The Tanzania Partnership for sustainability TACAIDS

COUNTRY PROFILE The country covers about 945,087 sq km (364,900 sq miles). Currently total population is estimated at 40 million The country became united Republic of Tanzania in Resulting from unity between Tanganyika mainland and Zanzibar islands

Background HIV prevalence in TZ is estimated at 5.7% and 1.4 mn. Tanzanians are estimated to live with HIV/AIDS National program on HIV/AIDS is financed by donors for about 95%. The USG account for 59% of National response to HIV/AIDS.

PEPFAR - TZ – Estimated USD 313m p.a. – Over 95 prime partners – 59% of the national response PEPFAR Prevention 17.9% - Blood Safety - PMTCT - injection safety -behavioral change initiatives ARV Drugs and services 37.8% Centrally used (US) 10% Others 12% Care &Mitigation 23.9% - Palliative, safe water, insecticide treated nets, VCT, OVC

PEPFAR TZ - Financial trend

Partnership Framework (PF) A paradigm shift from a ‘donor-recipient’ relationship to one partnership embodied by PEPFAR. PF outlines (mutual, non-binding) commitments and responsibilities for the USG and the GOT Set forth expected progress over time of USG support, the GOT investment and policy change. negotiations in Tanzania defines each PF and reflects each unique situation, capabilities and priorities.

Information on the Partnership Framework 5-year strategic framework that defines the USG’s collaboration with Government of Tanzania on HIV/AIDS. Describes at a high-level expected program, policy, and financial commitments between the two governments for 2009 to Once signed, it allows Tanzania to be eligible for additional HIV/AIDS resources from the USG.

Principles Country leadership; Sustainability; Improved Policy Environment Financial commitment

Goals 1.Service maintenance and scale-up; 2.Prevention; 3. Leadership and management; 4. Sustainable and secure HIV drug and commodity supply; 5. Human resources; 6. Evidence-based and strategic decision- making

GOALS 1.Prevention: VCT, PMTCT, Treatment, adherence, IDU, MSM and socio-gender issues. 2.Leadership, Management and Accountability: GOT leadership at all levels, Prioritized and costed national strategy for multi sectoral response, increased transparency and improve accountability 3.Human resources: Policy changes, adequate human resource, training, placement, Retention, productivity and performance

GOALS 4.Evidence-based and strategic decision-making: a)strategic planning for evidence-based, b)leverage support to expand and improve the quality of epidemic surveillance, c)HMIS/routine reporting, d)program monitoring and evaluation, e)operations research, and impact evaluation. f)synthesize and disseminate data and findings for use by policy-makers, program managers, and other stakeholders. These are only 4 goals, others to be presented by MOHSW

Management and Communications: It is “substantially new relationship” between GOT, USG, and other relevant stakeholders. Specifically, what bodies will monitor Framework commitments, and provide a structure for ongoing policy dialogue?  role of TNCM  annual Partnership Framework reviews: integrate into HIV sector reviews  ongoing engagement of PMO

GOT experience in PF 100% involvement by the GOT in programme devt. Opportunity to clarify - purpose, process, and content of Partnership Frameworks. Based on national strategies guidance The concept - established with transparency, accountability, and the active participation of other key partners.

GOT experience in PF … The purpose is clear and considered the on-going country efforts. Alignment to “Three Ones” principle. Country ownership through government leadership.

What under consideration? improvement of coordination of PEPFAR programme through the government. should help the government to have a costed national strategic plan on regular basis to qualify for the National Strategies Application [NSA] initiative of GFATM.

What under consideration? Integration of HIV/AIDS into strengthened health systems and a broader health development agenda President’s Malaria Initiative (PMI), tuberculosis, maternal child health, education, food and nutrition, economic strengthening, Millennium Challenge Corporation (MCC) and other programs as appropriate.

What under consideration? Setting targets, monitoring indicators through National monitoring and evaluation systems transparency in resource allocation

What under consideration? GOT involvement in the negotiation of partnership framework at each stage. joint decision-making emphasis on building TZ institutions to participate as prime partners

Partnership Framework Deliverables General Framework Due September 1 Five required sections, describing: overall purpose, and principles 5-year strategic overview goals, high-level commitments and objectives management structures process for completing Implementation Plan ~10 pages Accompanied by summary matrix describing allocation of $50 M in new resources Implementation Plan Due January 2010 May be amended over 5 years Includes greater detail than General Framework: baseline assessments (technical, policy, financial) Quantified, detailed commitments indicators and targets monitoring, review, and performance criteria ~20 pages

Conclusion PF provides opportunity for the USG to work with partner governments to more closely track HIV/AIDS and overall health financing through National Health Accounts (NHA), National AIDS Spending Assessments (NASA), and other financial monitoring and reporting systems. Working towards a costed national HIV/AIDS strategy should be an important priority for the Partnership. Principles of cost efficiency and cost effectiveness should be incorporated into the Framework.