Establishing AIDS Trust FundTanzanian Experience

Mrs. Beng’i IssaDirector of Finance, Administration and Resource

Mobilization, Tanzania Commission for AIDSInternational AIDS Conference 2014

Satellite Session, 23rd July 2014Melbourne, Australia

TANZANIA PROFILE

Total population is 44.6 million (2012 census)

945,087 km² or (364,900 M2)

25 Regions and 165 Local

Government Authorities

Unity of Tanganyika

mainland and Zanzibar islands

in 1964

HIV in Context

ART 512,000

Circumcision rate 72%

HIV Prevalence 5.1% (15-49yrs)

New infections 86,000 per year

1,500,000PLHIV and

2 million Orphans

Transmission to babies decreased to

15% from 26% (2012)

Education Programmes 80%

Major driver of epidemic - multiple

concurrent partnership

PMTCT coverage 65%

Finance Background

There is a value for money spent on HIV and AIDS (VFM 2012).

HIV and AIDS finances 27% of the total health budget. (NHA 2010)

Tanzania spend about 550 million USD per year.

HIV and AIDS national response is financed by donors by 71%

The annual gap is estimated at 50% (NMSF Costing 2008-12).

NATIONAL GAP ANALYSED 2008 -12

Preve

ntion

Treatm

ent and ca

reOVC

Socia

l mitiga

tion

Community devp

t

Research

Enabling e

nvironment

-1,600,000

-1,400,000

-1,200,000

-1,000,000

-800,000

-600,000

-400,000

-200,000

0

Multi-sector contribution

GOVT10%

DONORS71%

Private sector

2%

NHIF1%

Household16%

Current major funders in absolute cash

GoT3%

Global Fun

d20%

NMSF

GRANT4%

UN FAMILY

2%

USG71%

2001/2002

2002/2003

2003/2004

2004/2005

2005/06

2006/07

2007/08

2008/09

2009/10

2010/11

2011/12

2012/13

2013/14

est.

2014/15

est.

2015/16est.

-

100,000,000

200,000,000

300,000,000

400,000,000

500,000,000

600,000,000

700,000,000

800,000,000

900,000,000

Government of Tanzania

TACAIDS Est. TMAP

Global fund

NMSF Grant

PEPFAR

AIDS Trust Fund

UNDP supp. program UNJP3 UNDAP

LIFE OF HIV and AIDS PROGRAMMES IN TANZANIA

A need for investment?It is estimated that 86,000 new HIV infections inTanzanians i.e. about 80,000 people per year on Treatment.

It costs about USD 300 per person per year for Anti Retroviral Therapy.

WHO new guidelines on treatment of ART push for more needs of resources.

It is estimated that only 10% of people are reached by condoms.

Implementation of eMTCT strategy for positive mothers is at initial stages.

A need to scale up VMMC; the Government has set a target to circumcise 2.8 million males by 2017.

New evidence of prevention of new infections using cash transfers interventions

AIDS Trust Fund (ATF)The Government has approved establishment of the AIDS Trust Fund. It has taken 5 years of efforts.

Main objective is to ensure sustainability of financial resources for HIV response.

National AIDS Policy (2001) instructed the establishment of the AIDS Trust Fund.

The Trust fund will reduce donor dependence by 36%.

Focus of the next five years is to follow National HIV strategy and gaps identified.

ATF Status

It is established under TACAIDS Act No. 22 of 2001.

It intends to supplement the current funding mechanisms for the HIV and AIDS national response.

It is established as a public fund.

Governance Structure

PRIME MINISTER’S OFFICE

TACAIDS COMMISION

ATF BOARD OF TRUSTEE

CEO TACAIDS

ATF MANAGER

HIV PARLIAMENTARY COMMITTEE

Proposals declined

• Income taxes (companies)• Alcohol and Cigarettes• Gift

Union taxes

Declined by stakeholders

• Life insuranceExempted taxes

• Air ticketing• Buses and lorries at the bordersBias

•GOT contribution on VAT collected •Employers and employees taxes

Implementation principles

Agreed national priorities as per HIV and AIDS policy and strategies will be followed.

Involvement of all stakeholders from different sectors in decision making.

The Trust fund to contribute to the national efforts in the fight against HIV and AIDS in Tanzania.

The Trust Fund will not replace donor support to Tanzania.

Funds used will follow Government rules and regulations.

Speed and risk management.

Priority setting

National Strategies

Technical Working groups to be involved

Impact and Results

Existing national coordinating

mechanism to endorse

Approval by the Trustees

Promote decentralization

Included in the annual

Government budget

ATF Sources

GovernmentContribution

Foreign grants &

donations

Foreign and local private donations &

bequests

Investment income

Public fund raising events

publ

ic au

ction

s, m

eal f

undr

aisin

g

even

ts, m

usic

extra

vaga

nzas

, fas

hion

show

s, ra

ffles

, giv

eaw

ays a

nd tr

inke

t

sale

s, sp

onso

red

char

ity w

alks

and

mou

ntai

n cli

mbi

ng, a

nd sp

orts

tour

nam

ents

. Web

site/

onlin

e an

d

mob

ile p

hone

.

Donors contribution

on whole or part of

their grant assistance

resourcein

vest

mon

ey no

t

imm

edia

tely

need

ed in

shor

t-ter

m

instr

umen

ts su

ch as

Trea

sury

pape

rs

Foreign and

domestic private

sources.

receive favourable

tax treatment

Ring fenced budget allocation by the

GoT. Based on the costed Strategy and

total gap.

Expected ATF envelope

2015 2016 2017 2018 20190

20

40

60

80

100

120

140

othersGovtU

SD

CSO Funding and Involvement

CSOs in Tanzania plays important role in HIV National response

70% of the HIV donor resources are channeled through CSOs

Some of the CSOs finances the Government (Districts)

All coordination structures from the national to villages involves CSOs

Currently about 2% of the national resources are channeled by LGAs to CSOs

ATF operations will use existing mechanisms in relation to CSOs involvement.

Proposed allocation of funding from ATF

Treatment 50%

Preven-tion 20%

Mitigation

10%

Enabling environ-

ment 20%

Asanteni!