A new perspective on sustainability

I’m an info guy. I like data, and I came to the conference to present on our monitoring work through the ESI Project, collecting data for PEPFAR to make informed programmatic decisions. There was a lot of interest overall, and we got a lot of interesting questions: about sustainability, about how the data we collect is actually used to inform planning, in practice. More and more, responsibilities are turning towards countries. The reporting template we’ve created in South Africa is intended to ultimately belong to the Department of Health.

One of the many interesting insights to me was that shared by I think the head of the NAC in Nigeria in the satellite session on Country Ownership on Monday evening. When the question was raised about sustainability and how these programs would continue to be funded, he answered, “the countries themselves who will now have an opportunity to own the response to HIV.”

Ambassador Goosby’s commitment that PEPFAR “will do no harm” by changing its flow of resources was reassuring. He went on to say that PEPFAR was not attempting to cut and run but was rather looking to sustainability. Yet the United States and other key funders of HIV programs are experiencing difficult economic times and may be forced to curb the current level of funding to all international development. The countries where these programs are being implemented, however, are experiencing economic growth, averaging 6% in most cases, and in time should be able to support these programs themselves, with minimal outside assistance and the requisite political will to allocate resources appropriately.

The Executive Director of the Global Fund acknowledged that up until now investments being made by the Global Fund were being sent directly to the Ministry of Health, without the Ministry of Finance being involved. By engaging with the Ministry of Finance, the intention is to make sure that these funds are recognized as part of the national budget and prepare for a future when those dollars come from the country government instead of PEPFAR and other funders of development programs.

There has been a lot of talk about sustainability at AIDS 2012, especially with new information around “treatment as prevention” and the struggle to provide a growing number of ARVs to people living with HIV for the duration of their lives. It is interesting to see how the HIV landscape is changing, and how countries will be able to change their role as well, and have greater ownership over the programs the delegates and advocates of this conference have already begun.

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