ProjectsCEGAA undertakes projects in the field of economic governance for health, HIV/AIDS and related development issues in Africa, for and with governments, partner organisations and civil society. Current Projects (2010/2011) Giving power to the community: Community monitoring of HIV/AIDS and TB spending in two districts in South Africa (August 2009 to July 2011) CEGAA, in partnership with the Treatment Action Campaign (TAC), is strengthening the capacity of the TAC's community health activists in monitoring local service delivery, budgeting and expenditure for HIV/AIDS and TB at district level. This Budget Monitoring and Expenditure (BMET) project is supported by the Open Society Institute (OSI) and International Budget Partnership (IBP).
To read a wonderful story from the ground and a penetrating article on the BMET project, authored by our TAC Community Health Activist partners, access the TAC's April 2011 Equal Treatment newsletter (PDF) and go to pages 10 and 14. TAC Equal newsletter - April 2011 CEGAA and the TAC have shared information on this project with the Budget and Expenditure Monitoring Forum (BEMF - http://www.tac.org.za/community/BEMF), a group of civil society organisations that monitors the National Strategic Plan on HIV and AIDS 2007-2011 (better known as the NSP). The findings of a costing exercise of the South African comprehensive response to HIV/AIDS, projecting costs to 2031, done by CEGAA for the Results for Development Institute (R4D) and commissioned by the South African Government were also presented to the Forum. Members of the BEMF appreciated this input, and called for more information from all partners and government to enhance understanding and improve the status of HIV/AIDS financing, and to close the funding gap for HIV/AIDS interventions in South Africa. Our work with the BEMF has generated interest for budget monitoring work among other civic organisations, with BEMF members proactively seeking to learn from the CEGAA/TAC pilot project for application in their own work settings. For example, the Free State Provincial Coalition on AIDS has approached CEGAA to assist them with skills-building on budget monitoring and provision of technical support. The Coalition recognises that budget monitoring can assist them in alleviating many problems identified at community and clinic levels, where there are shortages of drugs and long waiting lists for ARVs. CEGAA and the TAC issued a joint statement summarising and commenting on national AIDS policy and funding upon the release of Budget 2010 (February 2010). To read the statement, go to: http://www.tac.org.za/community/node/2815 National AIDS Spending Assessment in South Africa (August 2010 to June 2011) CEGAA has undertaken an assessment of all HIV/AIDS and TB spending in South Africa. Provincial spending data, as well as the national picture, will inform the development of the new national and provincial strategic HIV/AIDS plans, and will contribute to the alignment of all actors' efforts to the national priorities. It is hoped that the evidence generated will lead to improved accountability, transparency, efficiency and sustainability of the response to HIV/AIDS and TB in South Africa. This project is funded by UNAIDS through its Technical Support Fund on behalf of the South African AIDS Council (SANAC). Since 2007, CEGAA has also provided NASA training, technical support and content expertise for National AIDS Councils for a number of countries in the region: Botswana, Ghana, Zimbabwe, Kenya, Uganda, Ethiopia, Lesotho and Swaziland. The NASAs provide very powerful evidence to inform the governments' and donors' resource allocative decisions. For example, in Botswana, the NASA data indicated that the increase in spending on treatment came at the expense of prevention activities, for which very little was going towards interventions for high-risk groups such as commercial sex workers (CSW) and men who have sex with men (MSM). As a consequence, Botswana's National AIDS Co-ordinating Agency (NACA) mobilised additional resources for prevention from donors, while the country's gay and lesbian network put pressure on the government to increase programs for MSMs and CSWs, which resulted in a program targeting high-risk groups. In Zambia, the NASA found limited alignment of all the efforts with the National HIV/AIDS Strategic Plan, and enabled the NAC to engage more meaningfully with the many donors to ensure an integrated and comprehensive response. Costing of the HIV/AIDS response in South Africa and its impact (November 2009 to December 2010) On behalf of the Results for Development Institute and South Africa's national Departments of Health and Treasury, CEGAA estimated the resources required for various scenarios in response to the HIV/AIDS epidemic in South Africa. As a contribution to the aids2031 Project, this work entailed reviewing all existing unit costs in the region, developing a useful database of the responses, modelled the impact of different intervention choices, and costing these to show the overall financial outlay and gains of the response options. The study shows that HIV/AIDS spending over the next few years will be high (R30 billion yearly by 2015) and that government will face a challenging financial shortfall against these costs. However, there is also cause for optimism: South Africa's potential assets, which include its political leadership, prospects for economic growth, vibrant civil society and business sectors, and international partners who are willing to bolster domestic funding, can be harnessed to secure the resources needed for managing the epidemic effectively. The results of this research were valuable to the national and provincial governments in making difficult allocative decisions, in realigning their efforts for the greatest impact, and in informing the development of new national and provincial strategic HIV/AIDS plans. Key findings from the project report, The Long-Run Costs and Financing of HIV/AIDS in South Africa, were cited at the 5th South African AIDS Conference held in Durban during June 2011. For access to the Report, please contact Nhlanhla Ndlovu at CEGAA: nhlanhla@cegaa.org Also see Page 3 of Impilo Dialogue Stakeholder Newsletter No.2 (PDF) for mention of CEGAA's participation at the 5th SA AIDS Conference's Business Accountability Panel Discussion. For access to this publication, go to: http://www.doh.gov.za/docs/misc-f.html HIV/AIDS fight will need R30bn yearly by 2015 HIV/AIDS and Health Budget Monitoring in Southern Africa - Mozambique, Zambia and Zimbabwe (March 2008 to February 2011) This project, funded by Oxfam-Novib, built the capacity of coalitions of civil society organisations in each country to undertake budget monitoring and expenditure tracking around issues of health and HIV/AIDS. http://www.lusakatimes.com/2011/07/02/eastern-province-records-reduction-hivaids-prevalence/ Participatory Budgeting towards the Millennium Development Goals (MDGs) in Angola, Zimbabwe and Mozambique (January 2010 to December 2012) CEGAA has provided capacity-strengthening and technical support to CSOs, NGOs and local government officials in each country in budget monitoring and expenditure tracking around development issues. We have worked closely with the Brazilian organisation, INESC, in supporting our Lucophone partners for improved economic governance of development issues. This project is funded by Oxfam-Novib. Monitoring Sexual and Reproductive Health Rights in six African countries (August 2010 to February 2013) Gender organisations engaged in monitoring the promotion and protection of sexual and reproductive health rights in their countries are being supported by Amanitare, HerWai and CEGAA to enhance their policy analysis, budget monitoring and advocacy. The project is funded by the European Union and Oxfam-Novib. Review of costing tools for Antiretroviral Therapy for the design and testing of a new global costing tool (March to December 2010) CEGAA participated in this project which was led by Health Development Africa (HDA) and funded by the World Health Organization. The tool and guidelines developed will be valuable for public health departments in estimating the resources required for their ART programmes. Various training and capacity-building activities CEGAA continues to develop and deliver training modules on health financing, costing, budgeting, financial management and community monitoring tools. One such workshop was delivered on behalf of the University of KwaZulu-Natal's Health Economics and AIDS Research Division (HEARD) for SADC programme managers (October 2010), and another for Master's students in Maternal Health. Parliamentarian training programmes On request, we provide training for parliamentarians in economic governance and financial management, including costing, budgeting monitoring and expenditure tracking.
Past Projects Building Capacity of CSOs to Participate Effectively in Budgetary processes and Expenditure Tracking for HIV/AIDS and Health in Southern Africa This project was piloted in Zambia, Zimbabwe and Mozambique, towards enhancing the participation of CSOs in government budget processes and in tracking of expenditure for health and HIV/AIDS. This project was supported by OXFAM-NOVIB (2008-2010). International Treatment Preparedness Campaign - training for partners CEGAA provided training in budget monitoring to the ITPC partners in Africa and Asia, who envisaged that through additional support of this kind, the MTT reports would incorporate financing components. Preparation of background document for World Health Organization CEGAA prepared a background document for the strategic direction of the newly established Health Systems Strengthening Unit in the HIV/AIDS Department of the World Health Organization (WHO). Capacity-building for Open Society Institute CSO partners in former Soviet Union countries CEGAA provided training and technical support to Romania, Georgia, Azerbaijan, Macedonia, Russia and Hungary in budget monitoring and expenditure tracking for their health budget projects, focusing on marginalised groups. This project was supported by the Open Society Institute. National AIDS Spending Assessment (NASA) and Resource Needs Estimation Training and Pre-Training Activities CEGAA successfully delivered a NASA and RNE training for several East and Southern African countries, in conjunction with the UNAIDS Technical Support Facility (TSF) in Johannesburg, South Africa (23-29 September 2007). Prior to the training, the participants undertook two activities in collecting data on domestic spending for HIV/AIDS and the unit costs of HIV/AIDS interventions. CEGAA undertook the technical support and oversight of these activities to 12 consultants from six countries, as well as the editing and finalisation of their reports. In addition, CEGAA provided an assessment and mapping of 21 ESA countries in terms of their resource tracking activities and needs, and prepared a concept paper to guide the interventions of UNAIDS in the region. This contribution has ensured that the NASA activities are initiated and driven by the respective participant countries, which is essential for their success. The NASAs provide very powerful evidence to inform the government's and donor's resource allocative decisions. For example, in Botswana, the data indicated that increased spending on treatment came at the expense of prevention activities, for which very little was going towards interventions for high-risk groups such as commercial sex workers (CSW) and men who have sex with men (MSM). As a consequence, Botswana's National AIDS Co-ordinating Agency (NACA) mobilised additional resources for prevention from donors, while the country's gay and lesbian network put pressure on the government to increase programs for MSMs and CSWs, which resulted in a programme targeting high-risk groups. In Zambia, the NASA found limited alignment of all the efforts with the National HIV/AIDS Strategic Plan, which enabled the NAC to engage more meaningfully with donors to ensure an integrated and comprehensive response. CSO BMET Training CEGAA conducted training for East and Southern Africa countries in HIV/AIDS and health budget monitoring and expenditure tracking (BMET). The initial training workshop was held in June 2007, in collaboration with the International Budget Partnership (IBP). This work was supported by the Ford Foundation. ASAP Training CEGAA provided technical facilitation at the ASAP training of HIV/AIDS managers and input to the curriculum development for HIV/AIDS programme managers. Aid Harmonisation and Alignment Framework for Action for the Southern African Development Community (SADC) CEGAA undertook a review of aid architecture relating to HIV/AIDS, as well as an assessment of progress towards the Paris Declaration, with regard to harmonisation and alignment of aid for HIV/AIDS, for the SADC Secretariat. The findings were well received at the SADC National AIDS Council Directors' meeting (October 2007), and contributed to the rigour of the SADC Communiqué. Subsequently, CEGAA drafted the SADC Framework for Action for Harmonisation and Alignment, which was adopted by the SADC members. Costing and Budgeting Training for National and Provincial HIV/AIDS Managers in South Africa CEGAA and the Futures Institute provided a successful training workshop for Constella Futures to the South African HIV/AIDS National and Provincial Managers to enhance their costing and budgeting skills. Technical Support to the IDASA AIDS Budget Unit for their multi-country civil society reports CEGAA provided extensive input and reviewing of the reports prepared by CSOs in Tanzania (and Zanzibar), Malawi, Ethiopia and Zambia. Modules for Masters Courses CEGAA prepared a distance learning module for MEDUNSA Master's students on the topic of Financing for HIV/AIDS in Africa. It is hoped that such models will be useful to other African academic departments in relevant disciplines. In addition, CEGAA has provided several learning experiences for students, and hopes to develop these into an internship programme for Master's degree candidates. |
