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FINANCING HIV/AIDS IN TANZANIA
Beng’i Issa
Outline• Introduction
• Sources of financing HIV/AIDS
• Volume of resources in Tanzania
• Financing and implementation Framework
• Budgeting for HIV/AIDS
• Funding modalities in Tanzania
• Fund Flow
• LGAs Response to HIV/AIDS
Introduction
• In 2007/08 HIV/AIDS finances estimated at 596.4 bn shs.
• Expected aid is 568 bn Shs.,
Introduction…• HIV/AIDS accounts for 10% of total
GOT spending
• 1/3 of the total aid flow to Tanzania is spent on HIV/AIDS.
• 95% of HIV/AIDS resources is financed by donors.
Sources of Funding for HIV/AIDS in Tanzania
• Government Consolidated Fund
• External sources• Locally collected Revenue
Financing Framework - Tanzania
Ministry of Finance
Locally Collected Revenue
MDAs,LGAs,CSOs,
Private Sector
Revenue External Resources
Big Financiers of HIV/AIDS
• There four main financiers of HIV/AIDS in Tanzania (USG, GFATM, IDA and GOT)
• USG and GFATM represents 86% of the donor support.
• USG alone accounts for 59% of the resources in Tanzania
HIV/AIDS Resources (10yrs)
-
100,000,000
200,000,000
300,000,000
400,000,000
500,000,000
600,000,000
700,000,000
2001/2002 2002/2003 2003/2004 2004/2005 2005/06 2006/07 2007/08 2008/09 2009/2010 2010/2011
Government Vs Donors (10yrs)
-
100,000,000
200,000,000
300,000,000
400,000,000
500,000,000
600,000,000
2001/2002 2002/2003 2003/2004 2004/2005 2005/06 2006/07 2007/08 2008/09 2009/2010 2010/2011
Government Donors
All Financiers
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
300,000,000
350,000,000
400,000,000
450,000,000
2001
/2002
2002
/2003
2003
/2004
2004
/2005
2005
/06
2006
/07
2007
/08
2008
/0920
09/20
1020
10/20
11
Government of TanzaniaWorld BankGlobal FundBelgiumUNAIDSUNICEFWFPWHOFAOFrench EmbassyDFIDSweden EmbassyJICACIDANorwayIreland (DCI)DANIDARoyal Netherlands EmbassyUNDPUNFPAUSGEUGermanySDC
Status in 2007/08
USG59%
JICA1%
Norway1%
WFP0%
UNICEF0%
Belgium0%
Sweden Embassy1%
Ireland (DCI)1%
UNDP0%
Royal Netherlands Embassy
1%
Global Fund15%
World Bank8%
Government of Tanzania13%
Implementation Framework
The framework for HIV/AIDS implementation in Tanzania has considered a
multi-sectoral approach.
PRIME MINISTER’S OFFICE
TANZANIA COMMISSION FOR AIDS(COORDINATING BODY)
RFA, GFATM Recipients
Technical AIDS
Coordinators
Tz Informal Economic Network On AIDS Initiative
CMACS AIDS BusinessCoalition in TZ
Regional Secretariats
Development Partners on AIDS
TNCMGFATM,
TMAP,etc.
IMTC on
HIV/AIDS
NACOPHA
Non-GovtOrgns
FaithBased Orgns VMACs
LGAs
WMACs Districts Council
for PLHIV
Informal Sector
Private Sector Ministries
Commissioners
Budgeting of HIV/AIDS in Tanzania…
• A specific code (objective A) for HIV/AIDS was introduced in 2004 and all sectors are using it when budgeting.
• The Government designed a software for resource allocation and MTEF development known as SBAS-Strategic Budget Allocation Software.
• This is where targets for MKUKUTA are aligned with the sectoral targets (including HIV/AIDS targets)
MTEF
01 S
03 S
02 C
OB
JECTIVES..A
,B,C
,…
MISSIO
N
VISION
03
02
01
02
03
04
01
TARGETSAligned to MKUKUTA
ACTIVITIES
Strategic Budget Allocation Software
I F M S
Local Government Authorities
• The government constitution gives each LGA status of the Government.
• LGAs can raise funds i.e. collect taxes, fees and charges.
• LGAs can finance own goods, services and financing development projects
Local Government Reform Programme
• The Local Government Legal requirement is operationalized through this programme.
• Main objective:– to enhance locally generated and centrally
disbursed financial resources.– Increase efficiency of the used resources.
Budget Cycle for LGAs• The Government issues budget guidelines
each year around December.
• The guidelines is prepared in collaboration with Ministry of Planning and Finance and PMORALG
• In the guidelines priorities are given, performance reviewed and levels of funding are given.
• Sectors Ministries put their guidelines through this guideline (Incl. HIV/AIDS)
Planning approach for LGAs • At the LGAs planning starts at lower level.
• When guidelines are issued
• Villages and urban prepares plans in participatory manner
• Village plans are consolidated and coordinated by Ward development Committees (3-5 villages)
• Integration is strengthened by technical sectors
Planning approach for LGAs…• Ward development Committees submit to the District
Authorities.
• At District plans are integrated with the Development Projects.
• Discussed in the sectors standing committees.
• Council Executives prepares Council draft plan and submit it to the Regional Secretariats (RS)
• RS – sector representatives scrutinize draft plans (look at adherence of policies and guidelines).
Planning approach for LGAs …• RS provide comments on the plans.
• Council Finance and planning committee discusses comments from RS
• The draft plan and budget is resubmitted to the RS
• At RS level plans from all councils are consolidated into Regional Plan.
• Regional plan is submitted to the PMO-RALG, then to the Ministry of Finance.
• The government budget is submitted to the Parliament (consolidated budgets from all Ministries).
Ja
Planning Framework
Rural Villages Urban Neighborhoods
Ward Devt. Committees
Council Executives
Standing Committees CSOs
Regional Secretariats
Ministry of Finance
PMO-RALG
The Parliament
Sectors
TechnicalInputs
CSOs
TACAIDS
People
Other MDAs
CSOsCSOs
Funding ModalitiesThese are main modalities of financing in Tanzania:– Direct project financing – PEPFAR and other off
budget funding– Government system of financing– Projectized BUT captured by the Government –
TMAP, GFATM– Pooled funding mechanism, i.e. Rapid Fund
Envelope (RFE), Basket Fund, HIV/AIDS Fund
Fund Flow • Exchequer system• Special Account• Direct Project funding• Pooled Funding
ISSUES ON FUND FLOW
MOF
TMAP
MDA’s CSO’sLGA,s FBO’s
INT’L NGO’s/FBO’s GLOBAL
FUND
PrivateSector
RFA’s
PEPFARRFE
TACAIDS
FOUNDATIONS
DEVELOPMENT PARTNERS
Delloitte and Touche
LGAs Response to HIV/AIDS• The recent PER and accountability assessment
confirmed that public expenditure management by the LGAs has steadily improved (scores on independent annual assessments and clean audit reports)
• The main Sources of fund have been the GFATM, TMAP and CIDA.
• Most LGAs planned for trainings, activities to support CHACs and sensitization.
LGAs Response to HIV/AIDS…• 75% of LGAs reviewed are supporting Orphans,
i.e. uniforms, fees,
• 61% of LGAs reviewed, economic support to PLHAs.
• Care and support is mainly for Home Based Care, other are centrally.
• 80% of LGAs planned for prevention activities e.g. schools interventions, youth, adult education, condom distribution, peer education, drama groups.
LGAs Response to HIV/AIDS• Government policy is to decentralise and devolve
more responsibility to local government,
• Role of the central Government is focused on policy, facilitation, capacity building, and monitoring.
• This is not very easy when most of sources of funds to HIV/AIDS are projectized for LGA budgets.
Funding modalities for the Districts
Exchequer financing
Own source
Individual Donors(Global Fund, TMAP, Axios, GTZ)
SWAP ModalityHealth Basket Fund
HIV/AIDS Fund
Projects
Grants i.e. Health and Block Grants
for HIV/AIDS
Grants e.g. education, Roads, HIV/AIDS etc
Local Collected Revenue, Local established funds
Improve governance - LGAsGood governance for HIV/AIDS interventions should consider:
– Participatory planning at LGAs level.
– Discussion of HIV/AIDS plans and budgets at full council meetings.
– Enforce decentralisation of financing intervention at LGA level.
– Devolve more responsibility to local governmentand improve accountability.
– CMACS should be used effectively.
A way forward• Involvement of CSOs and Private Sector.
• Transparent mechanisms for the CSOs and Private Sector to access funds through LGAs.
• Accountability through existing mechanisms set by the Government.
• Data collection and reporting for the response in the District.
ConclusionResources for HIV/AIDS can be very meaningful if used efficiently and
effectively.
Asanteni!!