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In those countries
facing an HIV/AIDS epidemic on the same scale
of South Africa, for example, if nothing is
done quickly to fight the epidemic, they could
face economic collapse within several
generations, with family incomes being cut in
half. new World Bank sponsored
research paper published, July 2003.
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AT A GLANCE
- In the past few years, the Bank has
committed about US$1.7 billion through
grants, loans and credits for programs to
fight HIV/AIDS. The Multi-Country HIV/AIDS
Program (MAP) for Africa has committed
more than US$1 billion to 28 countries to
fight HIV/AIDS. In the Caribbean, the Bank
has made available US$155 million through
the Caribbean MAP to fight HIV/AIDS. Of
this, US$104 million has been committed in
7 countries and one regional project.
- For the poorest countries, World Bank
support for HIV/AIDS projects can be up to
100% grant financed.
- In April 2004, the Bank entered into a
partnership with the Global Fund, UNICEF,
and the Clinton Foundation to make it
possible for developing countries to
purchase high-quality AIDS medicines at
low prices. The drug agreements could save
from US$150 to US$400 per patient per year
while the diagnostics agreements will
result in savings of up to 80%.
- To encourage countries to use Bank
funding for treatment, the US$60million
Treatment Acceleration Project (TAP) was
approved in June 2004. The TAP's grants to
Burkina Faso, Ghana and Mozambique will
test public sector/civil society
partnerships to scale up treatment.
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Overview
HIV/AIDS is rapidly reversing the
hard-won development achievements of
previous decades. Consequently, fighting
HIV/AIDS and other communicable diseases is
one of the eight Millennium Development
Goals (MDGs) - an international pledge to
halve the incidence of poverty and broadly
improve welfare by 2015. Given the primacy
of the impact of HIV/AIDS on development,
the World Bank has placed HIV/AIDS at the
center of its agenda.
HIV/AIDS poses an unprecedented threat to
global health, development and security.
About 40 million people are currently living
with HIV/AIDS and 5 million contracted HIV
in 2003 alone. More than 60 million people
have been infected with HIV since it was
first discovered more than 20 years ago and
approximately 15,000 new infections occur
every day. More than 95 percent of people
living with HIV/AIDS live in developing
countries and about half of all new
infections occur among young people (15 to
24).
World Bank sponsored research, published in
July 2003, found the long-term effects of
HIV/AIDS could be much worse than originally
predicted unless urgent steps were taken to
fight the epidemic more vigorously. The
report, The Long-run Economic Costs of AIDS:
Theory and an Application to South Africa,
warned that previous estimates, which
predicted declines of between 0.3 and 1.5
percent in GDP caused by the epidemic, were
too low. By killing mostly young adults,
AIDS robs children of one or both parents to
love, raise and educate them - undermining
the basis of economic growth over the long
haul. The study argued that a country like
South Africa could face economic collapse
unless it aggressively increases its
response to the epidemic. Similar studies
are underway in India, Kenya and Ethiopia.
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The Bank's Response
The Bank is one of the largest sources
of financing for HIV/AIDS programs in the
United Nations system. In the past few
years, the Bank has committed about US$1.7
billion through grants, loans and credits
for programs to fight HIV/AIDS. Since FY01,
the multi-sectoral nature of HIV/AIDS has
been reflected in the Bank's MAP, Education,
Transport, Urban Development and Water
Supply and Sanitation projects. For the
poorest countries, support for HIV/AIDS
projects from the World Bank's no-interest
concessional lending arm, the International
Development Association (IDA), can be up to
100% grant-financed. The Bank also works
with its partners to provide strategic
analysis, policy advice and other technical
expertise at the country level. As a
founding co-sponsor of UNAIDS, the Bank
works closely with other UN agencies to
strengthen HIV/AIDS work at country,
regional and global levels.
UNAIDS established the Global HIV/AIDS
Monitoring and Evaluation Support Team (GAMET),
which is located at the World Bank. GAMET
actively works with countries and diverse
donors to strengthen monitoring and
evaluation capacity at the country level.
The Bank, together with its partners and
major stakeholders is working on scaling up
access to care and antiretroviral therapy
(ART). The Treatment Acceleration Project
will provide US$60 million in grants to
Burkina Faso, Ghana and Mozambique to test
public sector/civil society partnerships to
scale up treatment. In April 2004, the Bank
entered into a partnership with the Global
Fund, UNICEF, and the Clinton Foundation to
make it possible for developing countries to
purchase high-quality AIDS medicines at low
prices. A technical guide on HIV/AIDS
procurement of medicines and related
supplies was produced by the Bank to
facilitate treatment programs.
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Regions in Focus
Sub-Saharan Africa: The
Multi-Country HIV/AIDS Program (MAP) for
Africa has made available an initial amount
of US$1 billion to scale up national
HIV/AIDS efforts and to support sub-regional
(multi-country) HIV/AIDS initiatives. The
MAP is a long-term commitment by the World
Bank to support HIV/AIDS programs for all
IDA countries. MAP funds, which are now
being provided as grants, are available to
any low-income African country that meets
the eligibility criteria laid out by the
World Bank. The overall goal of the MAP is
to intensify action in as many countries as
possible. Its specific objectives are to
scale up prevention, care, and treatment
programs, mitigate impact in all sectors,
and strengthen the implementation of
programs at all levels. In June 2004, an IDA
grant of US$60 million was approved in
support of a regional program which aims to
increase access to HIV/AIDS treatment in
three African countries: Burkina Faso,
Ghana, and Mozambique. The World Health
Organization (WHO) and the United Nations
Economic Commission for Africa (UNECA) will
provide technical and project coordination
support to facilitate an inter-country
learning process. An additional IDA grant
was approved in the amount of US$15 million
in support of efforts by the Government of
Mali to accelerate HIV/AIDS prevention,
treatment, and care.
Eastern Europe and Central Asia: The
Bank undertakes advocacy, analytical and
lending services in support of country-led
responses to HIV/AIDS in the region.
Sub-regional studies have been completed in
Southeastern Europe (case studies from
Bulgaria, Croatia and Romania), Poland and
the Baltic States, and one specific to
Central Asia is in progress. A Regional
Support Strategy was released in September
2003. Country-specific studies include the
Georgia Country Study and analyses of the
economic impacts of AIDS in Russia in 2002.
New FY03 projects include a US$60 million
loan for tuberculosis and AIDS control in
the Ukraine, and a US$150 million project in
the Russian Federation to support TB and HIV
control efforts. The Moldova AIDS Control
Project was launched in FY03 with US$ 5.5
million from an IDA grant.
East Asia and the Pacific: A
regional strategy outlining strategic
directions for the region's response to HIV
has just been completed. Support to this
region often occurs in the context of health
sector reform. For example, Vietnam's blood
transfusion centers are supported by Bank
financing (US$ 38.2 million). The China
Tuberculosis Project, totaling US$ 104
million, includes several HIV/AIDS
components, as does a health project (Health
IX), financed with US$ 60 million. Policy
guidance and analytic work are also
important elements of the work program in
this region.
South Asia: The Bank has been
engaged in South Asia since 1992 with the
approval of the First National AIDS Control
project of US$89 million in India. Over the
past decade the Bank has committed about
US$380 million in grants and credits to
fight the HIV/AIDS in the region.
The support has been wide ranging,
responding to specific country needs,
capacity and stage of the epidemic,
consisting of investment projects,
analytical work, and capacity building. The
Bank has active projects in India,
Bangladesh, Pakistan, Sri Lanka, and Bhutan
financing prevention, care and treatment and
building capacity of public and private
institutions to implement a strong multi-sectoral
program.
The Bank has also supported the analytical
work on examining the cost and consequences
of the anti-retroviral therapy policies in
India. In addition to country level work,
the Bank has contributed to regional
learning, in collaboration with UN agencies
and bilateral donors, on improving
surveillance, monitoring and evaluation,
using economic analysis to optimize resource
allocations for HIV prevention, and training
of journalists, together with program
managers, on how to use strategic
communications to fight HIV/AIDS.
Latin America and The Caribbean:
The Multi-Country HIV/AIDS Prevention (MAP)
and Control Adaptable Program Lending for
the Caribbean Region was approved in 2001
for US $155 million. The Caribbean Region
has the world's highest HIV prevalence rate
outside sub-Saharan Africa. As of September
2003, the World Bank has committed more than
US$550 million for programs in Argentina,
Barbados, Brazil, Dominican Republic, El
Salvador, Grenada, Guyana, Haiti, Honduras,
Jamaica, Mexico, Trinidad and Tobago, St.
Kitts and Nevis, and Venezuela. Projects for
St. Vincent and the Grenadines and Saint
Lucia are expected to be approved by the end
of July, 2004. Beyond financial assistance,
the World Bank has produced a variety of
research on the impact of HIV/AIDS in the
region to facilitate the implementation of
prevention and control strategies that are
tailored to the needs of both the region and
specific countries, including the HIV/AIDS
in Central America: An Overview of the
Epidemic and Priorities for Prevention
report, and the HIV/AIDS
in Latin American Countries: The Challenges
Ahead report.
The Middle East and North Africa:
The Bank has played a major advocacy role by
preparing a comprehensive report of the
HIV/AIDS situation in the region. At the
country level, the Bank is financing the
Djibouti AIDS Control Project (with an IDA
grant of US$ 12 million) and is supporting
the development of the Morocco and Lebanon
National HIV/AIDS Strategic Plans. In
addition to financial assistance, the World
Bank published a report entitled: 'HIV/AIDS
in the Middle East and North Africa: The
Costs of Inaction' which discusses the
impact of HIV/AIDS in the region and
highlights key challenges for prevention,
care and treatment strategies to take root.
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Research and Development for an HIV/AIDS
Vaccine
The Bank is involved in fostering
public-private partnerships to accelerate
the development of an HIV/AIDS vaccine for
use in developing countries. The Bank is a
founding member of the International AIDS
Vaccine Initiative (IAVI), a non-profit
organization, and has contributed US $5.3
million to the Initiative through the
Development Grant Facility. IAVI stimulates
investment and sponsors clinical trials of
promising candidate vaccines.
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UNAIDS and the World Bank
The Bank is a co-founding member of UNAIDS
which was established in 1996. UNAIDS is an
innovative joint venture of the UN family
that brings together the efforts and
resources of 10 UN system organizations. As
the main advocate for global action on
HIV/AIDS, UNAIDS leads, strengthens and
supports an expanded response aimed at
preventing the transmission of HIV,
providing care and support, reducing the
vulnerability of individuals and communities
to HIV/AIDS, and alleviating the impact of
the epidemic.
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Updated June 2004
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Media Contacts:
Phil Hay: (202) 473-1796. E-mail: Phay@worldbank.org
Stevan Jackson: (202) 458-5054. E-mail: Sjackson@worldbank.org
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