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Understanding the Investment Approach

Understanding the Investment Approach. Faith Mamba Regional Support Team Eastern and Southern Africa . The investment approach answers 8 critical questions. 1. What is the current state of the epidemic? And how is that expected to change?. UNDERSTAND. 2.

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Understanding the Investment Approach

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  1. Understanding the Investment Approach Faith Mamba Regional Support Team Eastern and Southern Africa

  2. The investment approach answers 8 critical questions 1 • What is the current state of the epidemic? And how is that expected to change? UNDERSTAND 2 • Where are we focusing our efforts and resources today? What is the current impact? And where does the money come from? 3 • What programme elements are required and at what scale for an optimal response? DESIGN 4 • What would the impact of this optimal programme be? 6 • How much money will be needed for HIV in the future and what are the net savings over time? DELIVER 5 • What bottlenecks and inefficiencies can be addressed and how? 7 • What financing options are available to close the financing gap once efficiency gains are achieved? SUSTAIN 8 • How will you guarantee stakeholder buy-in and operational excellence required?

  3. AIDS: investing strategically to maximize impact Critical Enablers Social: Political commitment and advocacy • Laws, legal policies, and practices • Community mobilisation • Stigma reduction • Mass media • Local responses to change risk environment Programme Community centred design and delivery • Programme communication • Management and incentives • Procurement and distribution • Research and innovation OBJECTIVES BASIC PROGRAMME ACTIVITIES Child infections & maternalmortality Keypopulations Stopping new infections Behaviour change Condoms Keeping people alive Male circumcision Treatment & care SYNERGIES WITH DEVELOPMENT SECTORS

  4. Countries Implementing the Investment Approach in ESA Investment Cases: Botswana South Africa Ethiopia Swaziland Lesotho Tanzania Kenya Uganda Madagascar Zambia Mauritius Zimbabwe Namibia NSP Development/MTR: Lesotho Kenya Namibia Rwanda Swaziland Zambia

  5. Core components of an HIV Investment Case Ideally, an investment case should: • Summarize the state of the epidemic and the response • Highlight what needs to be done to respond to HIV more effectively and at scale • Identify ways to improve value for money in HIV interventions • Outline current and future resource needs • Quantify additional lives saved and infections averted • Display the returns of investing more smartly in HIV • Suggest options for ensuring the sustainability of the HIV response • Articulate keydecisions to be taken to maximize the impact • In addition, investment cases need to be led by senior government officials and key stakeholders in each country.

  6. Observed shifts in the AIDS response as countries implement the Investment Approach • Better focus on the prioritization of high impact interventions and ensuring that interventions are delivered at scale; • The evidence generated has allowed countries to improve targeting and geographic focus of interventions; • Countries are exploring effective delivery models, integration and strengthening community systems; • There is better focus on the returns on the investments made in AIDS and a long term view planning (beyond 2015) adopted by countries;

  7. Observed Shifts in the AIDS response as countries implement the Investment Approach: • Countries are recognizing that efficiency improvements can reduce the resource gap; • placed Sustainable financing high on the agenda of most governments. Through this work countries are exploring: • The fiscal implications of HIV • Alternative sources of financing (AIDS Levy – Tanzania, Uganda; AIDS Trust – Kenya) • Shared responsibility (leveraging the dialogue to advocate for improved domestic allocations and predictable external financing that is aligned to national priorities

  8. Lessons Learnt from Implementing the IA: • Investment decisions are political. Country buy-in and ownership central to the IC development ….essential for hard choices about where to invest/disinvest • National processes have been helpful in securing buy-in and ownership of the IA and IC development process • The engagement of Ministries of Finance/Treasury, Development Planning remains a priority • Poor articulation of Critical Enablers and Synergies in Investment Cases/NSPs - Investment requirements for critical enablers are poorly understood and therefore often not prioritized • Strengthening the economic backbone of the current ICs and making linkages with broader health and development agenda • Data issues….unit costs. Leveraged partnerships with World Bank, PEPFAR, CDC, CHAI to overcome data challenges

  9. Thank You

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