1. Supporting community action on AIDS in developing countries MRS Training - Secretariat Value for Money in HIV/AIDS BOND meeting 3 rd Feb 2011 Liza Tong International HIV/AIDS Alliance

2. Supporting community action on AIDS in developing countries MRS Training - Secretariat Summary Why value for money? One approach to VfM, piloting SROI What worked well Challenges faced Learning from the process Recommendations

3. Supporting community action on AIDS in developing countries MRS Training - Secretariat 3 13 billion 2008 TIME MONEY

4. Supporting community action on AIDS in developing countries MRS Training - Secretariat Total available resources for AIDS 1986-2008 4 13 billion 2008 TIME MONEY VALUE

5. Supporting community action on AIDS in developing countries MRS Training - Secretariat 0 50 100 150 200 Health Benefit Global AIDS Expenditures Health benefit from investing in HIV prevention, care and treatment

6. Supporting community action on AIDS in developing countries MRS Training - Secretariat 0 50 100 150 200 Health Benefit Global AIDS Expenditures Health benefit from investing in HIV prevention, care and treatment ARV becomes available in developing countries MONEY VALUE Source: Stafano Bertozzi presentation at 5 th IAS conference Cape Town June 2009

7. Supporting community action on AIDS in developing countries MRS Training - Secretariat 0 50 100 150 200 Health Benefit Global AIDS Expenditures ECONOMIC CRISIS ? ? ARV becomes available in developing countries Two obvious responses: 1. Strategies to maintain/increase funding levels 2. Improve efficiency Health benefit from investing in HIV prevention, care and treatment Source: Stafano Bertozzi presentation at 5 th IAS conference Cape Town June 2009

8. Supporting community action on AIDS in developing countries MRS Training - Secretariat 0 50 100 150 200 Health Benefit Global AIDS Expenditures Two obvious responses: 1. Strategies to maintain/increase funding levels 2. Improve efficiency and effectivenss Health benefit from investing in HIV prevention, care and treatment Source: Stafano Bertozzi presentation at 5 th IAS conference Cape Town June 2009

9. Supporting community action on AIDS in developing countries MRS Training - Secretariat

10. Supporting community action on AIDS in developing countries MRS Training - Secretariat VfM in the field- Social return on investment Alliance has adapted this framework to attempt to measure and account for value created by a programme, beyond financial value

11. Supporting community action on AIDS in developing countries MRS Training - Secretariat So what is it ? A way of assigning a value to social, environmental and economic value created by your programme SROI is a framework for measuring and accounting for this broader concept of value Describes changes are happening through measuring social, environmental and economic outcomes, using monetary values to represent these. SROI = Value of benefits £1 of investment delivers £3 of social return Investment

12. Supporting community action on AIDS in developing countries MRS Training - Secretariat Stages of SROI Establishing scope and identifying stakeholders Mapping outcomes Evidencing outcomes and giving them a value Establishing impact (attribution, deadweight etc) Calculating the SROI Reporting, using and embedding

13. Supporting community action on AIDS in developing countries MRS Training - Secretariat CHAHA Started 2007 Global Fund Round 6, 41 districts in the states of Maharashtra, Andhra Pradesh, Tamil Nadu and Manipur. Target 64,000 children by the end of January 2011

14. Supporting community action on AIDS in developing countries MRS Training - Secretariat Example – selected financial proxies and direct costs StakeholderOutcomeProxy/direct cost description Source Children Affected by AIDS (younger age group) Improved health status through better nutrition Avoided costs of travel for health support and medicine Beneficiary consultation Cost of living India city comparison Parents/caregiversImproved livelihood status Increase in earnings through income generating projects Programme MIS Beneficiary consultation Parents/caregiversReduction in community/societal stigma towards PLHIV Average working days and salary gained from return to work Beneficiary consultation

15. Supporting community action on AIDS in developing countries MRS Training - Secretariat

16. Supporting community action on AIDS in developing countries MRS Training - Secretariat

17. Supporting community action on AIDS in developing countries MRS Training - Secretariat Drop off in value created over a 5 year period

18. Supporting community action on AIDS in developing countries MRS Training - Secretariat Challenges/limitations The most common question we get asked at conferences these days is ‘Should I do a SROI?’. People are attracted to the number at the end: £2.50 of value created for every £1 put in. But they often don’t realise how big an undertaking a SROI is. For SROI to work the whole organisation needs to be bought into the process and be prepared to set up robust measurement systems.' New Philanthropy Capital April 2010

19. Supporting community action on AIDS in developing countries MRS Training - Secretariat Lessons learned about the method Participatory, end user perspective on VfM Dispelled fear and misconceptions cost effectiveness=cost cutting Need simplified brief approach to use with end-beneficiaries Pilot SROI study conducted internally costs about $25 - $35k Minimum systems of M&E to be in place to do an evaluative study Use of focus groups and additional research, questionnaires and interviews Requires broader research of potential financial proxies (databank of financial proxies!)

20. Supporting community action on AIDS in developing countries MRS Training - Secretariat Recommendations Compliments other evaluative studies Best use: programme management tool Robust M&E systems, SROI built into at outset Forecast + Evaluative SROI Adapted M&E training Subjectivity and assumptions clearly documented