Donor funding for HIV/AIDS has skyrocketed in the last decade: from US$ 300 million in 1996 to US$ 8.9 billion in 2006; yet, little is understood about how these resources are being spent. This paper analyses the policies and practices of the world’s largest AIDS donors as they are applied in Mozambique, Uganda and Zambia. The report offers a number of recommendations for how donors can improve their programmes to increase the effectiveness of aid. Recommendations for all three donors include: jointly coordinate and plan activities to support the National AIDS Plan, assist the government in tracking total national AIDS funds, focus on building and measuring capacity, and develop strategies with host governments and other donors to ensure financial sustainability.
Resource allocation and health financing
The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria today approved 73 new grants worth more than US$ 1.1 billion over two years. The Board has also approved US$ 130 million for renewal of five grants that have reached the end of their five year life. More than 80 percent of the approved Round 7 grants are for low-income countries, with the majority of resources (66 percent) for Africa. Asia and the Western Pacific will receive 13 percent of the newly approved funding, Latin America and the Caribbean five percent, Eastern Europe three percent, and the Middle East 13 percent.
The act is intended to consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council for Medical Schemes as a juristic person; to provide for the appointment of the Registrar of Medical Schemes; to make provision for the registration and control of certain activities of medical schemes; to protect the interests of members of medical schemes; to provide for measures for the coordination of medical schemes; and to provide for incidental matters.
A comparative approach was adopted to study four groups of informal economy operators (cobblers, welders, carpenters, small scale market retailers) focusing on a method of prepayment which could help them access health care services. Two groups with a total of 714 operators were organized to prepay for health care services through a group premium, while the other two groups with a total of 702 operators prepaid through individual premium, each operator paying from his or her sources. Data collected showed that the four groups were similar in many respects. These similarities included levels of education, housing, and social services such as water supplies, health problems, family size and health seeking behaviour. At the end of a period of three years 76% of the members from the two groups who chose group premium payment were still members of the prepayment health scheme and were receiving health care. For the two groups which opted for individual premium payment only 15% of their members were still receiving health care services at the end of three years.
This study highlighted financial difficulty as the major obstacle to obtaining treatment in one province of South Africa. There is evidence in support of providing ARV treatment free of charge to HIV positive patients who qualify, as occurs in other provinces in South Africa. It is also suggested that providing ARV therapy at more local clinics in the community would make treatment more accessible. Provision of several months' supply of medicines per visit would help to reduce transport costs and minimise patient expenditure. These interventions may reduce the incidence of patients lost to follow-up in this community.
A number of different methodologies will be tested as part of the Risk Equalisation Fund (REF) shadow process in South Africa, according to the Registrar of Medical Schemes Patrick Masobe, under whose control the shadow process falls. The REF is being set up to make sure that all medical scheme members, regardless of their age or state of health, pay the same to access certain basic healthcare benefits. Medical schemes that have a large number of younger and healthier members will have to pay into the REF, while schemes with many older and sicker members will receive payments from the fund.
This research report examines how community organisations responding to HIV can be effectively supported. The report uses case studies to illustrate seven different models for supporting community organisations through a combination of funding, capacity building and networking. These models show the importance of tailoring funding and support according to an organisation’s needs, size and stage of development. These case studies also highlight the importance of providing multi-year funding to allow organisations to grow and the usefulness of horizontal learning and networking. Each of the models have the potential to be replicated or scaled-up.
Mandated jointly by the Government of the Republic of Zambia (GRZ) and the Cooperating Partners (CPs) committed to Poverty Reduction Budget Support (PRBS), the learning assessment (LA), integrated into the Joint Annual Review (JAR) 2007 process, pursued the overall objective of developing practical recommendations on strengthening the effectiveness and efficiency of PRBS-supported programme implementation. The recommendations are based on PRBS experience in general and the 2007 JAR process in particular. The quality of dialogue, performance and accountability was to be specifically assessed. Methodologically, the LA made use of good practices developed elsewhere, observations of JAR sessions, interviews, and written feedback.
Employer-financed health insurance systems, like those used in the United States, distort firms labor demand and adversely affect the economy. Since such costs vary with employment rather than hours worked, firms have an incentive to increase output by increasing worker hours rather than employment. This paper constructs a heterogeneous agent general equilibrium model where individuals differ with respect to their productivity and employment opportunities. The authors generate steady state results for several alternative models for financing health insurance: one in which health insurance is financed primarily through employer contributions that vary with employment; a second where insurance is funded through a non distortionary, lump-sum tax; and a third where insurance is funded by a payroll tax. They further measure the effects of each of the alternatives on output, employment, hours worked and inequality. These findings can be compared with East and Southern African communities that employ such employer-financed health insurance systems.
The World Health Assembly has in the past three years passed several resolutions on health financing and health worker shortages - yet there has been an overall increase in annual African deaths resulting from lack of sustainable health finance and health worker shortages. The worlds Health Ministers must now move from passing resolutions to effecting resolutions and emergency action to end the deaths of over 8 million Africans a year from preventable and treatable diseases.