Agenda item 6.1 UNAIDS/PCB (42)/18.8 UNIFIED BUDGET, RESULTS AND ACCOUNTABILITY FRAMEWORK (UBRAF) PERFORMANCE REPORTING 26-28 June 2018 | Geneva, Switzerland UNAIDS Programme Coordinating Board Issue date: 22 June 2018 1 UNAIDS/PCB(42)/18.8 Page 2/154 Additional document for this item: i. UNAIDS Performance Monitoring Report 2016–2017: Organizational Reports (UNAIDS/PCB (42)/18.9) Action required at this meeting: the Programme Coordinating Board is invited to: 1. Take note of the performance monitoring report and continued efforts to rationalize and strengthen reporting, in line with decisions of the Programme Coordinating Board, and based on experience and feedback on reporting; 2. Urge all constituencies to contribute to efforts to strengthen performance reporting and use UNAIDS annual performance monitoring reports to meet their reporting needs; 3. Request UNAIDS to continue to strengthen joint and collaborative action at country level as part of UN reform efforts and the implementation of the revised operating model of the Joint Programme. Cost implications of decisions: none UNAIDS/PCB(42)/18.8 Page 3/154 Contents ACRONYMS 4 HIGHLIGHTS 6 INTRODUCTION 13 STRATEGY RESULT AREAS 14 Strategy Result Area 1: HIV testing and treatment 14 SRA 2: Elimination of mother-to-child transmission (eMTCT) 28 SRA 3: HIV prevention among young people 34 SRA 4: HIV prevention with and for key populations 43 SRA 5: Gender inequality and gender-based violence 54 SRA 6: Human rights, stigma and discrimination 63 SRA7: Investment and efficiency 71 SRA 8: HIV and health service integration 78 SECRETARIAT CONTRIBUTIONS 85 S1: Leadership, advocacy and communication 85 S2: Partnerships, mobilization and innovation 88 S3: Strategic information 95 S4: Coordination, convening and country implementation 99 S5: Governance and mutual accountability 102 REGIONS 108 Regional summary report for Asia-Pacific 108 Regional summary report for eastern and southern Africa 115 Regional summary report for eastern Europe and central Asia 123 Regional summary report for Latin America and the Caribbean 129 Regional summary report for Middle East and North Africa 135 Regional summary report for western and central Africa 140 FINANCIAL INFORMATION 147 UNAIDS/PCB(42)/18.8 Page 4/154 ACRONYMS AIDS acquired immunodeficiency syndrome ART antiretroviral therapy CDC Centers for Disease Control and Prevention CEDAW Convention on the Elimination of All Forms of Discrimination Against Women eMTCT elimination of mother-to-child transmission of HIV FAO Food and Agriculture Organization Global Fund Global Fund to Fight AIDS, Tuberculosis and Malaria GRP Global Review Panel HIV human immunodeficiency virus HLM High-Level Meeting IATI International Aid Transparency Initiative IATT Interagency Task Teams ICW International Community of Women INPUD International Network of People who Use Drugs IOM International Organization for Migration IPPF International Planned Parenthood Federation LGBTI lesbian, gay, bisexual, transgender and intersex MNCH maternal, newborn and child health NASA National AIDS Spending Assessments NGO nongovernmental organization OCHA Office for the Coordination of Humanitarian Affairs OHCHR Office Of The United Nations High Commissioner For Human Rights PADO Paediatric ARV Drug Optimization PAHO Pan-American Health Organization PCB Programme Coordinating Board PEPFAR United States President’s Emergency Plan for AIDS Relief PMR Programme Monitoring Report PrEP pre-exposure prophylaxis QCPR Quadrennial Comprehensive Policy Review RMNCAH reproductive, maternal, newborn, child and adolescent health SADC Southern African Development Community SDGs Sustainable Development Goals SOGIE sexual orientations, gender identity and gender expressions SRA strategic results area STD sexually transmitted disease STI sexually transmitted infection TB tuberculosis UBRAF Unified Budget, Results and Accountability Framework UNAIDS United Nations Joint Programme on AIDS UNASUR Union of South American Nations UNGASS UN General Assembly Special Session UNITAID UN International Drug Purchasing Facility USAID United States Agency for International Development Cosponsors ILO International Labour Organization UNESCO United Nations Educational, Scientific and Cultural Organization UNDP United Nations Development Programme UNAIDS/PCB(42)/18.8 Page 5/154 UNFPA United Nations Population Fund UNHCR Office of the United Nations High Commissioner for Refugees UNICEF United Nations Children’s Fund UNODC United Nations Office on Drugs and Crime UN Women United Nations Entity for Gender Equality and the Empowerment of Women WFP World Food Programme WHO World Health Organization WB World Bank UNAIDS/PCB(42)/18.8 Page 6/154 HIGHLIGHTS Leadership and political commitment 1. In 2016–2017, the Joint United Nations Programme on HIV/AIDS (UNAIDS) sustained its leadership of the global HIV response. It maintained a focus on HIV in the 2030 Sustainable Development Agenda and continued to promote shared responsibility and global solidarity, ensuring no one is left behind. 2. The impact of this work was evident in the 2016 Political Declaration on Ending AIDS, adopted during the UN General Assembly High-Level Meeting on AIDS in June 2016. Recognizing that ending AIDS requires global commitment to reach bold targets, the Secretariat facilitated a process in which Member States agreed on a set of time- bound targets to mobilize political commitment to implement the ambitious UNAIDS 2016-2021 Strategy. 3. In July 2016, the 21st International AIDS Conference in Durban, South Africa, provided a platform for highlighting key issues such as the slow progress on HIV prevention, the need to empower community health-care workers and further strengthen community engagement, and ensure that HIV remains high on national, regional and global agendas. The need for sustainable and predictable funding, including increased domestic investments, was also emphasized. 4. During the 2016–2017 biennium, the UNAIDS Secretariat worked to support the Joint Programme in ensuring a results-based focus and strengthening the alignment of human and financial resources with corporate priorities, as determined by the UNAIDS 2016–2021 Strategy and the 2016 Political Declaration. 5. Recognizing that the new resource environment, the adoption of the SDGs and the context of UN reform, the Programme Coordinating Board (PCB) welcomed the recommendations of the Global Review Panel (GRP). That review was conducted in early 2017 to advise on refining and reinforcing the UNAIDS Joint Programme operating model. The UNAIDS Joint Programme Action Plan, which had been developed to implement the recommendations, informed that effort. The PCB endorsed the Action Plan in June 2017. Following the PCB’s approval of the Plan, the Secretariat has been facilitating a transparent and inclusive transition to the new operating model, providing progress updates on implementation at PCB meetings. 6. The GRP validated the fundamental elements and added value of the Joint Programme. It reiterated the importance of UNAIDS’ multisectoral approach and central role in the global health architecture, including as a vital partner to the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) and the United States President's Emergency Plan for AIDS Relief (PEPFAR). It highlighted the fact that the Joint Programme embodies key approaches required by Agenda 2030 and the 2016 Quadrennial Comprehensive Policy Review (QCPR), noting that UNAIDS represents a model 20 years ahead of its time. 7. The Action Plan prioritized strategic, coherent approaches that are tailored to country context and led by Joint UN Teams on AIDS. These approaches bring the added value, capacity and skill sets that are required to address specific country needs. They enable and encourage the Joint Programme to make integrated and effective contributions that are informed by country priorities, targets, capacity and resources. UNAIDS/PCB(42)/18.8 Page 7/154 8. In addition, ECOSOC recognized the Joint Programme as a model for UN reform in Resolution E/2017/L.27, where it stressed “the need for the Joint Programme to continue to set the path for reform by revising and updating its operating model, in particular in the areas of joint work, financing and accountability, and governance, as considered by the PCB […] at its 40th meeting […]”. This testifies to the efforts of the Secretariat to ensure that a resolution tabled and negotiated in Geneva is then successfully brought to and adopted in New York. 90–90–90 9. A major milestone in the HIV response was met in 2016: for the first time, more than half of all people living with HIV (53%) had access to HIV treatment and AIDS-related deaths had been reduced by almost half since 2005. Fully 19.5 million of the estimated 36.7 million people living with HIV had access to treatment, and AIDS- related deaths had been reduced from 1.9 million in 2005 to 1 million in 2016. 10. The massive expansion of antiretroviral therapy in the past 10–12 years, supported by coordinated activities across the Joint Programme, has been central to this success. Accelerated treatment access continues to underpin the 90–90–90 targets for HIV diagnosis, treatment and viral suppression, a vital pathway to reducing the number of new HIV infections to below 500 000 by 2020. 11. Part of this success can be attributed to the push by UNAIDS to transform the 90–90– 90 vision into a reality in countries. The 90–90–90 targets represented a shift in the approach to HIV treatment. The new