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Tackling the Decline in HIV Resources: Lessons Learned from HIV/AIDS Program Sustainability Analysis Tool (HAPSAT) Itamar Katz 1, Wendy Wong 1, Douglas Glandon 1, Brima Kargbo 2, Regina Ombam 3, Shanti Singh 4, John Osika 1 Abt Associates Inc. In collaboration with: I Aga Khan Foundation I Bitrán y Asociados I BRAC University I Broad Branch Associates I Deloitte Consulting, LLP I Forum One Communications I RTI International I Training Resources Group I Tulane University’s School of Public Health 1 Abt Associates, Health Systems 20/20, International Health Division, Bethesda, United States 2 National AIDS Secretariat, Freetown, Sierra Leone 3 National AIDS Control Council, Nairobi, Kenya 4 National AIDS Programme Secretariat, Georgetown, Guyana
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Background Heavy dependence on donor funding Expansion of HIV services beyond the levels that can be sustained 2
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HAPSAT: HIV/AIDS Program Sustainability Analysis Tool Sustainability of HIV programs in limited- resource settings: What should be prioritized? What efficiency measures should be applied? How should additional resources be mobilized? 3
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Objectives of the presentation In relation to prioritization and resource mobilization: HAPSAT framework Interests of policy makers of HIV responses Examples from Guyana, Kenya, Sierra Leone and South Sudan (conducted in additional 10 countries) 4
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Prioritization 5 Effectiveness of interventions: mainly for medical interventions Capacity (versus universal access) Cost Contextual issues
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Prioritization South Sudan: HIV awareness through radio vs. billboards 6 Cost per exposure ContextPriority Radio ads and talkshows US$ 0.003 Major information source for South Sudanese High BillboardsUS$ 0.05 Low literacy levels limits its use, potentially useful in urban areas Low
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Prioritization among MARPs South Sudan: Scaling up CSW outreach rather than constructing costly prevention centers Sierra Leone: Under the program leadership and support from UNAIDS, Global Fund and USAID (the latter through HAPSAT) Inclusion of MSM in the national strategic plan 7
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Resource mobilization strategies 8 Increased govt. budgetary allocations to HIV/AIDS interventions Earmarked taxation for HIV/AIDS Concessionary loans for HIV/AIDS programs Debt conversion (known also debt2health) Risk-pooling schemes (e.g. insurance) and special social assistance programs covering HIV/AIDS services Fundraising (special/endowment HIV/AIDS funds)
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9 Resource mobilization: Financing Kenya’s National HIV Response 2008/09 vs. 2012/13 2008/09 $687 million 2012/13 $1,003 million
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Lessons learned Understanding the reality Need for prioritization Need for diverse funding sources Resource mobilization Need for sustainability plans Sierra Leone: Govt. pledges to replace Global Fund financing once ends Guyana: Preparing for PEPFAR gradual pull out 10
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11 Email: hapsat@abtassoc.com itamar_katz@abtassoc.com Visit: www.hs2020.org/hapsat: Country reports, the HAPSAT tool and document on target setting For more information… Thank you
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