and AIDS program
Need for national leaders to see the urgency of supporting the HIV &AIDS country response Need for more LGUs to recognize the importance of HIV and AIDS prevention activities Need for more political champions
Lack of political support = inadequate government funding for the country response Inadequate funding = shortfalls in key target areas
Philippine National AIDS Council
a. Lack of enabling policies b. Conflicting provisions of laws affecting HIV and AIDS program implementation
STRATEGIC OBJECTIVES
To improve the coverage and quality of prevention programs for persons at most risk, vulnerable and living with HIV To improve the coverage and quality of TCS programs for people living with HIV (including those who remain at risk and vulnerable) and their families To enhance policies for scaling up implementation, effective management and coordination of HIV programs at all levels To strengthen capacities of the PNAC and its members to oversee the implementation of the 5th AMTP To strengthen partnerships and develop capacities for the 5th AMTP implementation of LGUs, private sector, civil society, including communities of atrisk, vulnerable, and living with HIV
KEY STRATEGIES
Develop evidence-based, targeted, comprehensive programs Capacitate service providers Provide equitable access to programs Enhance decentralized implementation Provide enabling environment Expand, build, strengthen management, partnerships and collaboration Develop capacity of partners
Indicator
2006 Baseline
19%
2010 Progress
29%
Status
OFF TRACK
Coverage
(Prevention)
Behavior
(Condom Use)
32%
32%
OFF TRACK
HIV Prevalence
0.28%
0.99%
PREVALENCE QUADRUPLED
Indicator
Status
OFF TRACK
Coverage
(Prevention)
Behavior
(Condom Use)
65%
65%
OFF TRACK
HIV Prevalence
0.16%
0.24%
PREVALENCE DOUBLED
Indicator
Status
OFF TRACK
Coverage
(Prevention)
Behavior
(Condom Use) As FSW Client As Sex Worker
No Data No Data 0.13% 22% 11% 0.21%
OFF TRACK OFF TRACK PREVALENCE DOUBLED (Grew by 53% in one site)
HIV Prevalence
The Epidemic
On average, 6 new HIV cases per day (1 in every 4 hours) is reported in the country From 2006 to 2010, the number of males reported to have contracted HIV increased compared to that during the 2001-2005 period 72 of the countrys 80 provinces in all 17 regions have reported HIV cases In 2011, the NCR had 54% of reported HIV cases, Region IV-A 10%, Region XI (7%), Region VII (6%), Region III (6%), Region VI (3%) and Region I (2%)
Philippine National AIDS Council
The Epidemic
Since 2007, there has been a big shift from heterosexual transmission to homosexual transmission, peaking in 2010
HIV transmission among Persons Who Inject Drugs (PWIDs) is rapidly increasing from just 7 reported cases in the last 22 years (1984-2006) to 147 cases in 2010 alone
2009
Registered Female Sex Workers (RFSW) Freelance Female Sex Workers (FFSWs) Males having Sex with Males (MSMs) Persons Who Inject Drugs (PWID) (selected sites)
Source: IHBSS
Philippine National AIDS Council
2011
0.13% 0.68% 2.12% 13%
94,049 (0.42%)
n.a.
Freelance (FFSW)
Male Clients of FSW Males who have Sex with Males (MSM) Injecting Drug Users (IDU)
Cost of Interventions
Effect (averting new infections)
High-cost, High-impact Low-cost, High-impact (prevention among most-at-risk (antiretroviral treatment and prevention of mother-to-child populations) transmission) (with 95% of infection averted) Low-cost, Low-impact (general awareness programmes through mass media and other channels)
High-cost, Low-impact (health systems strengthening through universal precautions and injection safety)
Priority Directions
Prevention: cover 80% of most-at-risk
populations or MARPs (e.g., registered and freelance FSW, male sex workers or MSW, males having sex with males or MSM, & persons who inject drugs or PWID) by 2013 in areas where most infections are coming from.
Priority Sites
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Category A Manila City Mandaluyong City Marikina City Pasig City Quezon City San Juan City Caloocan City Malabon City Navotas City Valenzuela City Las Pias City Makati City Muntinlupa City Paraaque City Pasay City Taguig City Pateros Danao City (Cebu) Cebu City Mandaue City (Cebu) Davao City Angeles City Category B Lapu-Lapu City (Cebu) Talisay City (Cebu) Antipolo City (Rizal) Cainta (Rizal) Bacoor (Cavite) Imus (Cavite) Dasmarias (Cavite) Lipa City (Batangas) Batangas City Bacolod City Puerto Princesa City (Palawan) Baguio City Iloilo City (Iloilo) Olongapo City Cagayan de Oro City Zamboanga City General Santos City Butuan City Category C San Fernando (Pampanga) Tarlac City, Tarlac Mabalacat (Pampanga) Dagupan City (Pangasinan) San Fernando (La Union) Iligan City Tagum (Davao del Norte) Panabo (Davao del Norte) Cotabato City Legaspi City Naga City Toledo (Cebu) Lucena City Cavite City San Pedro (Laguna) Calamba (Laguna) San Pablo (Laguna) Sta. Rosa (Laguna) Malolos (Bulacan) Meycauayan (Bulacan) San Jose del Monte (Bulacan) Marilao (Bulacan) Sta. Maria (Bulacan) San Mateo (Rizal) Taytay (Rizal) Tagbilaran City Tacloban City Malay (Aklan) Puerto Galera Tuguegarao City (Cagayan)
Key Strategies
Treatment Services for MARPs Anti-retroviral (ARV) drugs Monitoring of anti-retroviral therapy (ART) Drugs for opportunistic infections (OIs)
Philippine National AIDS Council
PLHIV on 1st line (94% of target ) Cost of ARV 1st line PLHIV on 2nd line (6% Target)
1,936 12,775,277
4,391 28,978,884
5,735 37,851,224
7,387 48,755,995
9,256 61,090,168
124 Cost of ARV 2nd line Total cost of ARV Cost of monitoring Cost of OI tx Total cost of Tx (PhP) 9,241,690 22,016,966
472
35,270,294 84,026,290
35,257,087
13,876,949
79,975,648
31,477,869
104,461,448
41,115,313
134,556,330
52,960,453
211,247,081
83,145,409
734,093,655
288,934,252
Systems Strengthening
Capacity building, operations research, advocacy Social services Policy formulation Surveillance Partnership, localization
22,471,400
92,043,200 18,543,200
8,780,200
7,132,500
3,592,500
3,642,500
3,592,500
3,642,500 30,382,700
27,900,000 28,900,000 29,900,000 30,900,000 Monitoring, Management support Partnership-building Total (in PhP) 3,796,000 1,693,000 993,000 993,000
31,900,000 993,000
2011
2012
2013
2014
2015
2016
SUM TOTAL
18,899,888,952
1,896,431,403
2,574,255,531
3,061,291,339
3,504,357,623
3,783,609,737
4,079,943,319
825,121,352
1,156,318,410
1,330,163,829
1,423,735,627
1,542,873,643
1,681,890,472
7,960,103,333
736,740,910
1,029,106,262
1,178,630,135
1,257,839,833
1,351,482,877
1,465,004,734
7,018,804,751
Total (A only)
621,982,878
878,147,819
984,770,883
1,051,308,761
1,132,636,538
1,233,843,128
5,902,690,007
Financing
National Government (Systems Strengthening, TCS, Prevention) Local Government (Prevention for MARPs) Philhealth (Treatment) Private sector (Prevention) ODA and international organizations (Prevention, Systems Strengthening, TCS)
Monitoring & evaluation More funding for STI, HIV & AIDS programs
Raising public awareness of STI, HIV and AIDS & translating knowledge to behavior change
Philippine National AIDS Council
The 5th AMTP is the national blueprint for a comprehensive approach to the HIV challenge. But its goal of halting the spread of HIV & AIDS by 2016 can be realized only thru an aggressive campaign focused at high-risk & vulnerable groups, firm commitment to the campaign by government and key stakeholders, & sustained and adequate funding and resources for prevention and TCS.
Philippine National AIDS Council