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Supporting community action on AIDS in developing countries

IHP+ CIVIL SOCIETY CONSULTATION

Financing the IHP: Intent, Commitment, Expectations and Concerns

What is the funding plan?

23 May 2008

Supporting community action on AIDS in developing countries

Supporting community action on AIDS in developing countries

Aim of this presentation

1. Do we know the financing needs to deliver on the health MDG’s?

2. What can we learn from the AIDS response – commitment, increased resources, delivery.

Supporting community action on AIDS in developing countries

Do we know how much is needed to deliver on the health MDG’s?Evans et al. (WHO): “We found that efficiency is positively

related to health expenditure per capita. Performance increased greatly with expenditure up to about $80 per capita a year, suggesting it is difficult for systems to be efficient at low expenditure. There seems to be a minimum level of health expenditure below which the system simply cannot work well.”

Supporting community action on AIDS in developing countries

How much is needed to fully finance health for all?

Using very rough estimates about economic growth, population growth, increased mobilisation of international resources and increased allocation of domestic resources to the health sector, it seems that US$24 billion to US$36 billion per year would be needed, for assistance to 54 low-income countries, with the intention to lift their government health expenditure to US$40 per person per year.

 That would require 0.066% to 0.1% of the Gross Domestic Product of the member states of the Organisation for Economic Cooperation and Development.

Supporting community action on AIDS in developing countries

Learning From AIDS Financing

• Importance of high level commitment

• ‘Three Ones’ Principles – with CS and PLWAOne National Plan, Coordinating Body, M&E

Framework

• Country owned comprehensive, costed national plans – with technical support from UNAIDS

• Internationally and nationally agreed Universal Access targets & indicators

• Internationally sustained financial commitments, especially since HIV treatment is for life – including GFATM

Supporting community action on AIDS in developing countries

Can the IHP+ deliver long term financing for health?The need for long-term, predictable and reliable

foreign assistance for ‘Health Systems Strengthening’ is as crucial as the need for long-term, predictable and reliable foreign assistance for AIDS treatment.

If we want to convince a Ministry of Health to start training 5,000 additional nurses in 2008, who will then be qualified in 2011, and who would then be hired for at least 10 years, the IHP needs to outline to Ministries of Finance and Health how foreign assistance for salaries will be available in 2021…

Supporting community action on AIDS in developing countries

A gap of $2.8 billion to scale up!

HSDP-III Financing Gap, 2007/08 to 2009/10

773 773 773

1,001 1,001 1,001

1,5612,344

2,840

-

1,000

2,000

3,000

4,000

5,000

Scenario 1 Scenario 2 Scenario 3

In m

illio

n U

S$

Funds by GoE Funds by Donors Financing Gap

Supporting community action on AIDS in developing countries

Sustainable Finance for Health – What is Needed?

• Commitment by all donors, led by G8 to fully finance the health MDG’s with timescales and targets

• Donors and Govts meeting their commitments – 0.7% ODA, 15% Abuja

• Resolve IMF fiscal constraints• Acceptance that sustainability for health is an

international responsibility • Utilization of GFATM and GAVI HSS and CSS windows• Increase effectiveness, transparency and performance

base of budget support and SWAP’s• Performance based funding to support results,

transparency and accountability – by securing and supporting civil society engagement at every level.

Supporting community action on AIDS in developing countries

Can the IHP+ deliver long term sustained funding for

health?