Transition and Sustainability: Lessons Learned, Questions and Priorities

July 26, 2018

Transition and Sustainability: Lessons Learned, Questions and Priorities

Transition and Sustainability: Lessons, Questions and Priorities

Outline

• Sustainability• Transition• The OpCon project• Satellite agenda

Transition and Sustainability: Lessons, Questions and Priorities

Much Accomplished – and Much Remaining to be Done

Number of New HIV Infections2020 Target

UNAIDS 2017 estimates. Global AIDS Monitoring 2017

Transition and Sustainability: Lessons, Questions and Priorities

Sustainability

Transition and Sustainability: Lessons, Questions and Priorities

Resources available for HIV in LMIC: all sources

Development Assistance for HIV/AIDS: 1990-2017

Transition and Sustainability: Lessons, Questions and Priorities

PEPFAR Funding, FY 2004-2018

Kaiser Family Foundation

Transition and Sustainability: Lessons, Questions and Priorities

Where does external HIV funding go?HIV/AIDS Development Assistance for Health 2015

HIV/AIDS Development Assistance for Health 2015

Transition and Sustainability: Lessons, Questions and Priorities

What does External HIV Funding Support?

Global Fund

NGOs & Foundations

United States

Care and SupportCounseling & Testing

Prevention

Health Systems

Treatment

OVCPMTCT

Other

Transition and Sustainability: Lessons, Questions and Priorities

Resources Needed

Fast-Track update on investments needed in the AIDS response, 2016–2030. Geneva: UNAIDS; 2016.

Transition and Sustainability: Lessons, Questions and Priorities

Sustainability and the PEPFAR Agenda

Human RightsImpactEfficiencyPartnershipSustainability

“For PEPFAR, sustainability of the HIV response means that a country has the enabling environment, services, systems and resources required to effectively and efficiently contain the HIV/AIDS epidemic.”

Sustainable HIV Epidemic ControlPEPFAR Position Paper, November 2016

Transition and Sustainability: Lessons, Questions and Priorities

The PEPFAR Sustainability Index

Transition and Sustainability: Lessons, Questions and Priorities

Sustainability and the Global Fund

Transition and Sustainability: Lessons, Questions and Priorities

Transition

Transition and Sustainability: Lessons, Questions and Priorities

Global Fund Transitions

Transition and Sustainability: Lessons, Questions and Priorities

Projected Global Fund HIV Transitions 2015-2040

Silverman, Center for Global Development, July 2018

OpCon Year 1 Projects

• Zambia: Adolescent self-testing • Zimbabwe: Urban DSD models• Côte d’Ivoire: Evaluation of out-of-pocket costs for adults on ART• Mozambique: Machine learning to predict defaulters• South Africa: Evaluation of CHW scale-up (part of the “surge”)

Can be used to fund program evaluations, costing studies, modeling, technical assistance, demonstration projects

Today’s Session• Michael Ruffner, Deputy Coordinator, Financial and Programmatic Sustainability, Office of

the Global AIDS Coordinator, U.S. Department of State. Sustainability: the view from PEPFAR.• Ade Fakoya, Senior Disease Coordinator, HIV, The Global Fund for AIDS, TB & Malaria

Sustainability: the view from the Global Fund.• Emily Hyle, Assistant Professor of Medicine, Harvard Medical School. Do less harm: modeling of

HIV program contraction • Henry Zakumumpa, Makerere University & Jess Wilhelm, Johns Hopkins University. The

impact of the PEPFAR pivot on “non priority” sites in Uganda. • Anna Deryabina, Central Asia Country Director, ICAP Columbia. The impact of Global Fund

transition strategies on national HIV programs in Central Asia.• Tom Ellman, Director, Southern African Medical Unit, Médicins Sans Frontières. What happens

to HIV programs when donors leave? • Gerald Gwinji, Secretary, Ministry of Health and Child Care, Zimbabwe. Zimbabwe’s approach to

HIV program transition and sustainability.

Transition and Sustainability: Lessons, Questions and Priorities

Acknowledgements

This project is supported by the U.S. President's Emergency Plan for AIDS Relief, through the Health Resources and Services Administration (HRSA) of

the U.S. Department of Health and Human Services (HHS) under grant UJ7HA31180, Optimizing Momentum toward Sustainable Epidemic

Control. This information or content and conclusions should not be construed as the official position or policy of, nor should any endorsements be inferred

by HRSA, HHS or the U.S. Government.