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Show me the money: The responsibility of the recipient countries. Dr Faustine Ndugulile MD MPH Member of Parliament-Tanzania IAS Governing Council Member-Africa. National HIV/AIDS prevalence is 5.7%. HIV and AIDS accounts for the 10% of the national budget ( PER 2010 ).
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Show me the money: The responsibility of the recipient countries Dr Faustine Ndugulile MD MPH Member of Parliament-Tanzania IAS Governing Council Member-Africa
National HIV/AIDS prevalence is 5.7%. HIV and AIDS accounts for the 10% of the national budget (PER 2010). National response requires about TSh 1 trillion per year. (NMSF 2008-12) Tanzania receives about TSh 550 billion per year. There is a financing gap of about 50%. Donor dependency on HIV/AIDS programme is about 97%. Background
Provides about USD 20 million per annum. 65% of the Government funding finances ART programme. The remaining fund is used for HIV/AIDS activities in other Ministries, Districts and Agencies. Districts are encouraged to work with the CSOs. Government Contribution
Active: CIDA, DANIDA, JICA, GIZ,USG, WB, UN, SIDA, GFATM, and Netherlands. 91% of all foreign funding comes from two donors: GFATM 20% and PEPFAR 71%. Remaining 9% come from 8 other multi- and bilateral donors. Other DPs not mentioned here are financing HIV through GBS. Since 2008 some DPs have phased out their support to HIV and AIDS. Development Partners – HIV and AIDS
Main supporters: Government, GFATM, NMSF Grant and MOHSW basket fund. Transfers include: IGA, OVC,CSW, PLHAs, materials to PLHIV, OVC, Widows support, school items and fees, NACOPHA cluster offices and Travel assistance Multi - Sectoral AIDS Committees activities Local Government Authorities
Now est. at 10,000 Direct funding to CSOs by foundations and development agencies accounts for more than 70% of the HIV and AIDS resources coming into Tanzania The greater portion of this is accounted for by PEPFAR and the Global Fund. Large portion does not go to national CSOs, but to international CSOs which sub-grants to national NGOs. CSOs roles are not clear (governance Vs service providers) More office budget and less accountability CSOs
Private sector is the smallest contributor to HIV and AIDS response, accounting for around 4% of spending compared to multilaterals. Private companies contributes through Work Place Programmes of own staff . The Government of Tanzania is intending to establish a mechanism which may involve Private Sector tocontribute HIV and AIDS programme in a more extensive way. Private sector
HIV/AIDS funding is not adequate. Multiple funding sources. Multiple areas of focus. Multiple reporting and accountability mechanisms. Preference of NGOs to Government systems. Challenges
Recipient countries should set their own agenda and priorities. These should country driven. Right policy environment and sound monetary policies to ensure effective and efficient use of local and external resources. Ensuring accountability and aid transparency. Well thought through intervention. High impact, low overhead costs. Role of recipient Governments
Advocate for increased local resources towards health. Establish legislations and political framework that would commit more local resources and create alternative funding mechanisms. To oversee the implementation of budgeted activities. To advocate value for money in HIV programmes including donor funds. Role of Parliament
Ways to reduce dependency • Governments should commit more local resources into HIV/AIDS. • Abuja Declaration- 15% of National budgets should go to health. • Government should establish alternative funding mechanisms • Tanzania intends to establish a Trust Fund for HIV/AIDS. • Fund to tax certain products for HIV/AIDS activities. • It is expected that this initiative will reduce funding gap by 40%. • Engagement of the private sector through Public-Private Partnership framework.
What can donor countries do? • Funding according to national priorities • Streamline funding and report mechanisms. • Funding transparency needed from donor countries. • Money to NGOs and CSOs-Better oversight and coordination is needed.
Thank you Asanteni