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The Polity Utility of Tracking State HIV/AIDS Allocations

The Polity Utility of Tracking State HIV/AIDS Allocations. UNAIDS Satellite Meeting: “National AIDS Accounts” XV International AIDS Conference Bangkok, July 2004. Teresa Guthrie AIDS Budget Unit ~ Idasa Cape Town, South Africa teresa@idasact.org.za. Policy Utility of Budget Analysis.

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The Polity Utility of Tracking State HIV/AIDS Allocations

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  1. The Polity Utility of Tracking State HIV/AIDS Allocations UNAIDS Satellite Meeting: “National AIDS Accounts” XV International AIDS Conference Bangkok, July 2004 Teresa Guthrie AIDS Budget Unit ~ Idasa Cape Town, South Africa teresa@idasact.org.za

  2. Policy Utility of Budget Analysis • Budget allocations give an indication of the level of States’ commitment to health and HIV/AIDS. • Allocations are indicators which can measure the attainment of global commitments: • Abuja Commitments – 15% of total annual budget to health. “We also pledge to make available the necessary resources for the improvement of the comprehensive multi-sectoral response, and that an appropriate and adequate portion of this amount is put at the disposal of the National Commissions/Councils for the fight against HIV/AIDS, Tuberculosis and Other Related Infectious Diseases.” • UNGASS Commitments • MDGs Teresa Guthrie ~ AIDS Budget Unit

  3. Utility of Budget Analysis cont. • Budget allocations give an indication of the attainment of human rights – issues of equity and efficiency in resource allocation, if based on need. • Indicates prioritisation of interventions • eg. Multi-sectoral vs health-dominated, • Prevention vs treatment focus. • Measures additionality. • Indicates what governments are spending on each of their citizens ~ per capita. Teresa Guthrie ~ AIDS Budget Unit

  4. Importantly…. • Resource tracking data is used by government officials, donors, and particularly civil society as an advocacy tool, to inform and influence policies and prioritisation of response, in terms of resource allocations. Teresa Guthrie ~ AIDS Budget Unit

  5. Some key examples of the findings:Public Health Allocationsin 4 African Countries Teresa Guthrie ~ AIDS Budget Unit

  6. Moz Abuja Nam - tot MoHSS SA Nam - health specific Ken Are African States meeting the Abuja Target in their Public Health Allocations?Health as share of total govt. expenditure 18.00% 16.00% 14.00% 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% 2000/1 2001/2 2002/3 2003/4 2004/5 2005/6 Sources: Mozambique National Statistics Institute Database, 2003. South African Budget Review, 2003/04 and Estimates of National Expenditure, 2003. Kenyan Estimates of Recurrent and Development Revenue, 2003, and National Aids Resource Envelope, 2003.

  7. 158,106,635 150,621,762 98,127,789 98,227,307 How much are states committed… or dependent?Mozambique: Total Health Budget Sources (USD) 180,000,000 160,000,000 140,000,000 120,000,000 100,000,000 80,000,000 60,000,000 40,000,000 20,000,000 0 2001 2002 State External Teresa Guthrie ~ AIDS Budget Unit Source: Mozambique INE, 2003. Source: MISAU -DPC 2003

  8. n/a Mozambique Kenya South Africa State annual health spending per capita 100 90 80 70 2000/01 60 2001/02 US$ 50 2002/03 2003/04 40 2004/05 30 2005/06 20 10 0 Sources: Mozambique National Statistics Institute Database, 2003. South African Budget Review, 2003/04 and Estimates of National Expenditure, 2003. Kenyan Estimates of Recurrent and Development Revenue, 2003, and National Aids Resource Envelope, 2003. Dorrington, 2002.

  9. HIV/AIDS Allocations Teresa Guthrie ~ AIDS Budget Unit

  10. State HIV allocations (Real) Donor and NGO HIV allocations (Real) Kenyan HIV/AIDS allocations (Kshs millions) 2000/01-2005/06 12,000 10,000 8,000 Kshs millions 6,000 4,000 2,000 0 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 Source: Kenyan National AIDS Resource Envelope, February 2003.

  11. Are State’s prioritising HIV/AIDS Spending? Share of total expenditure South Africa Kenya Mozambique 4.0% 3.5% 3.0% 2.5% 2.0% 1.5% 1.0% 0.5% 0.0% 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 Sources: Mozambique National Statistics Institute Database, 2003. South African Budget Review, 2003/04 and Estimates of National Expenditure, 2003. Kenyan Estimates of Recurrent and Development Revenue, 2003, and National Aids Resource Envelope, 2003.

  12. Kenya SA Moz HIV/AIDS allocations as Share of Total Health Expenditure 18.00% 16.00% 14.00% 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% 2000/1 2001/2 2002/3 2003/4 2004/5 2005/6 Sources: Mozambique National Statistics Institute Database, 2003. South African Budget Review, 2003/04 and Estimates of National Expenditure, 2003. Kenyan Estimates of Recurrent and Development Revenue, 2003, and National Aids Resource Envelope, 2003.

  13. South Africa Kenya HIV/AIDS annual allocations per capitain South Africa and Kenya (US$) 4 3.5 3 2.5 2 USD $ 1.5 1 0.5 0 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 Sources: South African Budget Review, 2003/04 and Estimates of National Expenditure, 2003. Kenyan Estimates of Recurrent and Development Revenue, 2003, and National Aids Resource Envelope, 2003. Dorrington, 2002. Teresa Guthrie ~ AIDS Budget Unit

  14. Composition of Kenyan HIV/AIDS by Activity Type Kenyan National Aids Resource Envelope, 2003. Teresa Guthrie ~ AIDS Budget Unit

  15. Research Management Treatment Care & Support Prevention NGO Transfers ARV treatment consumes increasing share of HIV/AIDS budget in SA. 1,600,000 1,400,000 1,200,000 1,000,000 800,000 ZAR '000 600,000 400,000 200,000 0 2000/2001 2001/2002 2002/2003 2003/2004 2004/2005 2005/2006 Sources: South Africa 2003/04 Estimates of National Expenditure. 2003 MTBPS. Idasa Calculations. Teresa Guthrie ~ AIDS Budget Unit

  16. For Public Pop. For HIV+ Pop. For AIDS sick Pop. What SA spends per population group on HIV/AIDS (ZAR real terms) (2000/01-2005/06) 1600 1400 1200 1000 Rand 800 600 400 200 0 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 Sources: South African 2003 IGFR. 2003 Estimates of National Expenditure. 2003 Budget Review. 2003 Provincial Budget Statements. Dorringtotn et al (2002). Idasa calculations. Teresa Guthrie ~ AIDS Budget Unit

  17. South Africa: Actual expenditure of HIV/AIDS transfers by sector R 385 m 85% 2000/1 2001/2 2002/3 75% R 109 m 37% R 18 m (includes funds rolled over from previous year) 450 400 350 300 250 R million 200 150 100 50 0 Education Health Social TOTAL Development Source: 2001 SA Intergovernmental Fiscal Review. 2001 Budget Review.Statement of the National and Provincial Governments' Revenue and Expenditure and National Borrowing (March02&03). Intervs.

  18. Budget-related recommendations • Increase political will ito action and allocations. • Increase state health allocations to meet Abuja Target & strengthen system. • Increase multisectoral budgets for HIV/AIDS. • Funded National Strategic HIV/AIDS plans (NSPs) • Funded National AIDS coordinating bodies. • Allocation based on need and equity. • Mix of funding channels. • Mix of funding sources. • Increase provincial and local skills. • Improve budgetary information. • Build capacity of local civil society and Parliamentarians to regularly monitor government expenditure. Teresa Guthrie ~ AIDS Budget Unit

  19. Way Forward • Increase capacity in-country - both within govt and civil society - to undertake resource tracking as sustained activity. • Improve state tracking and management of donor funds. • Harmonise the definitions and type of data collected to allow cross-comparison and tri-angulation. • Deepen analysis – actual expenditure, output assessment using programme indicators, efficiency and equity analysis based on costed need requirements. • Develop/ support networks of organisations involved in HIV/AIDS resource tracking. Teresa Guthrie ~ AIDS Budget Unit

  20. Critical Recommendations for establishing regional networks ~enabling civil society’s participation • Civil society organisations must be empowered to undertake HIV/AIDS budget monitoring, and participate in networks for resource tracking. • Capacity-building should occur through the process of budget analysis, undertaken by the CSOs. • On-going technical support and harmonisation of methods necessary. • Sharing of experiences and skills essential ~ electronically, study visits, peer-review and collaborative meetings. • External review processes & reference teams input to verify data and ensure appropriateness. Teresa Guthrie ~ AIDS Budget Unit

  21. Teresa Guthrie AIDS Budget Unit ~ Idasa Cape Town, South Africa teresa@idasact.org.za Thank you!

  22. AIDS Budget Unit provides research and analysis, and conducts training on the public finance issues related to government’s response to HIV/AIDS. 1. Analyse government budget from an HIV/AIDS perspective 2. Produce recommendations for policy-makers on allocations and effective funding mechanisms for transferring money for HIV/AIDS interventions 3. Build capacity in Parliament and civil society to participate in the budget process on HIV/AIDS issues Teresa Guthrie ~ AIDS Budget Unit

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