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

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Presentation on theme: "Financial sustainability of the AIDS Response in EECA Dr. Viorel Soltan, MPH, MBA, PhD."— Presentation transcript:

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 ) ~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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