FINANCING HIV/AIDS IN TANZANIA. Beng i Issa

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FINANCING HIV/AIDS IN TANZANIA Beng i Issa

LGAs Response to HIV/AIDS Introduction Outline Sources of financing HIV/AIDS Volume of resources in Tanzania Financing and implementation Framework Budgeting for HIV/AIDS Funding modalities in Tanzania Fund Flow

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 Revenue Ministry of Finance External Resources MDAs, LGAs, CSOs, Private Sector Locally Collected Revenue

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) 700,000,000 600,000,000 500,000,000 400,000,000 300,000,000 200,000,000 100,000,000-2001/2002 2002/2003 2003/2004 2004/2005 2005/06 2006/07 2007/08 2008/09 2009/2010 2010/2011

Government Vs Donors (10yrs) 600,000,000 500,000,000 400,000,000 300,000,000 200,000,000 100,000,000-2001/2002 2002/2003 2003/2004 2004/2005 2005/06 2006/07 2007/08 2008/09 2009/2010 2010/2011 Government Donors

All Financiers 450,000,000 Government of Tanzania World Bank Global Fund 400,000,000 Belgium UNAIDS 350,000,000 UNICEF WFP WHO 300,000,000 FAO French Embassy 250,000,000 DFID Sweden Embassy JICA 200,000,000 CIDA Norway 150,000,000 Ireland (DCI) DANIDA Royal Netherlands Embassy 100,000,000 UNDP UNFPA USG 50,000,000 EU Germany SDC 0 2001/2002 2002/2003 2003/2004 2004/2005 2005/06 2006/07 2007/08 2008/09 2009/2010 2010/2011

Status in 2007/08 Government of Tanzania 13% World Bank 8% Global Fund 15% USG 59% UNDP 0% Royal Netherlands Embassy 1% Norway 1% Ireland (DCI) 1% JICA 1% UNICEF 0% Belgium 0% WFP 0% Sweden Embassy 1%

Implementation Framework The framework for HIV/AIDS implementation in Tanzania has considered a multi-sectoral approach.

TNCM GFATM, TMAP,etc. PRIME MINISTER S OFFICE Commissioners TANZANIA COMMISSION FOR AIDS (COORDINATING BODY) Development Partners on AIDS IMTC on HIV/AIDS Regional Secretariats RFA, GFATM Recipients CMACS NACOPHA Tz Informal Economic Network On AIDS Initiative AIDS Business Coalition in TZ Technical AIDS Coordinators LGAs Non-Govt Orgns Faith Based Orgns WMACs VMACs Districts Council for PLHIV Informal Sector Private Sector Ministries

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)

I F M S MTEF VISION MISSION OBJECTIVES..A,B,C, TARGETS Aligned to MKUKUTA 01 S 02 C 03 S ACTIVITIES 01 02 03 01 02 03 04 Strategic Budget Allocation Software

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).

People TACAIDS Standing Committees Planning Framework The Parliament Ministry of Finance PMO-RALG Regional Secretariats Council Executives Other MDAs CSOs Sectors Technical Inputs Ward Devt. Committees CSOs Ja CSOs Rural Villages Urban Neighborhoods CSOs

Funding Modalities These 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

TMAP MOF FOUNDATIONS ISSUES ON FUND FLOW INT L NGO s/ FBO s RFE PEPFAR GLOBAL FUND DEVELOPMENT PARTNERS Delloitte and Touche TACAIDS RFA s MDA s LGA,s FBO s Private Sector CSO s

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 Grants e.g. education, Roads, HIV/AIDS etc Own source Local Collected Revenue, Local established funds Individual Donors (Global Fund, TMAP, Axios, GTZ) Projects SWAP Modality Health Basket Fund HIV/AIDS Fund Grants i.e. Health and Block Grants for HIV/AIDS

Improve governance - LGAs Good 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 government and 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.

Conclusion Resources for HIV/AIDS can be very meaningful if used efficiently and effectively.

Asanteni!!