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Focus of presentation

HIV & AIDS FUNDING AND ECONOMIC RECESSION: A CALL FOR VISIONARY LEADERSHIP International AIDS Conference Vienna, 2010 Vailet Mukotsanjera-Kowayi: HEAD: AIDS BUDGET UNIT. Focus of presentation. Overview of the AIDS Budget Unit The economic recession and HIV & AIDS funding

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Focus of presentation

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  1. HIV & AIDS FUNDING AND ECONOMIC RECESSION: A CALL FOR VISIONARY LEADERSHIPInternational AIDS Conference Vienna, 2010Vailet Mukotsanjera-Kowayi: HEAD: AIDS BUDGET UNIT

  2. Focus of presentation • Overview of the AIDS Budget Unit • The economic recession and HIV & AIDS funding • Effects of the global economic recession • Donor dependency and treatment implications • All hope is not lost: What options exist?

  3. Funding the fight: Budgeting for HIV/AIDS in developing countries (2004) Phase 1: 2002-2004 Multi-country research: • Southern Africa (South Africa, Namibia, Kenya, Mozambique) • Latin America (Argentina, Chile, Ecuador, Mexico, Nicaragua)

  4. HIV & AIDS Financing and Spending in Eastern & Southern Africa (2008) • Phase 2: 2005-2008 Multi-country research: • Ethiopia, Kenya, Tanzania (Zanzibar), Malawi, Zambia • ABU extended its network to countries which were not part of phase 1 • First attempt to use NASA • Results and experiences helped to informed phase 3

  5. Main findings • Low absorptive capacity • Mismatch between international & regional commitments and resource allocation • Low resource allocations for health strengthening activities • Low financial commitment by the national governments • More than 80% of HIV/AIDS activities donor funded

  6. The economic recession and HIV & AIDS funding • Main sources of HIV/AIDS funding • International/ donor • Domestic/ national • Private • Economic recession The general slow down of economic activity for more than two quarters NB***Recession affects the different funding sources differently

  7. Effects of recession on funding • International financiers** • PEPFAR reduced its budget for purchase of ARVs in 2009/10 • World Bank and UNITAD -- reduction in funding over the coming years in Malawi, Zimbabwe, Uganda, Mozambique & DRC • US, Netherlands and Ireland -- they will lower contributions to the Global Fund • 2009/10 Global Fund contributions to approved country grants reduced by 8-12% **(Source: Medecins Sans Frontieres (2010), No Time to Quit: HIV/AIDS Treatment Widening in Africa,)

  8. Effects of recession on funding Government • Government revenue base shrinking due to: • Companies closing down-- reduced corporate taxes • Retrenchments---- reduced income tax • Reduced household consumption--- reduced VAT Private sector • Companies closing down, reduced productivity, reduced profits- aim to lower costs • Households- unemployment, reduced disposable income • Reduction in “Diaspora income”

  9. Reality check: Contending national priorities

  10. Over reliance on HIV & AIDS donor funding Source: http://data.unaids.org/pub/report/2008

  11. Priority in treatment (2005-2007) http://www.unaids.org/en/CountryResponses/Countries

  12. Economic recession, donor dependency and treatment Implications for treatment programmes in Africa • Number of new patients to start ARV treatment has been cut six fold** • Drug stock-outs and disruptions in drug supply** • Lack of adherence- leads to mutation • Challenging options on who to treat (those already on treatment, on waiting list, new infections) **(Source: No Time to Quit: HIV/AIDS Treatment Widening in Africa, Medecins Sans Frontieres,2010)

  13. All hope is not lost: What options exist? • Need for options to make treatment programmes more sustainable • Governments can improve revenue collection • Through using effective revenue collection strategies e.g the coordinated revenue collection system of South African Revenue Service (SARS) • Taxation- e. g.in 1999, Zim introduced a 3% AIDS levy on taxable income. An innovative method- as long as the funds are used efficiently and equitably

  14. All hope is not lost: What options exist? • Public-Private Partnerships in HIV & AIDS financing • The need to employ demand driven resource allocation- based on needs • Political commitments must be reflected through openness to participatory decision making especially in resource allocation

  15. All hope is not lost: What options exist? • Given the economic recession: • there is need for increased accountability • Available resources should be allocated and in the most efficient and effective way • Available resources should be distributed in the most equitable manner and for intended purposes • Accountability efforts should be citizen centered, bottom-up approach to accountability

  16. Thank you!

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