Coordinated HIV/AIDS expenditure tracking: the Rwandan example

Itete KARAGIRE, Data AnalystNational AIDS Control Commission, Rwanda.

How to Make the Global HIV Response SustainableCuernavaca, Morelos, Mxico

Dr Agns BINAGWAHOExecutive SecretaryNational AIDS Control Commission, Rwanda.

1OVERVIEW OF PAPER/PRESENTATION

Background

Situation Today

The international response

Interface between international and national levels

The national response (Example of Rwanda)

Conclusion

Three stages in the history of the pandemicFrom 80s to 2003?National and International solidarity: (Exceptional assistance)BACKGROUND3UNAIDS, Global Report 2007 The number of people living with HIV continues to rise [33.2 million in 2007 from 29.0 million in 2001].

For every two people who go on antiretroviral therapy (ART), there are 5 new HIV infections [Some 2.5 million people were newly infected with the virus in 2007]

For the ones on ART it becomes a chronic disease

Increasing resistance to ART

No cure and no vaccine

SITUATION TODAY4No one, in any country, has a guaranteed way to ensure that AIDS will remain under control even in the western world

5The international responseReflection and researches example : AIDS 2031 9 work groups ( encourage region and global synergy)

Sustainability of finance RED33 cents Euros by flight ticket (France) ect

Preventionfocus and invest on long term solution VaccineMicrobicide Treatment Encourage and finance researches

6Exceptional assistance is only useful if there is integration at a national level

We will have to consider

The Paris declarationNational prioritiesThe 3 Ones EDPRS, NSP (NACC)

Interface between national and international levels73 Ones On national authority NACC

One National plan

One monitoring and evaluation systemThe national response(Example of Rwanda)At national level: Register the fight against AIDS as a top priority in the efforts for sustainable development.

2. We must strengthen multi-sector: Integrated into development plans and fight against poverty.

In Rwanda All 12 sectors of PRSP2 or EDPRS (e.g. : Education, Justice, Health, AgricultureInsist on budget support). decentralized

93. Acknowledge its epidemic

Preventionthe driving forces not to take international dataTreatment equity based on age, gender and geographical distribution.4. Knowing the cost of the response and secure the funds

The national response(Example of Rwanda)continued10 Government is community-oriented

Participatory process

Transparency

Fight corruption

Effectives 3 ones : National coordination

GF, PEPFAR and others around One national Plan

One protocol for treatment, VCT, PMTCT etc country wide

Geographic coverage for partners decided by National Institution

National Policy of Aid an NACC is in the monitoring comity

No tolerance for vertical programs

The national response (Example of Rwanda : Why does it work)

11 Full integration in development plan: construction of health infrastructure; Human resources ;

Workshops versus formal Education;

In the family planning

Multiple reporting and planning process

Examples of Rwanda : Challenges 12Rwanda resultsToday, Rwanda under the leadership of the government which is beyond the 3 ones apply the 3 ones for Big 3:

Ensure that 50% of all pregnant women benefit from the program of the reduction of HIV transmission from mother to child (PMTCT),

Increasing access to antiretroviral treatment to over 70% > 75 % of the population having health insurance

Increase in the last 2 years of the life expectancy to 4 years

13ConclusionsKeep the exceptional sensitization globallyIntegrating the national level

BUT

Integrating at the global levelDevelopment in the social sectorsNot vertical funds but budget support A single national support plan (PRSP, MTF) A single national reporting system

14Tomorrow total integration and alignment

GRACIAS