Sustaining National AIDS Programs and Planning for Donor Transition

In recent years, international donors have begun tapering foreign assistance. Donors are instead focusing on transitioning the management of development programs and disease responses to country governments—helping reduce countries’ dependence on foreign aid and preparing them to manage their own development challenges, without the need for external funding.

If this transition to self-reliance is to succeed, it will require technical assistance to countries to strengthen their capacity to implement policies, mobilize and manage public resources, and incorporate locally-led development principles, while maintaining progress already gained.

One crucial piece to these transitions is the continued role of civil society organizations; organizations that have typically been supported by external donors. In this era of diminishing foreign assistance, the essential functions civil society organizations often provide—linking individuals and communities into healthcare and extending the reach of government programs—are at risk. Unlike foreign donors, governments often face legal, regulatory, structural, human resource, financial, and political barriers to supporting and contracting with civil society organizations to provide services or implement multi-stage development projects.

Publications

Understanding the Costs of CSO-Delivered HIV Services for Key Populations in Guyana: Policy Implications for Social Contracting

Guyana’s Budget Process and Windows for Advocacy: A Guide to Inform Advocacy for HIV and Health Resources

Health Policy Plus: Social Contracting: Supporting Domestic Public Financing for Civil Society’s Role in the HIV Response

View all Featured Activity Publications

What We Do

HP+ is providing technical assistance to Global Fund recipients in Africa, Central and Eastern Europe, South America, and Southeast Asia to help them plan for the transition from external to domestic funding of their health systems—including their HIV responses—and explore “social contracting.”

We are supporting countries to develop and/or strengthen transition strategies and ensure those strategies are informed by multi-stakeholder transition readiness assessments. We are also supporting efforts to establish and implement social contracting mechanisms through which governments can finance civil society organizations to provide prevention, care, and service delivery—ensuring the sustainability of HIV and other health services. Specifically, we are helping countries to:

• Maximize impact through transition readiness assessments, action plans, strategies, and advocacy roadmaps
• Implement transition readiness assessments using the Global Fund and PEPFAR guidance and tools in collaboration with country stakeholders
• Design transition or sustainability plans/strategies/roadmaps with clear roles and responsibilities and key indicators for monitoring progress
• Strengthen the capacity of key stakeholders to effectively engage in readiness assessments and the strategic design of transition or enhanced co-financing strategies, workplans, and proposals
• Identify macro or micro components of  health systems for HIV, tuberculosis, or malaria transition planning (e.g., commodities, human resources for health, laboratory)
• Support the refinement of various Global Fund transition planning and assessment tools
• Identify country-specific governance challenges and solutions for transition
• Implement regulations for social contracting mechanisms to sustain and scale-up health service delivery in the face of donor declines
• Build sustainable, long-term HIV responses by strengthening government and civil society partnerships
• Overcome legal, regulatory, structural, human resources, financial, and political barriers to supporting and contracting with civil society organizations to provide services
• Strengthen government capacity and systems to manage the procurement and implementation of services through civil society organizations
• Identify resource needs for meeting ambitious HIV targets and epidemic control by 2030

News

Social Contracting: Hope for Expanded HIV Services in Guyana