1. Is E2 sufficient to ensure sustainability?
Definitions, principles, actors, priorities

2. Definitions Sustainability of Both immediate and long-term
Finances – predictable, increasingly domestic
(integrated) health and community systems
Institutional capacity, health work force
Local sustainability
Both immediate and long-term

3. Principles National ownership of plans and priorities
Global solidarity
Commonly agreed goals - mutual accountability
Synergies with other health and development sectors

4. Challenges
Perceptions in Ministries of Finance that MoHs are not accountable, e.g. off-budget support, GFATM absorption, or results of E2 studies
How to reverse crowding-out
How to advocate for use of economic growth, matching of burden of disease, competing sectors (which with greater ease demonstrate value for money)
Transitioning from donor support – also technical and market place elements
Pooled vs. nationally owned commodities
Transition costs money

5. Stakeholders Affected communities, activists Implementers Programs
Ministries of Health
Ministries of Finance, Treasury
Donors

6. E2 necessary, not sufficient
Allocate efficiently within HIV and health
Optimize service delivery models
Harmonize different actors
Better identify bottlenecks
Make explicit equity concerns

7. A new global compact
Countries take the lead – national vision and plan; partners pulled into alignment
Resources are reallocated according to country needs and priorities, for greater, more sustainable results
Partners and countries fill the investment gap together – ‘fair share’, based on capacity
Programs are implemented as efficiently as possible (without parallel structures, stand-alone services or higher than necessary program costs)

8. Sustainability elements for roadmap
Strengthen national strategic and costed operational plans
Methodology to determine “fair-share”
Address new data requirements: program and unit costs, expenditure surveys, evaluation studies, etc
Estimate return on investment
Development partners to more systematically strengthen E2 – tool kits, capacity strengthening
From 3 ones to joint M&E and accountability framework