15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrE1039)

Smith O, Bennett S, Stillman K
Partners for Health Reformplus

ISSUES: The Global Fund to Fight AIDS, TB and Malaria aims to attract, manage, and disburse resources to make a significant and sustainable impact on the three focal diseases. At the same time, the Global Fund is likely to have a variety of direct and indirect effects upon health care systems in general, which could be either positive or negative in nature. This is also true of other HIV/AIDS-focused donor initiatives. With donor pledges of resources to combat specific diseases potentially exceeding the entire annual public health budget in some countries, the impact of these funds on health systems is a critical area for research.

DESCRIPTION: The research objective is to document the effects of applying for and implementing Global Fund-supported activities on the health care systems of Benin and Ethiopia. Several thematic areas have been chosen to focus the study. A mix of research methodologies is utilized, including facility surveys, data collection through sentinel sites, analysis of data from routine information systems, in-depth interviews, focus group discussions, and document review.

LESSONS LEARNED: The inflow of large volumes of financial resources for specific diseases can have significant impacts on the health system of the recipient country. This, in turn, can have a significant effect on program outcomes for non-focal diseases. Key systemic areas that merit particular attention include the policy environment; the public/private mix; human resources; and systems for pharmaceuticals and commodities. These channels are at present not adequately understood. Timely analysis can offer valuable insights for key decision-makers and other stakeholders.

RECOMMENDATIONS: A common research protocol is being implemented in a total of about 10 countries through the System-Wide Effects of the Fund (SWEF) research network. Findings from the Benin and Ethiopia case studies will be compared to those conducted elsewhere. Research results will derive lessons for country-level decision-makers, the Global Fund itself, and the broader donor community.

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MoOrE1039

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