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Financial sustainability of the AIDS Response in EECA

Financial sustainability of the AIDS Response in EECA. Dr. Viorel Soltan, MPH, MBA , PhD. Sustainability. Benefits : ability to produce and maintain health outcomes for individuals and populations

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Financial sustainability of the AIDS Response in EECA

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  1. Financial sustainability of the AIDS Response in EECA Dr. Viorel Soltan, MPH, MBA, PhD

  2. Sustainability • Benefits: ability to produce and maintain health outcomes for individuals and populations • Institutionalization: ability to ensure program activities (incorporation of new programs into existing systems and structures) • Capacity to deliver programs --------------------------------------------------------------- • Financial sustainability - when the program is able to deliver products and services to generate outcomes and achieve its goal in a cost effective manner.

  3. EECA domestic funding • Public spending: governments are increasingly responsible to fund disease-related programs • Prioritization & Gov support : diagnosis and treatment • Substantial gap exists regarding complex interventions as treatment and prevention among KAP (PWID, SWs, MSM) • Only 11% investments are directed to KAP (UNAIDS, 2011)

  4. EECA domestic funding (cont.) UNAIDS, 2011

  5. EECA domestic funding (cont.) • Lack of support to civil society / community based activities – social contracting • Romania example (potential evolution for Balcan countries) • Dependency from external funding is high (4 countries are fully dependent on ART) • From 70% to 90% of funding for HIV programs for KAP comes from external donors.

  6. The Global Fund • TGF is the largest donor, including HR (over US$ 1.5 billion for the period of 2002-2016) • ~40% counter-part financing (20/40/60) • NFM: not less than 50% dedicated to KAP • Min 65% (75%) for LLMIC (ULMIC) for ART, lab services and treatment support in 3 years • Graduation: countries need to develop strategies for sustainability beyond TGF.

  7. Costs & Prices • Efficiency: how well HIV programs perform • Effectiveness: how useful is what HIV programs deliver • Systemic factors (corruption) • Procurement issues (pooled procurement, international procurement mechanisms etc.) • TRIPS Plus requirements (Ukraine, Georgia and Moldova example)

  8. EECA to do list • Invest smart • Better prioritization (focus on KAP) • Innovative programs (patient centered) • TB collaborative activities in HIV programs etc. • Develop social contracting • Institutionalize community oriented services • Develop SMART plans for graduation • Social accountability / advocate for Gov ownership and takeover

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