Harmonisation and Alignment of Aid for HIV/AIDS in the SADC Teresa Guthrie Centre for Economic Governance and AIDS in Africa Inaugural Conference of the African Health Economics and Policy Association Accra - Ghana, 10th - 12th March 2009 PS 02/5
Transcript
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Teresa Guthrie Centre for Economic Governance and AIDS in
Africa Inaugural Conference of the African Health Economics and
Policy Association Accra - Ghana, 10th - 12th March 2009 PS
02/5
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To assess the progress of SADC countries towards harmonisation
& alignment of funds for HIV and AIDS To review the existing
declarations & instruments To identify the blocks and
challenges To make suggestions for required actions.
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Literature review Interviews with key respondents from various
SADC countries Used data from country NASA reports, where
available
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Incidence of HIV/AIDS has been steadily increasing in the SADC
region for the last two decades 15 million HIV-positive people in
SADC Region 51% of all the infections in Africa are in SADC 37% of
the global total are in SADC Thus SADC region is the worst affected
in the world
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Member states have put in place measures at both national &
regional levels for treatment, prevention & mitigation
Multi-sectoral strategic plans (NSPs) and strong leadership
response Commitment to Abuja Declaration and Plan of Action, the
New Partnership for Africa's Development (NEPAD), the Millennium
Development Goals (MDG) and the UN General Assembly Special Session
of HIV/AIDS Increasing partnerships with International Cooperation
Partners (ICPs) - Donor coordination meetings, partnership
framework, ICP framework Increasing role of civil society
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SADC HIV/AIDS Strategic Framework and Plan of Action: 2003-2007
adopted Underscored the importance of resource mobilization in the
fight against HIV/AIDS Approved the establishment of a regional
fund for the implementation of the SADC HIV/AIDS Strategic
Framework and Programme of Action 2003-2007 Urged International
Cooperating Partners and international development finance
institutions to generously contribute to the fund Appealed for a
relaxation in the stringent requirements attached to accessing
these funds on the part of ICPs Members to continue efforts towards
allocating at least 15% of their national budgets to health,
consistent with the Abuja Declaration.
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Difficult to get a regional picture, requires country level
analysis and reporting to SADC Not all countries have undertaken
NASAs nor accurately costed their NSPs Some countries not aware of
all the commitments and disbursements made to HIV/AIDS, and very
few aware of the actual expenditure So do not have a clear picture
of the resources required, the resources available, and therefore
cannot estimate the resource gap & mobilise funds Limited
evidence on the extent of absorptive capacity (undermined by above
points)
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From external, domestic, and some private/ business sector
resources Increasing number of actors confusion, fragmentation,
duplication, undermining a coherent response Varying funding
mechanisms & reporting requirements varying complexity and
strengths & weaknesses
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Authority is dispersed National priorities are weakened M&E
is fragmented Implementation is slowed Duplication, gaps, wastage
of resources Poor absorption Impact is limited
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Aid Effectiveness Harmonisation and alignment Existing
declarations, instruments, tools Country efforts
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From OECD/DAC Civil Society
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Aid harmonisation refers to the creation of common arrangements
for managing foreign aid. It requires that donors should work
together to ensure that their systems and processes are
standardised to reduce transaction costs to the recipient
government. (AFRODAD, 2007).
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The adoption of common procedures: Use the national government
budget process (direct budget support) Use the government
accounting and procurement systems, Undertake joint: aid missions
to a country diagnostic studies (sit.analysis) monitoring, auditing
and evaluation processes
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Processes/ Declarations 2002 Monterrey - conference on
Financing for Development 2003 Rome: High-Level Forum on
Harmonization 2003 ICASA: The Three Ones conceptualized 2003
Maseru: HIV/AIDS Summit 2004 Washington: Harmonization of
International Funding 2004 Tanzania: Africa Region Workshop on
Harmonization, Alignment and Results 2005 Paris: Declaration on Aid
Effectiveness 2005 London: Global Task Team established 2005 Rio:
Three Ones Consultative Workshop 2006 Paris:Innovative Financing
for Development 2006 Rwanda: Harmonisation, Alignment and Aid
Management
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goes beyond previous agreements by attempting to lay down a
more practical, action- oriented roadmap to improve the quality of
aid and its impact on development (AFRODAD, 2007). 5 five key
principles: ownership alignment harmonisation managing for results
mutual accountability establishes a commitment to track and set
targets against 12 indicators of progress.
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Joint Assistance Strategies (JAS) or Development Aid Strategies
(DAS) for aid mobilization, coordination and utilization (eg.
Zambia, Malawi, Tanzania). Aim at increasing efficiency and
effectiveness in the mobilisation and utilisation of aid to achieve
development goals Number of reforms, such as the establishment of
new aid coordination mechanisms, which causing an increase in the
number of structures that that manage aid in the country. Aid and
Debt Policies Public Financial Management (PFM) reform Support for
the PFM agenda/ Action Plan Regular stakeholder dialogue forums,
partnership forums Increasing joint approaches: Planning, Reviews
and analytical work, SWAp, Direct budget support, Pooled funding
common funds.
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Plenary Session Wed!
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What is still Blocking Harmonisation and Alignment of Aid for
HIV/AIDS? Factors undermining One National Framework: NSP is often
disregarded by the various actors National target setting might be
unrealistic May be due to accommodating civil society demands NSP
are not well costed, leading to an under- or over-estimation of
resources required Donors continue to fund direct projects, which
may be on or off the plan, and which they may or may not report on
Civil society groups may not buy-in to the NSP nor feel the need to
report on their activities and expenditure
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Factors undermining One National Coordinating Authority Donors
still have their own agendas and interests, not consulting with
NACs Duplication and parallel systems of CCMs and National AIDS
Authority Staff shortages and gaps in the NAC, in the MoH and MoF
Civil society has role to hold govt and donors accountable, but
should also be accountable to NAC Power is not given to NACs to
manage the funds
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Factors undermining One M&E system: Lack of capacity in
M&E Financial reporting weak - Many NACs are not aware of what
has been spent on the HIV/AIDS national priorities Donors continue
to have individual programme monitoring & reviews, and separate
auditing requirements imposed on recipient Governments Failure of
national budget & accounting systems to link expenditure with
HIV/AIDS priorities The activities & outputs of civil society
are generally not included in the national M&E system (eg.
Swaziland has specifically developed the SHAPMoS but CSOs are
resisting)
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Factors undermining unified systems and procedures: The Public
Finance Management reform is progressing slowly, leading to a lack
of trust in Govt. systems & donor cynicism The national
procurement, auditing and accounting systems are weak, or perceived
to be weak by donors Some donors systems are inflexible, preventing
rapid alignment Governments do not provide clear guidelines on
scheduling and conduct of missions, nor demanding joint missions
Creating an optimal combination of DBS, Sector Support, Basket
Funding (what really contributes to harmonisation?)
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NAC/ governmental roles: NSP should be a living document that
guides the national response (responsive, involving all
stakeholders, buy-in, engendered) Governments to own and lead the
response to HIV/AIDS Governments to better define the rules of
engagement with partners Develop a clear agenda for action,
reflecting mutual accountability, building on countries' own
systems, with clear allocation of responsibilities for all parties
(govt, donors, civil society) NSP should be realistically costed,
and expenditure against the priority activities should be tracked
Establish and maintain structures for regular dialogue with all
stakeholders
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Increase/ demand for more joint approaches: Planning, Reviews
and analytical work, Direct budget support, SWAp, Pooled funding,
baskets Government and donors and civil society to agree on a
common framework for financial performance monitoring, strengthen
economic governance systems Design and implement a system of
assessing donors based on Paris Declaration norms eg. Donor Score
Card Government to formulate and implement an Aid Coordination
Calendar (donors to align their fiscal year) Sector ministries to
articulate work plans for their contribution to the HIV/AIDS
national priorities All levels of govt to enhance their own
accounting, reporting and transparency regarding fund utilisation
this will increase donor confidence and willingness to align and
encourage civil society accountability
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ICPs roles Increase predictability of donor funding
(longer-term commitments), with greater flexibility More funding
for general health systems strengthening More support for the
construction of solid national authorities and coordination
capacity Emphasis on human and institutional capacity building
Accept and use the national M&E and reporting systems Harmonize
reporting requirements, tools and indicators Donors to use national
systems for procurement, accounting and auditing Closer exchange
and effective dialogue between Global Fund and UN Emphasis on
strengthening govt. financial information systems, so as to enable
electronic timeous reporting on expenditure and easily available
data (computerised systems reporting according to NASA
categories)
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SADC Roles: Strengthened communication channels and mechanisms
for sharing info across SADC and between NACs sharing best
practices Strengthened position if negotiating as SADC Spearhead
the development of a Code of Conduct for all partners, particularly
relating to ICPs alignment with NSPs (eg. Donor Score Card) Fund
for the response to HIV/AIDS? Hold joint annual reviews of progress
towards harmonisation and alignment with all stakeholders Request
regular commitment & expenditure reports from Members to create
the regional funding picture Regional group to consider/ monitor
regional funding issues Encourage Members use of the RNE, NASA and
CHAT tools
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Civil Societys roles: Civil society could broaden its advocacy
focus to include processes such as alignment and harmonization
Generate more public debate on alignment to drive the access agenda
delivery of Universal Access relies on effective architecture
making the money work Demand the govt and ICP reveal their actual
expenditure in-country Reveal their own activities and expenditure
leading to improved governance and greater transparency (eg. recent
Declaration on Good Governance and Leadership) Demand greater
transparency of adherence to promises Increased financial
contribution from the private sector
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International Health partnership and related initiatives (IHP+)
is a collective commitment to work together in more effective ways
to improve health care Rationalising of the health architecture
Change in the way donors work together with partner countries
through coordinated efforts of all stakeholders the strengthening
of in-country health system services under the leadership of the
Government, acting with the representatives of civil society
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To prove the impact of the IHP+ will require strong,
transparent financial information & accounting systems by
governments. Spending of pooled funds is difficult to track to the
specific donor ~ adoption of single reporting by govt without
individual outputs reflected. Public contributions to health are
key to sustainability of programmes, and therefore donor-dependency
must be addressed. Evidence of basket funding for HIV/AIDS and
Partnership Forums donors maintain dominance in determining
spending priorities, and can gang up against govt. Are donors ready
to allow governments full determination of the use of funds? Will
funding for critical NGO services reduce?
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Teresa Guthrie Centre for Economic Governance and AIDS in
Africa [email protected] +27-82-872-4694