NASA September 17, 2015UNAIDS Spending assessment for political decision making in HIV/AIDS: Spending assessment for political decision making in HIV/AIDS: Experience & Opportunities Presenter Teresa Guthrie Centre for Economic Governance and AIDS in Africa (CEGAA) September, 2008

NASA 1.Introduction 2.NASA global findings 3.Opportunities for evidence-based political decision making Overview of Presentation

NASA INTRODUCTION: Resource Tracking Using NASA 11.3 As the international response to AIDS continues to scale-up, it is increasingly important to accurately track in detail: how funds are spent at the national level and where the funds originate. The data helps national-level decision-makers monitor the scope and effectiveness of their programs When aggregated across multiple countries, the data helps the international community evaluate the status of the global response

NASA KEY FINDINGS OF NASAs Examples from the regions

NASA SOURCES OF FUNDS

NASA HIV Financing Sources Ukraine and Russian Federation, 2006

NASA Composition of HIV international sources – Swaziland (05/06 & 06/07)

NASA Sources of HIV/AIDS Funds in Swaziland - 50,000, ,000, ,000, ,000, ,000, ,000, ,000, ,000,000 Year Emalangenn International funds Public Funds International funds 239,520, ,816,750 Public Funds 32,835, ,915, / /2007

NASA Ukraine and Russian Federation International Share, 2006

NASA FINANCING AGENTS

NASA Financing Agents in Moz

NASA AIDS SPENDING CATEGORIES

NASA Ukraine HIV Spending Priorities % 39% 3% 20% 0% 3% 15% 1% Prevention Care and Treatment Orphans and Vulnerable Children Program Management and Administration Strengthening Incentives for Human Resources Social Protection and Social Services excluding Orphans and Vulnerable Children Enabling Environment and Community Development Research excluding operations research which is included under

NASA EECA Countries* - Reported HIV Spending by Intervention

NASA Source: Resource Needs for an Expanded Response to AIDS in Low and Middle Income Countries. UNAIDS, Table 1. Prevention and Treatment and Care spending, Mexico

NASA AIDS Categories in Botswana

NASA Treatment Activities – by Source - Swaziland

NASA Changing Priorities - Swaziland

NASA

SERVICE PROVIDERS

NASA HIV Service Providers Expenditure by Intervention, , Moz Care & Treatment Prevention

NASA BENEFICIARY ANALYSIS

NASA Beneficiaries in Zambia

NASA MEASURING PROGRESS TOWARDS NATIONAL PRIORITIES

NASA Comparison of Costed NSP with NASA Spending - Swazi

NASA NSP Priorities vs Actual Spending - Zambia

NASA RESOURCE GAP ANALYSIS ~ Comparison of Estimated Resource Needs (RNE) with Actual Expenditure (NASA)

NASA Draft

NASA Draft Share of different programmatic areas in expenditures and resource needs in 2006 in selected SSA countries

NASA (domestic public and international sources) Comparison of Total financial resources needed and total Expenditures, Cambodia 2004 $19,638.8$19,676.8 $0.0 $10,000.0 $20,000.0

NASA Comparison between Estimated Needs (RNM) and Expenditures (NASA), Cambodia Selected interventions (Thousand USD) Estimated NeedsExpenditures (domestic public and international sources)

NASA Opportunities for Informing Evidence-Based Decision- Making

NASA Opportunities for evidence-based political decisions ADEQUACY OF FUNDING – PUBLIC & EXTERNAL –Public commitments-meeting national/international commitments ~ long-term sustainability –Comparison to costed NSP estimates of required resources – funding gap analysis –Centralised funding and spending with low funds for the sub-national level –Data not disaggregated according to national and sub-national levels –Discrepancies between allocations and actual expenditures ~ measurement of absorptive capacity, leakages, transaction costs

NASA Opportunities for evidence-based political decisions (2) ALLOCATIVE DECISIONS – PRIORITIES –Meeting national priorities (aligned to NSP?) –Balance between programmes ~ unsustainability of treatment costs without adequate prevention interventions ~ allocative efficiency –Equity in allocations ~ between geographical areas, providers, beneficiaries & according to need EFFICIENCY OF SPENDING –Provides varying unit costs for interventions, allows comparison of technical efficiency –Identifies poor absorption capacity ~ allows for exploration of factors: bottlenecks, dumping etc.

NASA Opportunities for evidence-based political decisions (3) C OORDINATION, H ARMONISATION AND A LIGNMENT –Alignment of the actual HIV/AIDS spending to NSP – public and external –Agent analysis shows who determines use of funds –Identifies poor harmonisation – duplicative financing & reporting, high transaction costs I NSTITUTIONALIZATION OF NASA –Within the Monitoring and Evaluation (M&E) framework –Using standardised financial information/ reporting mechanisms

NASA Opportunities for evidence-based political decisions (4) E NHANCED T RANSPARENCY, A CCOUNTABILITY & E CONOMIC G OVERNANCE –Increased pressure (& desire) for mutual accountability by all players –Promotes a (legal) framework to ensure all partners report through a national resource tracking system –Link framework to the National Resource Mobilisation and Management Strategy –Using the framework to harmonise standards of costing among different partners –Ensures transparent procurement systems & best pricing within and between countries & regions

NASA Opportunities for evidence-based political decisions (5) S TANDARDIZATION & C OMPARABILITY –Ensures standard classification of spending & activities within & between countries & regions Provides comprehensive list of possible interventions –Resource needs estimates Classification standardised with NASA Package of interventions Future requirements (funding gap) by programmes Comparison of TFRR & TE

NASA Thank You Teresa Guthrie Centre for Economic Governance and AIDS in Africa