Over the past year, the Government of Côte d’Ivoire has increased its focus on HIV and on other challenges of public health. Sound public health programming is an important element of good governance. It is important for the Ivoirian government, for the American government and for our global partners. UNAIDS has developed new goals that will prove to be demanding. These include the elimination of mother to child transmission by 2015 and the elimination of HIV altogether by 2030. To help achieve these goals, the President’s Emergency Program for Aids Relief (PEPFAR) is focused on epidemic control by funding the right things, at the right time, and in the right places.
To control the HIV/AIDS epidemic, which means saving lives and preventing new infections, we need to work together better and more efficiently than ever before. This means providing the highest possible level of prevention, care and treatment services in high prevalence, high population areas and targeting the most vulnerable populations. If we hope to eliminate this epidemic, HIV must continue to be a public health priority. This means that combatting HIV must be a domestic funding priority too. Now is the moment to act.
If we do not invest now we will pay even more later. Gains will be reversed and more people will become infected. We must focus now on funding a high-impact response to the HIV epidemic. This will stop new infections. We must ensure that people are tested, enrolled into care and treatment, and continue their treatment regimens. According to the experts, failure to do this will increase the global cost of the epidemic by $31 billion annually by 2030. This estimate reflects only the additional cost of care and treatment, not the loss of life and of economic activity. We cannot afford this cost. This will threaten Côte d’Ivoire’s future and its place as an emerging economy.
Fortunately, recent data indicates that new infections of HIV and deaths due to AIDS have both declined in Côte d’Ivoire. We need to ensure this positive trend continues. As we look to the future, PEPFAR has designated Côte d’Ivoire a “Long-Term Strategy” country. This means that we can expect U.S. Government support to continue. Over its history, PEPFAR has steadily expanded it efforts here. The budget in Côte d’Ivoire has averaged $100 million annually over the past ten years. In the upcoming year our program will spend approximately $140 million.
However, the future budget is not likely to grow. We also have new Congressional mandates for scaling up treatment. As a result, the PEPFAR program must shift its strategy and consolidate. It must focus on how to control the epidemic. These shifts will include:
- A geographic focus on high-population, high-prevalence areas;
- An emphasis on activities essential to saving lives and preventing new infections; and
- A transition away from testing sites in which no or few people living with HIV are identified.
It is clear that the continued USG contribution, combined with other international donors, will not cover the full needs of the national HIV strategy in Côte d’Ivoire.
To help ensure a stable future for Ivoirians, additional domestic investment in the HIV response and public health overall, through quality health care, community support, and health systems, will be essential.
We remain confident that together we can eliminate HIV in Côte d’Ivoire by 2030.