Expert Consultation on Costing HIV Responses in Asia RETA A Tool to Estimate Resource Gaps for Preventing HIV Among Men Who Have Sex with Men Expert Consultation on Costing HIV Responses in Asia Bangkok - 28 October 2010

Advocacy and Men Who Have Sex With Men Evidence from as early as 2000 has shown that HIV is disproportionately affecting men who have sex with men in Asia, yet until very recently there has been minimal financial investment in interventions to address HIV risk among men who have sex with men Coverage of prevention services for men who have sex with men in the region is estimated at a mere 5% The CAA report is galvanizing attention and the imperative to scale up coverage among at-risk populations, particularly men who have sex with men Key advocacy issues are emerging, but the most critical is for community advocates to become “resources literate”

Why did we build RETA? To increase funding and assure that funds are allocated appropriately to programming for men who have sex with men To improve our evidence base for advocacy To ensure that community advocates understand money flows To facilitate community engagement with governments and donors to advocate for increased resources for HIV prevention programs for men who have sex with men

Data needed to feed into RETA Current / recent population size estimates All men who have sex with men and/or sub-populations The unique feature of RETA is that users can categorise men who have sex with men into sub-populations which are relevant to their setting. Different sub-populations have different HIV prevention needs and are more or less accessible to services. These two factors have dramatic impacts on estimates of resource needs. RETA is the only tool developed to date that provides this option, and with its ease of use, can facilitate civil society groups to understand resource issues, and help them engage more professionally with governments and donors.

Data needed to feed into RETA Current / recent population size estimates All men who have sex with men and/or sub-populations Population coverage scale up targets Targeting delivery of services to sub-populations The unique feature of RETA is that users can categorise men who have sex with men into sub-populations which are relevant to their setting. Different sub-populations have different HIV prevention needs and are more or less accessible to services. These two factors have dramatic impacts on estimates of resource needs. RETA is the only tool developed to date that provides this option, and with its ease of use, can facilitate civil society groups to understand resource issues, and help them engage more professionally with governments and donors.

Data needed to feed into RETA Current / recent population size estimates All men who have sex with men and/or sub-populations Population coverage scale up targets Targeting delivery of services to sub-populations Services costing information Comprehensive Package of Services The unique feature of RETA is that users can categorise men who have sex with men into sub-populations which are relevant to their setting. Different sub-populations have different HIV prevention needs and are more or less accessible to services. These two factors have dramatic impacts on estimates of resource needs. RETA is the only tool developed to date that provides this option, and with its ease of use, can facilitate civil society groups to understand resource issues, and help them engage more professionally with governments and donors.

Data needed to feed into RETA Current / recent population size estimates All men who have sex with men and/or sub-populations Population coverage scale up targets Targeting delivery of services to sub-populations Services costing information Comprehensive Package of Services Current or anticipated program funding The unique feature of RETA is that users can categorise men who have sex with men into sub-populations which are relevant to their setting. Different sub-populations have different HIV prevention needs and are more or less accessible to services. These two factors have dramatic impacts on estimates of resource needs. RETA is the only tool developed to date that provides this option, and with its ease of use, can facilitate civil society groups to understand resource issues, and help them engage more professionally with governments and donors.

# of people targeted per year x average cost of comprehensive package of services = estimated annual cost of comprehensive package of services estimated annual cost of comprehensive package of services - total anticipated annual funding = estimated annual funding gap This is the basic algorithm used by RETA. It is quite simple. We estimate populations sizes (by subpopulation if possible), and multiply this population by a WEIGHTED average cost (weighted by accessibility and coverage of sub-populations) to derive the annual resource estimate. Subtracting the total anticipated funding from all sources (government, donor, foundation, international and local NGOs, etc) gives us the estimated annual resource gap.

What advocacy information is generated by the tool? RETA is specific to men who have sex with men and breaks down into sub-populations, addressing prevention and enabling environment Includes process for determining costs of services, based on EXISTING services (with consideration of good practice) Comprehensive Package of Services Estimates Resource needs and gaps: Annual, 5 year total Scenarios by population estimate Resources needed by sub-population Resources needed by component for the comprehensive package of services It will tell us how much funding is currently available, and how much is going to be needed in addition to scale up coverage of the comprehensive package of services Other tools include the recently developed UNAIDS/ADB/UNDP Asia Model. These tools are designed for use by national program managers to estimate resources needed for a national response, and do not consider segmenting of populations and targeting of services to those most at need. They also require higher level of technical capacity to gather the data needed to input, particularly in costing of HIV prevention services.

Summary results table. Shows: 1- estimated population adjusted for population growth). Population size is also presented for 3 different scenarios of population size estimate based on % of total male population. 2- numbers of men to be targeted each year, according to annual increases in target coverage (and also according to 3 scenarios of population size estimate) 3 – total resources estimated by year and total for 5 years 4 – estimated available or anticipated resources (red) 5- Annual resource gap 6 – average cost of comprehensive package of services per beneficiary, per year

Could skip this slide Detailed results table. Shows: 1- population size estimate 2-target population per year 3-resources needed by component of comprehensive package of services. 1st 4 rows based on service cost data inputted by user. Enabling environment, research, and M&E are based on % of program costs (%s are also modifiable by user)

Results are also presented in graphical format for use in reports, proposals, advocacy documents