Owen Ryan, Deputy Director, Public Policy

Demand for programs for key populations in Africa from countries receiving international donor assistance

Owen Ryan, John Macom, Michelle Moses-Eisenstein

Owen Ryan, Deputy Director, Public Policy

Argentina

Bolivia

Brazil

Cambodia

China

Colombia

Ecuad

orEg

ypt

El Sa

lvador

Georgi

aGhan

a

Guatemala

Honduras India

Indonesia

Jamaic

aKen

ya Laos

Malawi

Mexico

Nepal

Nicarag

ua

Nigeria

Pakist

an

Panam

a

Paragu

ayPeru

Seneg

al

Serb

iaSu

dan

Tanzan

ia

Thail

and

Ukraine

Urugu

ay

Vietnam

Zambia

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HIV Prevalence Among MSM Population Prevalence of HIV (Ages >/= 15 years)

%

Source: Beyrer C, Baral SD, Walker D, Wirtz AL, Johns B, Sifakis F. The Expanding Epidemics of HIV Type 1 Among Men Who Have Sex With Men in Low- and Middle-Income Countries: Diversity and Consistency [published online ahead of print June 23 2010]. Epidemiol Review. 2010;32(1):137–51.

Owen Ryan, Deputy Director, Public Policy

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Owen Ryan, Deputy Director, Public Policy

Methods:

• PEPFAR COPs 2007 to 2010

• Global Fund proposals Rounds 1 through 10

• Eastern / Western & Central / Southern

• Men who have sex with men, people who inject drugs, female sex workers

• Search terms

• Excluded proposals: unsearchable, non-English, regional / multi-country, not

approved, rolling continuation channel, single stream funding

Note on “MARPs” and “IDU”

Owen Ryan, Deputy Director, Public Policy

164 Total

PEPFAR69

GFATM95

Eastern56

West/Central46

Southern62

Owen Ryan, Deputy Director, Public Policy

Owen Ryan, Deputy Director, Public Policy

Proposals with key populations programming by region and donor

• 107 proposals contained at least one program for female sex workers (65%)• 47 proposals contained at least one program for MSM (29%)• 21 proposals contained at least one program for IDU (13%)

• Note: interplay of programs for female sex workers, MSM and IDU.

Owen Ryan, Deputy Director, Public Policy

Proposals with key populations epidemiology by region/donor 2007 - 2010

Matched = proposal contains epidemiological information specific to one of these three populations and programs intending to serve the same population.

Owen Ryan, Deputy Director, Public Policy

Global Fund PEPFAR0tan28a566028

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ProposalsProposals with programsProposals with epiMatched Proposals

Cascade of proposals by donor 2007-2010

Owen Ryan, Deputy Director, Public Policy

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Owen Ryan, Deputy Director, Public Policy

Results:

• Of the 164 searchable documents, nearly two-thirds contained at least one program serving female sex workers (65 %, 107 proposals), • less than one-third contained at least one program serving men who have sex with men (29%, 47 proposals), • and a minority proposed programming for people who inject drugs (13%, 21 proposals).

• Demand for these programs was highly concentrated in a subset of countries.

• Epidemiological data for at least one key population was included in a majority of these proposals (63%, 67 proposals), but in many cases these data were not linked to programs.