Programme The new era in HIV/AIDS treatment and prevention: science, implementation and finance Wednesday 27 – Thursday 28 June 2012 | WP1170 In Jiva Hill Park Hotel, Crozet Context and aims Recent scientific evidence has confirmed two paradigm-changing clinical and realities with regard to the global HIV/AIDS epidemic. First, that placing HIV-infected individuals on antiretroviral therapy (ART) as early as practically possible increases the probability of healthy life and thus enhances their economic and social contributions to their communities and countries. Second, that placing HIV-infected individuals on antiretroviral therapy greatly reduces the risk that they will transmit the virus. In May 2011, the U.S. National Institutes of Health released findings from a landmark clinical trial, HPTN 052, showing that early initiation of ART by HIV- infected individuals reduced the chance of death and severe illness by 41% and reduced transmission of HIV to uninfected sexual partners by 96%. The trial was named Breakthrough of the Year for 2011 by Science, because of the potential of mass testing and treatment to greatly reduce HIV-related morbidity and mortality and the number of new occurring each year. These findings suggest a new approach to the fight against HIV/AIDS, increasingly referred to as Treatment as Prevention (TasP). While further trials are getting underway on six continents to fully explore the epidemiological and operational implications of large-scale implementation of TasP, there is an urgent need for thought leaders and policy makers to debate the implications of these findings. How can we move from a world of limited antiretroviral therapy and knowledge of HIV status to a world of widespread HIV testing and treatment? What are the political and operational hurdles to be overcome in this journey? And most importantly, how can the massive scale-up in testing and treatment required over the next few years be financed? This small and invitation-only meeting in Geneva will bring together a select group of leaders from international policy organizations, international financing organizations and the scientific community, as well as programmatic and political leadership from the most affected countries, to share their perspectives and experience and to chart a course for further collaboration and action.

Wilton Park is organising this roundtable in co-operation with Professor Sir Richard Feachem of Group at the University of California and Gilead Sciences.

Speakers are asked to make introductory comments for 5 minutes which will be followed by round-table discussion in which all are encouraged to participate.

Wednesday 27 June

1700 Participants check in and receive event information

1800-1900 Drinks reception and group photograph

1900-2100 Opening dinner Welcome: Richard Feachem Director, The Global Health Group, University of California, San Francisco John Martin Chief Executive Officer and Chairman, Board of Directors Gilead Sciences Inc, Foster City Speaker: Michel Sidibé Executive Director, Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva

Thursday 28 June – meeting in Le Hangar

0830 Tea/coffee available

0845-0900 Welcome to conference Robin Hart Director of Programmes, Wilton Park, Steyning Richard Feachem Director, The Global Health Group, University of California, San Francisco

0900-1030 1. The science Overview of the current science on test and treat. What do we know? What are we in the process of finding out? What major evidence gaps still need to be addressed? Chair: Joep Lange, Head, Department of Global Health, Academic Medical Centre, University of Amsterdam; Executive Scientific Director, Amsterdam Institute for Global Health and Development, Amsterdam Helen Ayles Senior Lecturer, Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine; Research Director, Zambia AIDS Related (ZAMBART), Lusaka Panellists: Gottfried Hirnschall Director, HIV/AIDS Department, World Health Organisation (WHO), Geneva Julio Montaner Director, British Columbia Centre for Excellence in HIV/AIDS; Professor, Division of AIDS, University of British Columbia, Vancouver Brian Williams Founder and Honorary Research Fellow, South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch

1030-1100 Tea/coffee

1100-1230 2. The country perspective If resources were available, what are the concrete operational challenges for implementing test and treat? What has been learned from pilot demonstration projects and what might be the time horizon for full scale implementation? Could the early adoption of a test and treat policy be appropriate for some countries, but not for others? Chair: Sheila Tlou, Former Minister of Health, Botswana; Regional Director, UNAIDS Regional Support Team, Eastern and Southern Africa, Joint United Nations Programme on HIV/AIDS (UNAIDS), Johannesburg Panellists: Agnes Binagwaho (pre-recorded video) Minister of Health, Ministry of Health, Kigali and Sabin Nsanzimana (pre-recorded video) Director, HIV/AIDS and other STIs, Rwanda Biomedical Center, Kigali Praphan Phanuphak Director, Thai Red Cross AIDS Research Centre, Bangkok Mansur Kabir Director, Department of Public Health, Federal Ministry of Health, Abuja Celia Christie-Samuels Consultant Paediatrician; Professor of Paediatrics (Infectious Diseases, and Public Health), University of the West Indies, Kingston

1230-1330 Lunch

1330-1500 3. The global response What is the view of the international and bilateral agencies on test and treat? How may they support research, policy making and subsequent implementation in most affected countries? Chair: Fareed Abdullah, Chief Executive, South African National AIDS Council, Pretoria Panellists: Luís Sambo Regional Director, Regional Office for Africa, World Health Organisation (WHO), Brazzaville Bertrand Audoin Executive Director, International AIDS Society (IAS), Geneva Bernhard Schwartländer Director, Evidence, Strategy and Results Department, Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva

1500-1530 Tea/coffee

1530-1700 4. The money How might test and treat be financed? Scaling up of domestic resources? Increased international flows? Difficulties created by the current global financial crisis? Opportunities for smarter investments? Chair: Diarmaid McDonald, Stop AIDS Campaign Coordinator, UK Consortium on AIDS and International Development, London Robert Hecht Principal and Managing Director, Results for Development Institute, Washington DC

Panellists: Denis Broun Executive Director, UNITAID, Geneva Debrework Zewdie Deputy Executive Director, Global Fund to Fight AIDS, Tuberculosis and , Geneva

1700-1730 Closing remarks Chair: Richard Feachem, Director, The Global Health Group, University of California, San Francisco