Toward Country-owned HIV Responses: What Strategies are Countries Implementing to Achieve Sustainability?

Resource Type: Technical Report
Authors: Denise Jacobson and Eun Hyeog Chang
Published: September 2018

Resource Description: As decreases or cessation of donor funding for Human Immunodeficiency Virus (HIV) looms, countries are faced with the urgent need to plan for the sustainability of their HIV responses. Health Finance & Governance (HFG) has helped more than 30 countries over the past six years to design and implement strategies to ensure successful transitions from donor-supported to country-owned HIV responses. HFG supported activities in six main interrelated categories: financing data for decision making; sustainability planning and financing strategies; service delivery and Antiretroviral drugs (ARV) supply; health insurance and strategic purchasing; workforce and efficiency; and institutional capacity building.

This demand for health system strengthening support for HIV reveals the breadth and depth of expertise that is needed to ensure that countries are ready to finance and lead their HIV responses with little or no outside support. It also shows a recognition by countries and donors of the importance of deliberate transition planning with associated technical assistance and resources.

Although much progress has been made, in most countries there is still a need for technical assistance and especially institutional capacity building so they can continue the planning process successfully. It is also critical that transition plans include explicit strategies for sustaining community-based outreach and prevention services in addition to facility-based care and treatment. The next few years of transition planning and implementation will be crucial for ensuring that countries sustain and expand the gains accomplished in the past 15 years and for their achievement of HIV epidemic control.


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