1. NATIONAL AIDS CONTROL COUNCIL Sustainable Country Ownership through Domestic Financing and Efficient Management of the HIV Response in Kenya Regina Ombam, NACC Aaron Mulaki, HPP Daniel Mwai, HPP Date: 21/03/2013 Venue: Birchwood Hotel @ Conference Centre

2. NATIONAL AIDS CONTROL COUNCIL The Kenyan context   Kenya heavily dependent on external resources for HIV interventions (70-80%)   HIV prevalence 6.2%, 1.6 million people living with HIV (2011 )   In 2011, estimated adult mortality at 29%, 24% of all morbidity and, 15% of <5 mortality related to HIV   In 2011, 67% of pregnant women received ART for preventing the transmission of HIV to their babies

3. NATIONAL AIDS CONTROL COUNCIL   Kenya aims to be a middle income country by 2030 (Vision 2030)   Economic growth should translate to higher allocation for HIV   It is estimated that cost of HIV response will increase by 116% between 2010 and 2020   Funding gap will reach US $ 1.75 billion between 2010/2011 and 2019/2020, comprising 0.3% of GDP   Long-term epidemics such as HIV require long term commitment of resources Significant funding gap is emerging

4. NATIONAL AIDS CONTROL COUNCIL   A long-term financing strategy for HIV is being developed by GoK   NACC proposes establishment of an AIDS Trust Fund (ATF) where GOK will allocate 1% of Tax revenue to the Fund   Memo approved by Cabinet in December 2012   ATF would fill the funding gap by 70% between 2010 and 2020, and 159% between 2030 and 2030   Other promising innovative income generating options considered include: airline levy, dormant fund, mobile phone levy etc Addressing the gap

5. NATIONAL AIDS CONTROL COUNCIL

6.   Raising new sustainable finances for HIV is necessary BUT not sufficient to END AIDS   The funding gap could further be addressed through efficient management of existing HIV interventions   Kenya has identified high impact, low cost interventions that are being embedded in the HIV Strategic plan Example-HIV Testing and Counseling   The country has re-assessed and changed the HIV testing algorithm   Algorithm change yields total cost savings of $ 3,229,197 in 2013 and 2014 against total costs of $21,045,902 in the same period using the current algorithm Other measures to address the gap

7. NATIONAL AIDS CONTROL COUNCIL   Competing national priorities, as well as maintaining HIV on new county governments radar   Perception by other actors that ATF will set a wrong precedence   NACC working to ensure that guarantee of funds is through legislation Challenges and counter strategies

8. NATIONAL AIDS CONTROL COUNCIL   Kenya well placed to generate funding model that can be adapted by countries facing similar predicaments   Savings (from HTC Algorithm example) will allow for the reallocation of funds in programs experiencing shortfalls   Funding gaps are also raising rich discussions on value for money Lessons learned and conclusion

9. NATIONAL AIDS CONTROL COUNCIL   National AIDS Control Council   USAID-Health Policy Project, Kenya   UNAIDS Acknowledgements

10. NATIONAL AIDS CONTROL COUNCIL THANK YOU www.nacc.or.ke www.healthpolicyproject.com