Synergies between National AIDS Accounts and the National Health Accounts Framework

1. Synergies between National AIDS Accounts and the National Health Accounts Framework EIP/FER, WHO, Geneva Satellite meeting on Resource tracking and priority setting – National Aids Accounts 13 July, 2004 Evidence and Information for Policy

2. Importance of National Health Accounts • Systematic Collection of health expenditure data for policy use as early as the 50's and 60's in US, France and by WHO in a number of Member States. • Today – OECD reports health expenditure data in a standardized manner for 30 Member States and an additional 70 or so countries have undertaken partial or full NHA studies • At a time where calls for better national accountability, decentralization, global resource tracking, additionality, PRSPs, MDGs and monitoring and evaluation – demands for more countries to routinely undertake NHAs and to include additional breakdowns.

3. Why link National AIDS Accounts and NHA? • At a time when the bulk of new surge of donor funding for health is for HIV/AIDS, NAA analysis is timely and relevant for policy makers • Linking NAA to NHA will make it • A more durable tool, more likely to be institutionalized within Governments • Relevant for other initiatives such as global resource tracking for other priority diseases or interventions, additionality, PRSPs and MDGs • Easier to assess sustainability of HIV/AIDS programs in the context of broader health systems • Use of internationally comparable methods/definitions

4. 100 80 60 40 20 2 4 6 8 Relationship between Health Expenditures and Life Expectancy Switzerland USA Life expectancy Djibouti Namabia Kenya Swaziland Liberia Malawi Botswana Zimbabwe High HIV mortality rate Sierre Leone Log of total health expenditures per capita in international dollars

6. NHA resources can facilitate NAA • Producer Guide has already developed standard definitions, boundaries and framework for NHA. A supplement is being developed for disease specific priorities following the same standard tool – http://www.who.int/nha/docs/en/ • WHO NHA website provides resources such as country NHA documents, experts who answer questions, NHA data for countries, etc. Same experts are also working on NAA and can facilitate NAA work in countries. www.who.int/nha • WHO builds capacity not only by promoting NHA through networks and providing technical assistance in countries, but strengthens and compliments the efforts to develop NHA and NAA through its 6 regional and 141 country representative offices.

7. Conclusions • While NAA can be developed without NHA, existence of NHA or its simultaneous development yields greater consistency and comparability and ensures greater likelihood of institutionalization and sustainability. • Linking NHA and NAA enhances information availability for making policy relevant decisions in broader health system context and also harmonizes the efforts for country statisticians. • WHO and its network of partners on NHA look forward to working ever more closely with UNAIDS and its partners on NAA (who are often the same partners) for close collaboration and integration of these two inter-twined areas.