1. BY A MANENJI NAC-FINANCE DIRECTOR WHERE WILL THE MONEY COME FROM? CHALLENGES & APPROACHES TO SUSTAINABILITY A CASE OF NATIONAL AIDS TRUST FUND (AIDS LEVY) IN ZIMBABWE

2. BACKGROUND OF AIDS LEVY Home-grown resource mobilisation initiative meant to raise resources for the national response to HIV and AIDS. Established by an Act of Parliament Section 14, subsection 14 and 15 of the Finance Act, Chapter 23:04 1999, AIDS Levy is charged on individuals, companies and trusts at a rate of 3% of the amount of income tax assessed. `

3. RATIONALE FOR THE TAX LEVY The idea was conceived in late 1990s, in response to worsening HIV and AIDS situation – in the face of limited government funding. PLHIV realised treatment cost demanded more resources than another illness, got organised with support of civil organisations such as ZAN demanding more action from the government.

4. RATIONALE FOR THE TAX LEVY Cont AIDS Levy was intended to finance key HIV and AIDS interventions and operations of the National AIDS Council. The fund demonstrated the political commitment hence it acted as “seed fund” into which donors were expected to contribute and augment available national resources.

5. ESTABLISHMENT PROCESS A bill was developed and presented to Parliament and Section 14, subsection 14 and 15 of the Finance Act, Chapter 23:04, charging of individuals, companies and trusts at a rate of 3% of the amount of income tax assessed as AIDS levy became law in 1999. In the case of individuals, the tax is levied on the income tax assessed after deducting any credits accruing to the individual taxpayer.

6. ESTABLISHMENT PROCESS Cont In 1999 NACZ was formed through Chapter 15:14 among other functions it was expected to combat the spread of AIDS and administer the NATF. Zimbabwe Revenue Authority (ZIMRA) was tasked to collect and hand over the AIDS levy at end of each month.

7. ESTABLISHMENT PROCESS Cont

8. ADMINISTRATION OF AIDS LEVY NACZ is run by 12 member Board, drawn from the key sectors. The secretariat is headed by CEO and has structures at Provincial and district levels. The levy is deposited into a two signatory NAC bank account at the end of the month. Funds are allocated through an annual work plan and budget approved by the Minister of Health and Child Welfare

9. ADMINISTRATION Cont Resources are allocated according to % set by the Board which currently stands as follows: 50% Treatment, care and support 10% Prevention 5% Creating Enabling environment

10. ADMINISTRATION Cont 6% M & E, Programme Mgt & Coordination 5% Capital items 24% Programme Logistics & Support Fund is subjected to both external and audit each year. Last external audit was for 2011.

11. HOW TO ACCESS NATF To access resources from NATF: a) Identify the thematic area the intervention is categorized under. b) Engage the relevant coordinator for the inclusion of the activity in the budget. d) At implementation time arrange with Coordinate to draw down the resources

12. CHALLENGES Lack of trust and confidence by stakeholder at the inception. Funds decimated by hyperinflation [2006 -2008]. Challenges of up-take till 2006. Weakened health delivery system severely affect NATF’s potential. Demand much more than amount being generated. Contribution being made by 30% of the population in the formal sector.

13. RECOMMENDATIONS Keep coordinative/ admin structure smaller – integrate with existing local development structures. Have specific and clear criteria for grant allocation. Ensure transparency and accountability – audit, etc. Ensure that key stakeholders are represented on board

14. RECOMMENDATIONS Make timely disbursements. Broaden base of AIDS levy by including the small to medium enterprises and informal sector. Introduce the public private partnerships, (use medical insurance, pharmaceutical manufacturers and retailers and private medical doctors )

15. LESSONS LEANT Sustainable way of funding national response to HIV & AIDS. Community ownership. Consistent funding mechanism Flexible mode of funding Prompt decision making Requires bold decision at the introduction stage. Demonstrate government and political will.

16. COLLECTIONS SINCE 2009

17. TOTAL EXPENDITURE SINCE 2009

18. TREATMENT EXPENDITURE BREAKDOWN

19. AID LEVY IN ACTION- Handover of ARV medicines to Ministry of Health and Child Welfare

20. AID LEVY IN ACTION- Part of the Shangani male community who were medically circumcised

21. THANK YOU!!