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Abt Associates Inc.

Tackling the Decline in HIV Resources: Lessons Learned from HIV/AIDS Program Sustainability Analysis Tool (HAPSAT). 1 Abt Associates, Health Systems 20/20, International Health Division, Bethesda, United States 2 National AIDS Secretariat, Freetown, Sierra Leone

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Abt Associates Inc.

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  1. Tackling the Decline in HIV Resources: Lessons Learned from HIV/AIDS Program Sustainability Analysis Tool (HAPSAT) 1 Abt Associates, Health Systems 20/20, International Health Division, Bethesda, United States 2 National AIDS Secretariat, Freetown, Sierra Leone 3 National AIDS Control Council, Nairobi, Kenya 4 National AIDS Programme Secretariat, Georgetown, Guyana Itamar Katz1, Wendy Wong1, Douglas Glandon1, Brima Kargbo2, Regina Ombam3, Shanti Singh4, John Osika1 Abt Associates Inc. In collaboration with:IAga Khan Foundation I Bitrán y Asociados I BRAC University I Broad Branch Associates I Deloitte Consulting, LLP I Forum One Communications I RTI International I Training Resources Group I Tulane University’s School of Public Health

  2. Background • Heavy dependence on donor funding • Expansion of HIV services beyond the levels that can be sustained

  3. HAPSAT: HIV/AIDS Program Sustainability Analysis Tool • Sustainability of HIV programs in limited-resource settings: • What should be prioritized? • What efficiency measures should be applied? • How should additional resources be mobilized?

  4. Objectives of the presentation • In relation to prioritization and resource mobilization: • HAPSAT framework • Interests of policy makers of HIV responses • Examples from Guyana, Kenya, Sierra Leone and South Sudan (conducted in additional 10 countries)

  5. Prioritization • Effectiveness of interventions: mainly for medical interventions • Capacity (versus universal access) • Cost • Contextual issues

  6. Prioritization South Sudan: HIV awareness through radio vs. billboards

  7. Prioritization among MARPs • South Sudan: Scaling up CSW outreach rather than constructing costly prevention centers • Sierra Leone: Under the program leadership and support from UNAIDS, Global Fund and USAID (the latter through HAPSAT) Inclusion of MSM in the national strategic plan

  8. Resource mobilization strategies • Increased govt. budgetary allocations to HIV/AIDS interventions • Earmarked taxation for HIV/AIDS • Concessionary loans for HIV/AIDS programs • Debt conversion (know also debt2health) • Risk-pooling schemes (e.g. insurance) and special social assistance programs covering HIV/AIDS services • Fundraising (special/endowment HIV/AIDS funds)

  9. Resource mobilization: Financing Kenya’s National HIV Response 2008/09 vs. 2012/13 2008/09 $687 million 2012/13 $1,003 million

  10. Lessons learned • Understanding the reality Need for prioritization • Need for diverse funding sources Resource mobilization • Need for sustainability plans • Sierra Leone: Govt. pledges to replace Global Fund financing once ends • Guyana: Preparing for PEPFAR gradual pull out

  11. Email: hapsat@abtassoc.com itamar_katz@abtassoc.com Visit: www.hs2020.org/hapsat: Country reports, the HAPSAT tool and document on target setting For more information… Thank you

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