Tackling the Decline in HIV Resources: Lessons Learned from HIV/AIDS Program Sustainability
Analysis Tool (HAPSAT) Itamar Katz1, Wendy Wong1, Douglas Glandon1, Brima Kargbo2, Regina Ombam3, Shanti Singh4, John Osika1
Abt Associates Inc. In collaboration with:I Aga Khan Foundation I Bitrán y Asociados I BRAC University I Broad Branch Associates I Deloitte Consulting, LLP I Forum One Communications I RTI International I Training Resources Group I Tulane University’s School of Public Health
1 Abt Associates, Health Systems 20/20, International Health Division, Bethesda, United States2 National AIDS Secretariat, Freetown, Sierra Leone3 National AIDS Control Council, Nairobi, Kenya4 National AIDS Programme Secretariat, Georgetown, Guyana
Background
Heavy dependence on donor funding Expansion of HIV services beyond the levels
that can be sustained
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HAPSAT: HIV/AIDS Program Sustainability Analysis Tool
Sustainability of HIV programs in limited-resource settings: What should be prioritized? What efficiency measures should be applied? How should additional resources be mobilized?
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Objectives of the presentation
In relation to prioritization and resource mobilization: HAPSAT framework Interests of policy makers of HIV responses
Examples from Guyana, Kenya, Sierra Leone and South Sudan (conducted in additional 10 countries)
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Prioritization
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Effectiveness of interventions: mainly for medical interventions
Capacity (versus universal access)
Cost
Contextual issues
Prioritization
South Sudan: HIV awareness through radio vs. billboards
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Cost per exposure Context Priority
Radio ads and talkshow
s US$ 0.003
Major information source for South
SudaneseHigh
Billboards US$ 0.05
Low literacy levels limits its use,
potentially useful in urban areas
Low
Prioritization among MARPs
South Sudan: Scaling up CSW outreach rather than constructing costly prevention centers
Sierra Leone: Under the program leadership and support from UNAIDS, Global Fund and USAID (the latter through HAPSAT) Inclusion of MSM in the national strategic plan
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Resource mobilization strategies
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Increased govt. budgetary allocations to HIV/AIDS interventions
Earmarked taxation for HIV/AIDS Concessionary loans for HIV/AIDS programs Debt conversion (known also debt2health) Risk-pooling schemes (e.g. insurance) and special
social assistance programs covering HIV/AIDS services
Fundraising (special/endowment HIV/AIDS funds)
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Resource mobilization: Financing Kenya’s National HIV Response 2008/09 vs. 2012/13
2008/09$687 million
2012/13$1,003 million
13%
87%
Insurance Premiums
Innovative Financing
Increased Gov-ernment Budget
27%
73%
Country Donor
Lessons learned
Understanding the reality Need for prioritization
Need for diverse funding sources Resource mobilization
Need for sustainability plans Sierra Leone: Govt. pledges to replace Global
Fund financing once ends Guyana: Preparing for PEPFAR gradual pull out
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Email:[email protected][email protected]
Visit:www.hs2020.org/hapsat: Country reports, the HAPSAT tool and document on target setting
For more information…
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