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Is E2 sufficient to ensure sustainability?

Is E2 sufficient to ensure sustainability?. Definitions, principles, actors, priorities. Definitions. Sustainability of Finances – predictable, increasingly domestic (integrated) health and community systems Institutional capacity, health work force Local sustainability

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Is E2 sufficient to ensure sustainability?

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  1. Is E2 sufficient to ensure sustainability? Definitions, principles, actors, priorities

  2. Definitions • Sustainability of • Finances – predictable, increasingly domestic • (integrated) health and community systems • Institutional capacity, health work force • Local sustainability • Both immediate and long-term

  3. Principles • National ownership of plans and priorities • Global solidarity • Commonly agreed goals - mutual accountability • Synergies with other health and development sectors

  4. Challenges • 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

  5. Stakeholders • Affected communities, activists • Implementers • Programs • Ministries of Health • Ministries of Finance, Treasury • Donors

  6. E2 necessary, not sufficient • Allocate efficiently within HIV and health • Optimize service delivery models • Harmonize different actors • Better identify bottlenecks • Make explicit equity concerns

  7. 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)

  8. Sustainability elements for roadmap • Strengthen national strategic and costed operational plans • 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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