| Every year billions of budget and donor dollars are set aside for HIV/AIDS programmes. But who tracks how these dollars are spent and the value that is gained in return? This was one of the issues raised at a recent press briefing of the National AIDS Committee.Earlier this month the United Nations held their high level meeting on the subject of HIV/AIDS. Coming out of that meeting is a Political Declaration on HIV/AIDS: Intensifying our Efforts to Eliminate HIV/AIDS. In that document there were a number of issues that were updated based on the progress made by all countries since the last meeting and among these was the issue of spending within the numerous HIV/AIDS programmes and initiatives that dot the landscape.The document speaks on the behalf of the entire assembly and Article 27 states: “Recall our commitment that prevention must be the cornerstone of the global HIV and AIDS response, but note that many national HIV prevention programmes and spending priorities do not adequately reflect this commitment, that spending on HIV prevention is insufficient to mount a vigorous, effective and comprehensive global HIV prevention response, that national prevention programmes are often not sufficiently coordinated and evidence-based, that prevention strategies do not adequately reflect infection patterns or sufficiently focus on populations at higher risk of HIV, and that only 33 percent of countries have prevalence targets for young people and only 34 percent have specific goals in place for condom programming;”Article 28 continues: “Note with concern that national prevention strategies and programmes are often too generic in nature and do not adequately respond to infection patterns and the disease burden; for example, where heterosexual sex is the dominant mode of transmission, married or cohabiting individuals, including those in sero-discordant relationships, account for the majority of new infections but they are not sufficiently targeted with testing and prevention interventions.”Yet earlier this year at the opening of the Sixteenth Meeting of the Executive Board of the Pan-Caribbean Partnership against HIV/AIDS (PANCAP) at the Caricom Secretariat, Turkeyen, Head of Human and Social Development at Caricom, Ms Myrna Bernard noted in counterpoint that the recent global economic crisis has resulted in a significant decrease in donor spending for HIV/AIDS, especially for low- and middle-income countriesShe highlighted the fact that the crisis has had a negative impact on AIDS programmes in these countries but prevention programmes were identified as the most likely to be worst affected in all countries receiving external funding.Bernard added. “This point must be of specific concern to the Region since control of the epidemic is contingent on reducing the number of new infections which in turn requires aggressive development and implementation of prevention campaigns targeting those deemed to be more at risk.”But the issue is not that there is reduced funding available which is indeed a fact due to the recent global crisis, instead it is that the agencies involved may not be spending the funds properly.And Mrs. Merle Mendonca of the National Aids Committee addressed this concern during a recent press briefing. She said that there needs to be a greater push for monitoring and evaluation at the national and regional levels.She pointed out that the failure to address the issue of national spending on the epidemic to the extent of agencies and sub-agencies will create difficulties in the organization mechanisms.Since it is very difficult to address planning if you cannot obtain accurate information on the cash flows and resource utilisation of agencies. The failure to address AIDS programmes as a cohesive whole instead of as multiple agencies within the national framework means too that there will be duplication of effort in the field.Further in, the declarations address the issue of sustainability in the spending employed by these programmes.Article 45 of the declaration states: “Acknowledge that the current trajectory of costs of HIV programmes is not sustainable and that programmes must become more cost-effective and evidence-based and deliver better value for money, and that poorly coordinated and transaction-heavy responses and lack of proper governance and financial accountability impede progress;”A little over two months ago the Minister of Health, Dr. Leslie Ramsammy reiterated the Government’s commitment to the UNAIDS position of zero new transmission, zero mother-to-child transmission, zero deaths from HIV and zero stigma and discrimination as it relates to HIV/AIDS. He was at the time addressing a stakeholders’ meeting to discuss the findings of the HIV/AIDS Programme Sustainability Analysis Tool (HAPSAT), a venture which comes as a collaborative effort between the Ministry of Health’s National AIDS Programme Secretariat and the Health Systems Strengthening programme (HS20/20), and which is funded by USAID.“We have already established,Deion Jones Falcons Jersey, globally, the first milestone on this trajectory which is zero mother-to-child transmission by 2015. That is no longer a goal that Guyana stands alone with; this has become a global pact.”The Minister said at that forum that a decision was taken to gain collaborative input into addressing the way forward as it relates to achieving the ambitious trajectory.He underscored that the move is geared at examining how existing programmes in this regard can be scaled up and be sustained for the long haul.“This is not a fight that is a two-year or a five-year project…this is our national health response, that must not only deal with the crisis that face us immediately but that must deal with other crises in the future while sustaining the gains that have already been made.”“We are sitting here because we are indeed change agents. We are here to act; we are here to make a difference in people’s lives. It means then delivering results…”That event saw Dr Itamar Katz of USAID presenting the major findings and recommendations of the HAPSAT.According to USAID, Guyana’s success in reducing HIV prevalence, coupled with global decline in HIV/AIDS funding, necessitates an examination of the financial sustainability of Guyana’s AIDS Programme. A preliminary HAPSAT brief was designed to provide Guyana’s National AIDS Programme with a preliminary analysis of the unit costs and financial and human resources available, and needed, to sustain the HIV/AIDS programme through 2015.The USAID analysis focuses on activities that a broad group of stakeholders involved in Guyana’s HIV/AIDS programme identified as being critical to the sustainability of the programme. |
