Consolidation and Focus Daygan Eagar 6 th BEMF meeting 15 July 2011 Taking the BEMF forward

Why the BEMF? + Emerged out of the JCSMF, which proved to be effective in monitoring the formulation and implementation of HIV and AIDS strategic plans (OP and NSAP). + But political will no longer the major barrier to expansion of the programme. + Moratorium in the Free State highlighted systemic weaknesses, particularly budgeting and expenditure, were now major barriers

+ Moratoriums, long waiting lists and stockouts have become an unacceptable feature of the state’s highly active antiretroviral treatments (HAART) and prevention of mother-to-child transmission (PMTCT) programmes. The programmes are poorly monitored. Their budgets are not evidence-based. Expenditure on them is opaque and poorly managed. Health officials are failing to properly develop, manage, monitor and evaluate health budgets and expenditure. They are not being held accountable. The consequence of this dire situation is that many people are dying avoidably. (BEMF launch statement)

Purpose of the forum + Provide a forum for discussion, debate and to share information on pressing budget and expenditure related issues + Coordinate the efforts of civil society organisations involved in Budget Monitoring and Expenditure Tracking (BMET) + To provide support to membership based organisations in their efforts to mobilize for better budgeting and expenditure on health care

Importance of BEMF is becoming increasingly apparent + Very little improvement in the way resources are allocated and used + Most of the problems highlighted in Integrated Support Team reports remain + Better resourcing of HIV and AIDS interventions but TB remains a real challenge + NSP is currently being developed. This requires costing and budgeting + NHI has long-term implications for the funding of healthcare

The need for consolidation and focus + Meeting with OSI raised a number of important questions for the forum to consider. + What are our expectations of the forum? + What are the roles and responsibilities of each of its members? + What is SECTION27 and coordinator's role? + Need to consider these in terms of the objectives outlined in BEMF proposal.

Objective 1 + The consolidation of the forum, its membership and identity in order to enhance its position as a role-player in the monitoring of health financing, budgeting and expenditure + Key questions: + How do we ensure sustained and long-term participation in the forum by key role players? + Who do we need to approach to participate? + How do we raise the forums profile?

Objective 2 + To facilitate cooperation between civil society organisations working on BMET with a view to ensuring greater communication, knowledge exchange and the development of partnerships + Key questions: + What should the purpose of our meetings be? + How do we improve cooperation and engagement between meetings?

Objective 3 + To develop civil society’s understanding of and capacity to engage with health care financing, budgeting and expenditure issues and processes with the particular aim of enhancing membership-based organisations’ capacity to campaign for better budgeting and expenditure + Key questions: + What is the forum’s role in this regard? + What about capacity building workshops?

Objective 4 + To coordinate civil society’s efforts to hold government to account for instances where it fails to fulfill its obligations with regard to health care financing, budgeting and expenditure + Key questions: + What are forum priorities (NSP, TB, IST, Legislation)? + How do we engage with these priorities?