Is E2 sufficient to ensure sustainability? by jgdQQ5M7


									Is E2 sufficient to ensure

Definitions, principles, actors, priorities

• Sustainability of
   –   Finances – predictable, increasingly domestic
   –   (integrated) health and community systems
   –   Institutional capacity, health work force
   –   Local sustainability

• Both immediate and long-term
• National ownership of plans and priorities

• Global solidarity

• Commonly agreed goals - mutual accountability

• Synergies with other health and development
• Perceptions in Ministries of Finance that MoHs
  are not accountable, e.g. off-budget support,
  GFATM absorption, or results of E2 studies
• How to reverse crowding-out
• How to advocate for use of economic growth,
  matching of burden of disease, competing
  sectors (which with greater ease demonstrate
  value for money)
• Transitioning from donor support – also
  technical and market place elements
• Pooled vs. nationally owned commodities
• Transition costs money
•   Affected communities, activists
•   Implementers
•   Programs
•   Ministries of Health
•   Ministries of Finance, Treasury
•   Donors
   E2 necessary, not sufficient
• Allocate efficiently within HIV and health

• Optimize service delivery models

• Harmonize different actors

• Better identify bottlenecks

• Make explicit equity concerns
         A new global compact
• Countries take the lead – national vision and plan;
  partners pulled into alignment

• Resources are reallocated according to country needs
  and priorities, for greater, more sustainable results

• Partners and countries fill the investment gap together –
  ‘fair share’, based on capacity

• Programs are implemented as efficiently as possible
  (without parallel structures, stand-alone services or
  higher than necessary program costs)
             Sustainability elements
                  for roadmap
• Strengthen national strategic and costed operational

• Methodology to determine “fair-share”

• Address new data requirements: program and unit costs,
  expenditure surveys, evaluation studies, etc

• Estimate return on investment

• Development partners to more systematically strengthen
  E2 – tool kits, capacity strengthening

• From 3 ones to joint M&E and accountability framework

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