16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

MONITORING HIV/AIDS FINANCIAL FLOWS FROM GLOBAL INITIATIVES

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAd0103

Dmytraczenko T., De S.
Abt Associates Inc., Bethesda, MD, United States

BACKGROUND: Unprecedented increases in funding to fight the HIV/AIDS pandemic in recent years have largely flowed through new global and bilateral initiatives - The Global Fund, the World Bank's MAP and the US President's Emergency Plan. Though the Three One's Initiative attempts to harmonize M&E efforts, each global initiative is using its own M&E framework for reporting by grant recipients. Additionally, national AIDS strategies often set their own targets and countries are encouraged to report on core indicators for implementation of the UNGASS Declaration of Commitment. Financial indicators are conspicuously absent from most M&E frameworks.

METHODS: The international classification of health accounts - a methodology vetted through over 30 years of use in more than 50 countries - is adapted to track the flow of HIV/AIDS funds. The origins of funds are identified as well as allocation to specific program and service delivery components of interest to global and bilateral initiatives, and national strategic plans. Estimates of spending by program/ treatment categories are presented for 7 countries - with generalized and concentrated-epidemics - across 3 regions from 1998 – 2004.

RESULTS: In most cases, funds were not allocated according to the spending priorities established in national strategic plans. Further, though the principal of additionality has been met in many countries, increases in government spending on HIV/AIDS are relatively small, as is the reduction of the burden of financing on households. Meeting bilateral and global output targets would require significant increases in funding and/or improvement in the effectiveness of country-level disbursements.

CONCLUSIONS: As HIV/AIDS funds increasingly flow from external sources to NGOs, the ability of government to exercise stewardship over prevention and care is challenged. As demonstrated by the experiences of the governments of Kenya, Malawi, Rwanda, Ukraine, Vietnam, Zambia and Zimbabwe, developing systems to track the flow of resources against program objectives can be a powerful tool in guiding HIV/AIDS policy.

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2006-08-13
ThAd0103

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