Abstract #197  -  Expanding Long Term Sustainable Financing for HIV in African Countries: First country Results
Authors:   Presenting Author:   Dr. Robert Greener - UNAIDS
Additional Authors:  Dr. Tomas Lievens, Mr. Erik Lamontagne,
Aim: This paper reports on first results from work initiated by UNAIDS to investigate the available sources of financing in middle-income countries in relation to planned expenditure or estimated resource needs, and to recommend measures that could meet the identified financing gaps in a sustainable way. The aim of the work is to enable each country to produce a long-term financing map that can be used as a basis for resource mobilisation.
Method / Issue: AIDS is a long-term epidemic that requires a commitment of resources that is sustained in the long term, and can be sufficiently predictable to allow the affected countries to plan effectively the scaling up of services. The resource needs for HIV prevention, AIDS care and treatment and impact mitigation constitute a significant proportion of the gross national income (GNI) in the highest burden countries of sub-Saharan Africa. For most countries, their capacity to finance the proper response to the epidemic cannot meet the needs. Additional external financing will be necessary and governments must initiate other financing mechanisms at national and regional level in order to ensure a sustainable financing of the response to HIV over the long term. Key informant interviews and other forms of data collection were used in two southern African countries (Swaziland and Lesotho) to analyse the current structure of financing of HIV programmes, and to assess the potential of a range of traditional and possible future innovative mechanisms to finance HIV programmes. In each country, the process of stakeholder consultation included national workshop where potential mechanisms and the outline of a financing map was discussed.
Results / Comments: Universal Access raises challenges in budgetary management and delivery capacity that require increased and further diversified financing. UNAIDS is investigating available opportunities for financing in low- and middle-income countries in relation to planned expenditures and estimated resource needs over 10-15 years. These first results for two middle-income countries in Southern African (Swaziland and Lesotho) will be presented along with progress reports from other countries. UNAIDS will seek to establish a network to exchange information and ideas on implementation of new financing mechanisms specific to different national contexts.
Discussion: The work shows that current financing should be used to increase the efficiency of activities and to develop new financing mechanisms at country and regional levels. Their respective maturation period must be taken into account in order to avoid critical shortages in reaching universal access to HIV prevention, treatment, care and support. Similar work is planned in 6-8 further countries in sub-Saharan Africa during the next 12-18 months.
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