Role of Financial Monitoring in National AIDS Monitoring and - - PowerPoint PPT Presentation

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Role of Financial Monitoring in National AIDS Monitoring and - - PowerPoint PPT Presentation

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Role of Financial Monitoring in National AIDS Monitoring and Evaluation Experience from Eastern Europe and Central Asia Anja Nitzsche-Bell, M&E Advisor, UNAIDS RST Euro Regional NASA Workshop Bucharest, Romania, 03 December 2007

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Role of Financial Monitoring in National AIDS Monitoring and Evaluation – Experience from Eastern Europe and Central Asia

Anja Nitzsche-Bell, M&E Advisor,

UNAIDS RST Euro Regional NASA Workshop Bucharest, Romania, 03 December 2007

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Why HIV/AIDS M&E?

“Raise it, spend it, prove it”

Richard Feachem, frm. Executive Director Global Fund to Fight AIDS, TB and Malaria

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Why M&E of HIV/AIDS?

Increasing demand for effective M&E of the epidemic and the response due to: Rapid expansion of new resources available to respond to the epidemic (GFATM, PEPFAR, WB, public funding, etc.) Rapid scale-up of treatment and prevention programs (3x5, Universal Access) Global push for improved coordination among donors and among donors and national HIV/AIDS programs – focus on strengthening national capacities

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The “Three Ones”

Key Principles

  • 1. One agreed HIV and AIDS action

framework

  • 2. One national AIDS coordinating

authority

  • 3. One agreed monitoring and evaluation

framework

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Components of a National M&E System

Biological and behavioral HIV/AIDS surveillance Essential research on HIV/AIDS prevention, treatment and care Program activity monitoring and program evaluation Financial monitoring, resource needs estimates

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Financial M&E to monitor program implementation and effectiveness

Allows answering questions addressing:

  • Spending Patterns

– What are key funding sources (public, private, non-for-profit

  • rganizations, donors, etc.) – proportional spending

– How does national level spending compare to spending at the sub-national level?

  • Cost-efficiency

– How are economic inputs into HIV/AIDS programs (funds, expertise, time, etc.) converted into results? – Do we see economies of scale as service coverage goes up?

  • Equity

– Are populations in need benefiting?

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Financial Resource Tracking in Eastern Europe and Central Asia

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Data includes:

  • International donors,

domestic spending (including public spending and out

  • of-

pocket expenditures)

  • International

Foundations and GF included from 2003

  • nwards, PEPFAR

included from 2004

  • nwards

8,297

1996 1997 1998 1999 2000 2001 2002 2003 2004 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000

$ US Million

292 485 479 893 1,359 1,623 6,079

Signing

  • f DOC

Estimated total annual resources available for AIDS 1996 – 2005

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Trends in domestic and international AIDS funding, 10 CIS countries

$0 $10 $20 $30 $40 $50 $60 $70 2001 2002 2003 2004 2005 2006 Millions Domestic Public Expenditures International Financing

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Domestic public expenditures for HIV and AIDS in ten CIS States and Latvia, 2006

2006 1% 13% 1% 0% 12% 2% 1% 61% 1% 1% 7%

Armenia Belarus Georgia Kyrgyzstan Kazakhstan Latvia Moldova Russian Federation Tajikistan Uzbekistan Ukraine

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Per capita domestic public expenditures for HIV and AIDS (CIS and Latvia, 2005-2006)

Domestic Expenditures/cap 2005-2006

0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Domestic per capita05 Domestic per capita06 Armenia Belarus Georgia Kazakhstan Kyrgyz Rep. Moldova Russia Tajikistan Ukraine Uzbekistan Latvia

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Financial Resource Tracking in Selected Countries

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Country reporting on domestic expenditure (DoC review, March 2006)

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Conducting NASA in the Russian Federation to assess HIV/AIDS Spending, 2004

  • Government Funding:

37 million US$

  • Donor Funding:

30 million US$

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Allocations by Functions, 2004

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Allocation to Preventive Activities by Function, 2004

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CONCLUSION

  • Low spending: Only 0.2% of the total Russian health

budget was allocated to HIV/AIDS treatment and prevention in 2004.

  • Imbalance in spending for prevention activities: close

to 50% spent on blood safety, one-fifth of the funds aimed at mother-to-child transmission and 30% was spent on mass media activities (almost zero spending on MARPs).

  • Insufficient funding for T&C: 23 % of public funding

allocated to treatment and care (diagnostics, purchasing

  • f test systems, ARV, OI treatment).
  • Major funding gap for social support and mitigation:

0.06%. No funding allocated for orphans and vulnerable children.

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HIV/AIDS NHA Sub-analysis Ukraine, 2004

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Sources of Health Financing for HIV/AIDS in Ukraine, 2004

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International Comparison for Expenditures for HIV/AIDS by Functions