Managing Risk and Overcoming Health Systems Bottlenecks in Haiti Emerging Lessons

Managing Risk and Overcoming Health

Systems Bottlenecks in Haiti Emerging Lessons

Jessica Faieta - Senior Country-Director, UNDP/Haiti&

Dr Joelle Deas – National HIV Program, Ministry of Health/Haiti

UNDP and The Global Fund

• To date UNDP is the Principal Recipient (PR) of 64 Global Fund Grants in 29 countries (1.4 billion, 13% of GF resources)

• UNDP, mandated with Capacity Development has the role of a Transient PR .

• To date UNDP handed-over 14 grants to National Entities. (Transition/handover underway in 8 countries)

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Global Fund in Haiti

• UNDP is the Principal Recipient (PR) for the Global Fund HIV Grant (US$ 52 million) and TB Grant (US$ 10 million)

• PSI is PR for Malaria Round 8 Grant (US$ 31 million) • Due to the 2009 OIG audit and 2010 earthquake, Haiti was

placed under Additional Safeguards Policy (ASP)• UNDP became PR of the HIV & TB grants amidst the 2010

post-earthquake context :January 12th 2010 Earthquake Cholera OutbreakDifficult Hurricane SeasonPolitical Instability

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PEPFAR in Haiti

• Launched in Haiti in 2004 with the relatively modest budget of $28 million

• PEPFAR Haiti’s budget has grown exponentially every two years to reach $56 million in 2006, $100 million in 2008, and $144 million in 2010

• PEPFAR Haiti’s main activities include Prevention, Care and Support, Treatment, and Health Systems Strengthening

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Haiti HIV Implementation Context

• In Haiti UNDP is managing the implementation of the HIV Grant through 14 Sub-recipients.

• US Government agencies are implementing PEPFAR activities in Haiti through about 31 partners.

Both implement their activities through the Ministry of Health and other partners – government, NGOs, private entities, and universities at the central and local levels.

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Why This Collaboration?

• The Global Fund and PEPFAR/US Government are the 2 largest donors for HIV and TB in Haiti

As of today: the Global Fund has committed a total of US$ 189

million for HIV and US$ 38 million for TB for Haiti

PEPFAR invested approximately US$729 million in support of Haiti’s national HIV/AIDS response, between 2004 and 2011

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Main Services Targeted under this Collaboration for the HIV Component

• Antiretroviral Therapy (ART), Voluntary Counseling and Testing (VCT) and Prevention of Mother to Child Transmission (PMTCT)

• Services for Orphans and Vulnerable Children (OVCs)• Services for Most at Risk Populations (MARPs)• Health Systems Strengthening-Related Services • Reporting, Monitoring and Evaluation

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Main Steps Taken So Far / Achievements

• A mapping exercise on the co-funded Organizations /Services by the 2 donors

• Applying the Cost-Sharing Principles for co-funded organizations/specific services

• Conducted the first joint On-Sight Data Verification (OSDV) exercise for HIV services

• Leading partners in the National Exercise for Quantification of HIV drugs

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Main Steps Taken So Far / Achievements

• CCM reform: Vital for the GF program oversight through “Grant Management Solutions” (GMS) funded by USAID

• Appointment of a GF/PEPFAR Liaison Officer (Focal Point) who is also a member of both the CCM Oversight and Project Development committees (writing new proposals to the GF)

• Harmonize the Supply Chain for HIV health products through one entity “Supply Management Systems” (SCMS)

• Reflections with the Ministry of Health on the unique consolidated supply chain and on the health information system

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Why This Collaboration?

• For Better Planning: who does what, where, with whom

• Avoiding Duplications

• More Efficient Utilization of Resources

• Reaching wider coverage: services and geographically

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How did this Collaboration Benefit the Response to HIV and TB in Haiti?

• Better coordinated efforts to support the National AIDS Program and the National TB program (no duplications)

• Better planning/clearer vision, particularly the procurement planning and availing of HIV-related health products for the Haitian people

• Sharing of implementation best-practices

• Better reporting through one integrated reporting system for HIV (On-going)

• Better Coverage (both geographical and provision of services)

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The Way Ahead

• To continue the planning process, finalizing the planning data-base

• To conduct the planned “Portfolio Review” - October 2012 • To outline a more structured collaboration strategy in light

of the planned “Portfolio Review”• To continue the joint OSDVs (HIV done in March and TB

planned for September 2012) • To continue working towards the envisioned unified

procurement system for the country• To continue working towards a unified health information

system

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Conclusion

The Collaboration between the Global Fund and PEPFAR/US Government in Haiti led to:

Improved efficiency in the fight against HIV and Tuberculosis in Haiti

Improved performance of both programs

This Partnership results in : Improvement in the outcomes in the fight against the 2 diseases in Haiti and benefiting the 2 programs.

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Thank You

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