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Presentation on theme: "DOMESTIC FUNDING FOR HIV & AIDS RESPONSE The AIDS Levy in ZIMBABWE By Dr. T. Magure NAC Chief Executive Officer."— Presentation transcript:


2 Background…NAC established  1999 was perhaps the year of turning of the tide in HIV and AIDS where in the following happened:  The 1 st National HIV and AIDS Policy was developed in 1999; supported by the National HIV and AIDS Strategic Framework -  The National AIDS Council was established in 1999 and operationalised in 2000 to inter-alia: coordinate, facilitate, mobilize, support and monitor a decentralized national Multi-Sectoral response to HIV and AIDS

3 NAC Mandate MANDATE: To provide for measures to combat the spread of Human Immuno Deficiency Virus (HIV) and management, coordination and implementation of programmes that reduce the impact of HIV and AIDS. (The National AIDS Council Act Chapter 15:14 of 2000)

4 Zimbabwe HIV Situation Population: 12.7 million (2011) HIV Prevalence: 15% HIV Incidence: 0.98% ART: 747, 200 Source: UNDP data

5 Percent HIV positive men and women age 15-49 HIV Prevalence by Province Mashonaland West 15% Mashonaland Central 14% Mashonaland East 16% Manicaland 14% Masvingo 14% Midlands 15% Matabeleland North 18% Matabeleland South 21% Bulawayo 19% Harare 13% Zimbabwe: 15% ZDHS 2010/11

6 6 Source: 2008 Report on the Global Epidemic (UNAIDS) Zimbabwe The Sharpest HIV Decline in Southern Africa

7 Home-grown resource mobilisation initiative meant to raise resources for the national response to HIV and AIDS Established by an ACT of Parliament Stipulates that formally employed individuals and corporates be levied 3% of their taxable income towards the National AIDS Trust Fund ZIMRA directly deposits the funds into a NAC account NAC administers the fund The National Aids Trust Fund

8  The idea was conceived in late 1990s, in response to worsening HIV and AIDS situation – in the face of limited government funding  Various institutions, including PLHIV implemented a sustained lobbying campaign  A bill was thus developed and presented to Parliament  The Government presented the idea as a means of self sufficiency in responding to HIV and AIDS  Also as a basis on which donor funds can be attracted  Parliament passed the bill, resulting in the AIDS Levy as we know it today Establishment Process

9 To pursue objectives of the National AIDS Strategic Plan To provide support for HIV and AIDS programmes in the community To assist in the procurement of drugs for infected To undertake prevention measures To cater for HIV and AIDS OVC To facilitate training of people engaged in HIV and AIDS activities To promote, M&E and research To establish a secretariat for the pursuit of the objectives NATF Objectives,

10 The NAC Board has produced detailed instructions on administration of fund Fund has been decentralized through NAC structures at PAAC, DAAC and WAAC level, wherein NAC has established AIDS Action Committees to stand in for the Board at those levels DAAC is the most active element of the decentralized structures – In 2015, each of the 10 provincial offices will receive $500, 000.00 for provincial non-health programmes 50% of the estimated $38 million will go for procurement of ARVs Administration of fund

11 50% Treatment 10% prevention 3% Advocacy 3% M&E 3% Coordination 4% Mitigation 3% CHBC 1% Communication 10% Capital Items 13% Admin Thematic allocations…

12 AIDS Levy successes US$150 million has been raised since 2009 HIV Prevalence reduction from over 30% before 2000 to 15% in 2011 30% of all ART clients supported through AIDS Levy Procurement of ART Commodities – drugs and equipment Health and sector workers support and retention Has given birth to the new PPP arrangement – called Increased Access to Treatment Supported development and implementation of sector policies Flexible fund – supports cancer and TB, and covers gaps during Global Fund shortages

13 ART Coverage ART coverage has continued to rise in Zimbabwe, spurred by both national and donor investment Coverage now stands at 747 000 clients out of estimated 1,2 million in need What is significant to note is that all HIV positive people are targeted for treatment – at a CD4 count of 500 Previously, Zimbabwe had achieved universal access – ie. The expressed need for ART had been met at CD4 count of 350

14 AIDS Levy successes: Diagnostic Equipment EquipmentQuantity CD4 Count High Throughput Machines 4 CD4 Count Medium Throughput Machines 12 Chemistry Analysers High4 Chemistry Analysers Medium Throughput 12 Haematology Machines High throughput 4 Haematology Machines- medium throughput 12 Gene- Experts Machines12

15 General Purchases ARVs Anti TB Medicines Anti Cancer Medicines Laboratory Equipment & Reagents HIV & Syphilis Test Kits NBSZ Blood bags & Blood Test Kits & Reagents CHBC Kits Male Circumcision kits

16 Donor % Support Global Fund 35 NATF 30 USG 18 Other 16 CHAI 1 Funding Partners Distribution for ART

17 AIDS Levy Build On: Improved Access to Treatment NAC in partnership with other public sector entities and private sector players recently established an Improved access to treatment plan - more on the lines of a public private partnership arrangement The scheme is meant to benefit employees on medical aid – especially public service workers – who may detest queuing at public ART outlet centres In the Plan, NAC procures ARVs worth millions per year at cheaper prices and through the National Pharmaceutical Company, distributes some of them to private pharmacies

18 PPP Private pharmacies sell to people on medical aid at $17.00 per month instead of the previously at least $55.00 The National Pharmaceuticals charges a handling fee, while the private pharmacies levy their own mark-up NAC recovers the money invested in procuring ARVs and ploughs it back in the procurement chain Close to US$ 1 million already been raised so far in 2014 The arrangement has a potential for NAC to raise additional US$5 million per year in two years


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