United Nations Declaration on HIV/AIDS ―Signed by 192 member states. ―Acknowledged that “HIV/AIDS constitutes a global emergency and poses one of the.

United Nations Declaration United Nations Declaration on HIV/AIDS on HIV/AIDS

―Signed by 192 member states.Signed by 192 member states.

―Acknowledged that “HIV/AIDS constitutes a Acknowledged that “HIV/AIDS constitutes a global emergency and poses one of the most global emergency and poses one of the most formidable challenges to the development, formidable challenges to the development, progress and stability of our respective progress and stability of our respective societies and the world at large, and requires societies and the world at large, and requires an exceptional and comprehensive global an exceptional and comprehensive global response.”response.”

―Countries to develop financial plans for Countries to develop financial plans for Universal Access by December 2006Universal Access by December 2006

““BMS Global Access Program”BMS Global Access Program”

ScienceScience

CommitmentCommitment

CompassionCompassion

Multiple StakeholdersMultiple Stakeholders

IMPROVED ACCESS

TO MEDICINES

IMPROVED ACCESS

TO MEDICINES

Developed Country

Governments

Multilaterals (UN,WHO,WTO,

etc)

Developing Country

Governments

Pharmaceutical Industry

Media

NGO’s

Funding Agencies

Academia

Facilitating Access to HIVFacilitating Access to HIVin Developing Countriesin Developing Countries

Society & Culture

ARV Supply

Healthcare System

Access

PovertyStigma

Political WillSkepticism of Western Medicine

Infrastructure Funding

Physician expertise in HIV

Drug PricingSecuring distribution channels

Global Healthcare Partners (e.g. UNAIDS, WHO)

Accelerating Access Initiative (AAI)Accelerating Access Initiative (AAI)

5 UN Organizations

UNAIDS

WHO

UNICEF

UN Population Fund

World Bank

Accelerating Access Initiative (AAI)Accelerating Access Initiative (AAI)

• Accelerate sustained access to appropriate Accelerate sustained access to appropriate interventions and affordable HIV-related interventions and affordable HIV-related medicines and diagnostics for developing medicines and diagnostics for developing countries and those hardest hit by the countries and those hardest hit by the epidemicepidemic

• Reach significantly greater numbers of people Reach significantly greater numbers of people in need through new alliances involving in need through new alliances involving committed governments, private industry, UN, committed governments, private industry, UN, development agencies, NGO’s and people development agencies, NGO’s and people living with HIVliving with HIV

• Establish and support a context of a broader Establish and support a context of a broader framework of care, treatment and supportframework of care, treatment and support

The 6 Guiding Principles of AAIThe 6 Guiding Principles of AAI

• Unequivocal and ongoing political commitment by Unequivocal and ongoing political commitment by national governmentsnational governments

• Strengthened national capacityStrengthened national capacity

• Engagement of all sectors of national society and Engagement of all sectors of national society and the global communitythe global community

• Efficient, reliable and secure distribution systemsEfficient, reliable and secure distribution systems

• Significant additional funding from new national Significant additional funding from new national and international sources, and international sources,

• Continued investment in research and Continued investment in research and development by the pharmaceutical industrydevelopment by the pharmaceutical industry

How Business Could Succeed How Business Could Succeed in Scaling Up the Business in Scaling Up the Business Response to AIDS in AfricaResponse to AIDS in Africa

1 November 2006, Geneva Switzerland1 November 2006, Geneva Switzerland

Secure the FutureSecure the Future

www.BMS.comwww.BMS.com

www.SECURETHEFUTURE.comwww.SECURETHEFUTURE.com

• Global AIDS pandemicGlobal AIDS pandemic• Pharmaceutical companies as primary target Pharmaceutical companies as primary target

(pricing, patents, litigation, access) (pricing, patents, litigation, access) • Leadership opportunity for Bristol-Myers Squibb Leadership opportunity for Bristol-Myers Squibb

and HIV franchiseand HIV franchise• Public / private partnerships –Public / private partnerships –

a humanitarian opportunitya humanitarian opportunity• Personal request from Kofi Annan Personal request from Kofi Annan

Why Bristol-Myers Squibb Why Bristol-Myers Squibb and and Secure the Future?Secure the Future?

Why Bristol-Myers Squibb Why Bristol-Myers Squibb and and Secure the Future?Secure the Future?

1995 1997 2001 2004

A Progression Toward Despair inA Progression Toward Despair inSub-Saharan AfricaSub-Saharan Africa

A Progression Toward Despair inA Progression Toward Despair inSub-Saharan AfricaSub-Saharan Africa

HIV/AIDS Infected AdultsHIV/AIDS Infected AdultsHIV/AIDS Infected AdultsHIV/AIDS Infected Adults

• 8,500 new 8,500 new infectionsinfectionsper dayper day

20052005

46%46%WomenWomen

50%50%WomenWomen

57%57%WomenWomen

+ 1.8 million+ 1.8 million children children

12.9 MM

20.8 MM22.0 MM

23.5 MM

57%57%WomenWomen

+ 1.9 million+ 1.9 million children children

Lack of basic infrastructure: rural environmentLack of basic infrastructure: rural environment

Lack of health care infrastructure Lack of health care infrastructure && equipment equipment

Lack of training / capacityLack of training / capacity

Lack of political leadershipLack of political leadership

Food security / clean waterFood security / clean water

Psycho-social issues / CompliancePsycho-social issues / Compliance

Treatment Treatment && monitoring costs monitoring costs

Challenges –Challenges –Access to Care and SupportAccess to Care and Support

Challenges –Challenges –Access to Care and SupportAccess to Care and Support

Southern Africa –Southern Africa –South Africa, Lesotho, Namibia, Botswana, South Africa, Lesotho, Namibia, Botswana,

Swaziland Mali, Senegal, Burkina Faso, Cote Swaziland Mali, Senegal, Burkina Faso, Cote d’Ivoire, Ugandad’Ivoire, Uganda

• Launched May 1999Launched May 1999

• Commitment of $150 millionCommitment of $150 million

• Focused on women and childrenFocused on women and children

• Eleven full-time professional and support staffEleven full-time professional and support staffbased in South Africa and Malibased in South Africa and Mali

• Independent Advisory BoardIndependent Advisory Board

• Largest corporate commitmentLargest corporate commitment

• Program components –Program components – Medical research Medical research && care care Community outreach and educationCommunity outreach and education

• To date, 207 projects totaling $150 millionTo date, 207 projects totaling $150 million

Prevent HIV/AIDS and STDPrevent HIV/AIDS and STDtransmissiontransmission

Reduce the impact of HIV/AIDS on Reduce the impact of HIV/AIDS on individuals by empowering infectedindividuals by empowering infectedand affected women and childrenand affected women and children

Expand access to treatment by Expand access to treatment by informing public health policyinforming public health policy

ObjectivesObjectives

Public / private partnership as embodied in Public / private partnership as embodied in government policies against HIV/AIDSgovernment policies against HIV/AIDS

Compatible with and complementary to healthCompatible with and complementary to healthcare prioritiescare priorities

Governed cooperativelyGoverned cooperatively

Sensitivity to the local contextSensitivity to the local context

Ethically unassailableEthically unassailable

Catalyst for expanded participationCatalyst for expanded participation

Grants must be innovative and sustainable Grants must be innovative and sustainable

Guiding PrinciplesGuiding Principles

• Partnering with other stakeholdersPartnering with other stakeholdersincluding governmentsincluding governments

• Alignment with country strategiesAlignment with country strategies

• Identification of locally relevant solutions: Identification of locally relevant solutions: Community and medical levelsCommunity and medical levels

• Monitor and evaluate projectsMonitor and evaluate projects

• Expenditure and financial controlExpenditure and financial control

• Communication of resultsCommunication of results

• Capacity and sustainabilityCapacity and sustainability

ChallengesChallengesChallengesChallenges

Capacity BuildingCapacity BuildingMedical University ofMedical University ofSouthern Africa Southern Africa (MEDUNSA)(MEDUNSA)Public Health FellowshipsPublic Health Fellowships

Distance learning inDistance learning inall five countriesall five countries

258 public health specialists 258 public health specialists graduated in May, 2005graduated in May, 2005

• Cheick Anta Diop University, DakarCheick Anta Diop University, Dakar Campus and field practicum course for all 4 countriesCampus and field practicum course for all 4 countries

120 public health specialists by 2007120 public health specialists by 2007

When GrandparentsWhen GrandparentsBecome Mothers AgainBecome Mothers Again

Western Cape Province, South AfricaWestern Cape Province, South Africa

Initially 67 Grandmothers, now 297 Initially 67 Grandmothers, now 297

Led to Formation of Grandparents Against Led to Formation of Grandparents Against Poverty & AIDS (GAPA)Poverty & AIDS (GAPA)

Replicated in nine other provincesReplicated in nine other provinces

Care & SupportCare & Supportfor Orphansfor Orphans

•Cross-border STI and HIV Prevention Program centered Cross-border STI and HIV Prevention Program centered around railroads and major rail stations along West around railroads and major rail stations along West Africa’s rail lines linking Senegal, Mali, Burkina Faso and Africa’s rail lines linking Senegal, Mali, Burkina Faso and the Ivory Coastthe Ivory Coast

•Targets 2 million people: those who use rail lines, live Targets 2 million people: those who use rail lines, live near 4 major rail hubs, commercial sex workers, mobile near 4 major rail hubs, commercial sex workers, mobile vendors, migrants and employees of railroads and their vendors, migrants and employees of railroads and their familiesfamilies

Rail-LinkRail-Link

Medical Research and Care Medical Research and Care

Prevention of Mother-to-Child Transmission Prevention of Mother-to-Child Transmission • First Trials Supported Studying Prevention of First Trials Supported Studying Prevention of

Mother-to-Child Transmission of HIVMother-to-Child Transmission of HIVafter birthafter birth

• $600,000 grant to Perinatal HIV Research$600,000 grant to Perinatal HIV ResearchUnit – Chris Hani Baragwanath Hospital, Unit – Chris Hani Baragwanath Hospital, Soweto, South AfricaSoweto, South Africa

• Innovative project earns Dr. Glenda GrayInnovative project earns Dr. Glenda Grayand colleagues: Nelson Mandela Award for and colleagues: Nelson Mandela Award for Health and Human RightsHealth and Human Rights

Medical Research and CareMedical Research and Care

DiagnosisDiagnosis

• Improved managementImproved managementof HIV by reducing theof HIV by reducing thecost of patientcost of patientmonitoring throughmonitoring throughCD4 testingCD4 testing

• Reduced cost of testing by 70-80 percentReduced cost of testing by 70-80 percent

• Approved by U.S. FDAApproved by U.S. FDA

The voices of women and children The voices of women and children describing stigma and describing stigma and

discrimination:discrimination:

““SECURE THE FUTURE is establishing a SECURE THE FUTURE is establishing a new paradigm for combating the AIDS new paradigm for combating the AIDS

pandemic in Africa. The unique approach pandemic in Africa. The unique approach of offering both community and medical of offering both community and medical

services is critically important to efforts to services is critically important to efforts to stem the devastation of this disease.” stem the devastation of this disease.”

Dr. Pearl NtsekheDr. Pearl Ntsekhe

Lesotho Ministry of Health and Social WelfareLesotho Ministry of Health and Social Welfare

““The relationships we forge through The relationships we forge through SECURE THE FUTURE are as important SECURE THE FUTURE are as important as the funds we received. Our partners as the funds we received. Our partners helped us with process and procedure helped us with process and procedure improvements, they showed us how to improvements, they showed us how to achieve our objectives better and they achieve our objectives better and they enhanced the well being of our entire enhanced the well being of our entire

organization.”organization.”Reverend Edward BaralemwaReverend Edward Baralemwa

Pan African Christian AIDS NetworkPan African Christian AIDS Network

Bristol-Myers Squibb/BaylorBristol-Myers Squibb/Baylor

Pediatric AIDS InitiativePediatric AIDS Initiative

Obstacles to TreatmentObstacles to Treatment

• Lack of Infrastructure (clinics, labs, Lack of Infrastructure (clinics, labs, diagnostic testing, etc.) diagnostic testing, etc.)

• Lack of health professionals (especially Lack of health professionals (especially pediatricians)pediatricians)

• Cost and limited availability of suitable Cost and limited availability of suitable pediatric drug formulationspediatric drug formulations

Children’s Centers of ExcellenceChildren’s Centers of Excellence

Botswana-BaylorBotswana-BaylorCollege Children’sCollege Children’sClinical Centre ofClinical Centre ofExcellence at PrincessExcellence at PrincessMarina Hospital in GaboroneMarina Hospital in Gaborone

First Pediatric HIV/AIDS Clinic in AfricaFirst Pediatric HIV/AIDS Clinic in Africa More than 1,500 children on ART in firstMore than 1,500 children on ART in first

yearyear Four new centers opened (Lesotho, Swaziland, Four new centers opened (Lesotho, Swaziland,

Burkina Faso, Uganda)Burkina Faso, Uganda)

Children’s Center of Excellence – LesothoChildren’s Center of Excellence – LesothoOpened December 1, 2005Opened December 1, 2005

Pediatric AIDS Corp for AfricaPediatric AIDS Corp for Africa

• Recruit 50 pediatricians or family Recruit 50 pediatricians or family practitioners each year for five yearspractitioners each year for five years

• Minimum of one year of serviceMinimum of one year of service• Based in countries with COE’s but working Based in countries with COE’s but working

out in communitiesout in communities• Responsible for care, treatment and Responsible for care, treatment and

trainingtraining

Secure the FutureSecure the FutureCare and Support for Women Care and Support for Women

&&Children with HIV/AIDSChildren with HIV/AIDS

““When the history of this When the history of this epidemic is written, we epidemic is written, we should all ask ourselves, should all ask ourselves, what did we do to help?” what did we do to help?”

Festus Mogae Festus Mogae President, BotswanaPresident, Botswana 19991999