Ethiopia: Focusing our Program for Impact & Efficiency

Slides:



Advertisements
Similar presentations
The U.S. Presidents Emergency Plan for AIDS Relief Title The U.S Presidents Emergency Plan for AIDS Relief PEPFAR Male Circumcision Technical Working Group.
Advertisements

PEPFAR’s Approach to Maximize Efficiency, Effectiveness and Impact
HEALING THE CRISIS The urgent need to improve public health in SEE Ana Stavljenic-Rukavina Zagreb University School of Medicine and OSI NY:Sub-board for.
The U.S. President’s Emergency Plan for AIDS Relief The Evolving HIV Prevention Strategy for IDUs in PEPFAR Amb. Eric Goosby US Global AIDS Coordinator.
Introduction to PEPFAR 3.0 and DATIM.
Towards an AIDS-Free Generation Women & Girls and HIV in PEPFAR
Bobby Jefferson Senior HMIS Advisor Futures Group The Site Capacity Assessment (SCA) Tool and other Mechanisms to Monitor Transition Status Track 1 Implementers.
The Polity Utility of Tracking State HIV/AIDS Allocations UNAIDS Satellite Meeting: “National AIDS Accounts” XV International AIDS Conference Bangkok,
Slide 2 Key Points Although HIV/AIDS is found throughout the world, most people living with HIV/AIDS reside in low- and middle-income countries More people.
Methods for Estimating Global Resource Needs for HIV/AIDS John Stover, Lori Bollinger International AIDS Economic Network Meeting, Washington,
Complete Community Assistance Through School-Based Platforms Helping Africa help itself.
Global Fund – PEPFAR Coordination The Tanzania Example Dr. Fatma Mrisho Chairperson TACAIDS.
African Business Leaders on Health GBC Conference on TB, HIV-TB Co-infection & Global Fund Partnership Johannesburg, October 2010 Technical Assistance.
Managing Risk and Overcoming Health Systems Bottlenecks in Haiti Emerging Lessons Jessica Faieta - Senior Country-Director, UNDP/Haiti & Dr Joelle Deas.
Teresa Guthrie M.PH (Health Economics) HIV modelling for in-country ownership solutions – generation of evidence IAS Conference, Washington DC, July.
1 CHILDREN AFFECTED BY HIV/AIDS : Botswana Experience BY MINISTER OF HEALTH BOTSWANA HON. PROF. SHEILA DINOTSHE TLOU DATE 29 NOVEMBER 2007 IRELAND.
DPG-AIDS Welcome Michelle Roland, Lead On behalf of DPG-AIDS.
Future HIV Financing Direction: Reality Check Brian Rettmann, PEPFAR Country Coordinator.
‘More Than Just Lip Service: Scaling up sex work initiatives’ Making the Money Matter: Support for sex worker initiatives through the Global Fund for HIV,
The Role of the School in Health, Learning and Development in Low Income Countries Lesley Drake, Coordinator.
Tajikistan The Global Fund to Fight AIDS, Tuberculosis and Malaria Support to the Strategic Plan to Prevent HIV/AIDS Epidemics in Tajikistan. November.
Tracking Expenditure for HIV and AIDS in Africa ~ Cross-Country Comparisons Guthrie, T., Kioko, U. Inaugural Conference of the African Health Economics.
The President’s Emergency Plan for AIDS Relief Next Generation Indicators.
IF : 1 FUNDING SLOWDOWN. IF : 2 BUILDS ON PAST, BUT DOES BETTER WE HAVE DONE A LOT… Unprecedented scale up of HIV prevention, treatment, care and support.
Enabling Continuity of a Public Health ARV Treatment program in a resource limited setting: The Case of the transition of the African Comprehensive HIV/AIDS.
The PHRplus Project is funded by U.S. Agency for International Development and implemented by: Abt Associates Inc. and partners, Development Associates,
Svetlana Spassova, MD Ministry of Health, Bulgaria Chisinau
HIV/AIDS in Latin America and the Caribbean: Challenges Ernest Massiah, Inter American Development Bank Inter American Development Bank.
Global Trends in HIV/AIDS Monitoring and Evaluation Deborah Rugg, PhD Associate Director for Monitoring and Evaluation HHS/US Centers for Disease Control.
Strengthening HR Capacity to Address the HIV Crisis Dr. Mphu Ramatlapeng Minister of Health, Lesotho 2 February 2012 Father Michael Kelly Lecture.
The U.S. President’s Emergency Plan for AIDS Relief 2011 Country Operational Plan Briefing to Development Partners in Health in Kenya December 3, 2011.
Pioneering IMAI: Developing an integrated approach in Uganda Dr Elizabeth Madraa, Program Manager National STD/AIDS Control Program MOH - UGANDA 5 th Dec.
Downloaded from Current Status of ART Opportunities & Challenges Kibrebeal Melaku,MD Associate Professor.
Review Rationale & Context for MER: Programmatic Shifts Amy Gottlieb, PhD, MPH OVC M&E Meeting February 19 – 20, 2014.
PEPFAR Investment Strategy (8 years of PEPFAR) Data source : OGAC Budget Total PEPFAR Investment: $21,285,918,291 Saving Lives : Changing the.
Yemaneberhan Taddesse.  PASDEP(plan of accelerated and sustainable development for the Eradication of poverty) Poverty reduction strategy is the main.
DEVELOPMENT PARTNERS GROUP (DPG) SPECIAL BRIEFING SESSION ON HIV&AIDS 5 OCTOBER 2006 By DPG AIDS 1.
Prevention of HIV infection: How effectively are countries responding to changing epidemics in the Asia Pacific Region? 1.
HIV/AIDS and Mental Health Integration: Is Something Not Right
Efficiency, Effectiveness, and Financial Sustainability: The Importance of Country Ownership Dr Bernhard Schwartländer UNAIDS.
What is PEPFAR? Presidential Emergency Plan for AIDS Relief PEPFAR announced in January 2003 Provides $15 billion to 15 countries Seeks to building upon.
Understanding the Investment Approach Faith Mamba Regional Support Team Eastern and Southern Africa.
Getting more value for money: working with countries and partners toward greater effectiveness and efficiency Peter Stegman, Senior Economist.
PEPFAR The Global Fund and PEPFAR: Strategic Collaboration for Greater Impact Mark Edington, Director, Grants Management, Global Fund Julia Martin, Chief.
HIV/AIDS A MAJOR DEVELOPMENT CONCERN FOR THE AFRICAN DEVELOPMENT BANK March 2008.
De Beers Response to HIV/AIDS 19 th June 2006 World Bank Group- CommDev Workshop.
The Bank’s Regional HIV/AIDS Strategies An Overview.
Ministry of Public Health & Population Haiti Toward Universal Care HIV/AIDS October 2010.
Fast-Tracking Treatment to End AIDS ICASA Ambassador Deborah Birx, MD U.S. Global AIDS Coordinator November 30, 2015.
NFM: Modular Template Measurement Framework: Modules, Interventions and Indicators LFA M&E Training February
United Republic of Tanzania Ministry of Health & Social Welfare MINISTRY OF HEALTH AND SOCIAL WELFARE NATIONAL AIDS CONTROL PROGRAM HIV CARE AND TREATMENT.
Strengthening Integration between RMNCH and HIV services Nuhu Yaqub WHO Tanzania.
The impact of HIV/AIDS on Botswana (The effects of the pandemic in our country.)
Main achievements and further developments 2006 and beyond: Overcoming HIV/AIDS epidemic in Ukraine (programme (programme supported by the Global Fund)
Fifteenth Board Meeting Geneva, April 2007 Partners in Impact Results Report Global Fund Board Meeting Geneva, April 2007.
33 MEETING OF THE UNAIDS PROGRAMME COORDINATING BOARD GENEVA, SWITZERLAND DECEMBER 2013 THE EQUITY DEFICIT: UNEQUAL AND UNFAIR ACCESS TO HIV TREATMENT,
Prevention of Mother-to-Child Transmission of HIV: Scale-up of Critical Services in Uganda (District- based Approach) Edward Bitarakwate, MD, MPH Technical.
Equity focused bottleneck analysis and development of costed evidence informed national plan for MTCT elimination: United Republic of Tanzania Dr. Deborah.
PEPFAR 3.0 Controlling the epidemic & delivering on the promise of an AIDS-free generation through Geographic Prioritization Implications for OVC Programming.
Office of Global Health and HIV (OGHH) Office of Overseas Programming & Training Support (OPATS) Health The Global Response to Caring for Orphans and Vulnerable.
UNITAID PSI HIV SELF-TESTING AFRICA
HIV/AIDS Epidemic in India Trends, Lessons, Challenges & Opportunities
Demanding a high impact HIV response: civil society advocacy and the President’s Emergency Plan for Aids Relief (PEPFAR) Dorothy Namutamba International.
Overview of guidance/frameworks
The SWA Collaborative Behaviors
International Treatment Preparedness Coalition (ITPC)
China 2010 UNGASS Country Progress Report
Morris Edwards Nadia Liu
Access to HIV/AIDS Medicines The 3x5 strategy
Deliver Ethiopia 7/27/2019.
Presentation transcript:

Ethiopia: Focusing our Program for Impact & Efficiency Jocelyn Felter Brown Acting Coordinator, PEPFAR Ethiopia

Ethiopia – Important Features Population 90 million Predominantly rural agrarian country Growing economy with large infrastructure development projects Low/decreasing national HIV/AIDS prevalence: 1.4% Has reached the “Tipping Point” Significant Urban to Rural HIV/AIDS disparity: mixed epidemic Government is the primary service provider Strong political commitment to health & equity of services Significant Global Fund investment, but expected to decline with New Funding Model

Ethiopia: Three Ways of Looking at HIV Distribution: Prevalence, No Ethiopia: Three Ways of Looking at HIV Distribution: Prevalence, No. Infected, and Density, 2011

PEPFAR Expenditures by Geographic Location & HIV Burden with Adult Prevalence Source: HIV Related Estimates and Projections for Ethiopia – 2012. Excludes National and Above National Spending

Focusing the Program: Start with Clinical Care & Treatment Adoption of 2013 WHO Guidelines 2013 2014 2015 Number of Adults in need of ART* 431,761 530,835 542,632 National Coverage Rate & Goals @69% = 298,336 80%  434,106 *Source: Spectrum HIV Related Estimates and Projections for Ethiopia, 2014

Focus on Clinical Care & Treatment Historically…US University treatment partners led clinical care & treatment efforts Partners accomplished what they were brought to Ethiopia to do; time to move more responsibility to Government of Ethiopia Promising results from transition of University partners to Regional Health Bureaus in 3 regions demonstrated success and ability to manage funding Assumption is that we can achieve same treatment goals, at same level of quality, but more efficiently – across all regions

Achieving Efficiency in Clinical Care & Treatment USD, in millions PEPFAR/HHS-Ethiopia Funding, by Partner Type COP14 local partner funding breakdown (rounded) is as follows: $ 31m RHBs, $ 4m USE (NDFE + Police), $ 5 local universities, $ 3.6m MOH+EHNRI, $ 17m local NGOs (EPHA, FGAE, NEP+, etc) * 2014 reflects the COP14 submission, new funds only

Defining Our Core Understand: Design: We adapted the UNAIDS Investment Case Framework to further focus and rationalize our PEPFAR program in Ethiopia Understand: Current state of epidemic—and how it’s expected to change National Response: What is USG’s current role -- how might or should it change? What are roles of other HIV Donors, Global Fund, Government, private sector -- how might they change? Design: What are the core program elements/critical enablers required to Save Lives and Prevent New Infections? What are the core program elements /critical enablers USG is uniquely qualified to deliver? How and when and to whom should non-core programs/non-critical enablers transition or end? What is the cost of the core program? With success and efficiencies shown w/ C&T Transition, in 2013 we realized the need to focus the program further, to apply a more focused approach to all program areas, with the goal to maximize public health impact

Prioritizing Activities Activities critical to saving lives, preventing new infections - and/or which USG is uniquely qualified Core Activities that directly support our goals and cannot yet be done well by other partners or host gov’t. Near Core Activities that do not directly serve our HIV/AIDS goals and/or can be taken on by other partners or host gov’t or civil society. Non Core Must Do Should Do Nice to Do

Defining the Core: Results Economic Strengthening (non-OVC) TA In-school Youth prevention Low-risk prevention (GPY) PPP TA Infection Prevention Cross-border Cervical cancer screening Non-Core Blood Safety TA to Private Sector Health Svcs VMMC In-School Youth funding to MOE Leadership and Governance (w/ transition plan) Community/Peer Support Ongoing Construction Commitments Near-Core Treatment Prevention (High & Med Risk) Targeted Testing Supply Chain TA HIV/AIDS Commodities Evidence Base (SI, SS, M&E) HC Financing/Insurance Training HMIS OVC (incl. ES) Core

Using Data to Maximize Program Investment Evidence Base Analysis Utilized most current ANC surveillance data to ensure sufficient support in regions and refugee sites with increasing prevalence Tracked those emerging regions transected by major transport corridors and targeted funding toward hottest Hot Spots Assessed areas where HRH capacity is most limited and targeted ToT support Economic Analysis We utilized national PEPFAR expenditure data to calculate unit expenditures, which allowed us to ‘cost’ our program’s core interventions Expenditure data at regional and partner level prompted refinement to certain activities and regional interventions Site-Level Analysis Directed spend toward highest-volume and highest-yield facilities; reduced spend to facilities with low-volume/low-yield

Geographic Analysis: HIV+ yield distribution across PMTCT sites 80% (14,260) of patients in 22% (371) of 1,668 sites Key: High Yield = >1 patient/month Low Yield = <1 patient/month

Stakeholder Coordination With a more focused PEPFAR program, on-going stakeholder alignment is key to sustain gains and prevent service gaps Government Years of successful TA and strong Gov’t support ensure readiness to take over Cervical Cancer, Infection Prevention, VMMC, Blood Safety Extensive Gov’t led Health Extension Worker program is able to take on more Community-focused activities Global Fund Revolving fund for ES allows PEPFAR to focus on OVC House Holds On-going HSS funding can support health infrastructure needs Commitment to significant funding of ARVs, RTKs Civil Society & Private Sector Years of USG and Global Fund support have capacitated CSOs to take on more Community and Peer Support activities Years of TA to Private Sector providers have strengthened their ability to serve clients and support business

ETHIOPIA HAS A REAL CHANCE AT AN AIDS FREE GENERATION Thank You