08-X1412: NACA - National AIDS Spending Assessment

The monitoring and evaluation of the policy responses would be greatly facilitated if policymakers were

continually well informed about the overall flow of funds for health in Botswana, both from the perspective of

who is financing such spending, and the purposes for which it is being used. The resource envelope

revealed by these flows and their current uses will enable policymakers to assess overall resource

constraints, choose among competing demands on health resources and, depending on the nature of these

flows, identify policy mechanisms best able to achieve desired health objectives.

The National AIDS Spending Assessment (NASA) resource tracking algorithm is designed to describe the

financial flows and expenditures using the same categories as the globally estimated resource needs. This

alignment is recommended in order to provide the necessary information (as advised by the Global UNAIDS

Resource Tracking Consortium) on the financial gap between resources available and resources needed,

as well as a greater harmonization of different policy tools frequently used in the field of HIV and AIDS.

By doing so, NASA provides indicators of the financial country responses to HIV/AIDS and supports the

monitoring of resource mobilization. Thus, NASA is a tool to install a continuous financial information

system within the national monitoring and evaluation framework. NASA serves several purposes within

different time-frames. In the short term, NASA aims to contribute to the production of an UNGASS indicator

for public expenditure; in the longer term, more comprehensive information provided by NASA may be used

to:

--monitor the implementation of the National Strategic Plan;

--monitor advances towards completion of nationally or internationally adopted goals such as universal

access to treatment or care;

--provide evidence of compliance with the principle of additionality required by a few external donors or

international agencies; and fulfill other information needs as these emerge always more demanding

Within the Mid-Term Review of the NSF, the National AIDS Coordinating Agency (NACA) examined the

actual resource environment by conducting a NASA for financial years 2003-2005. The NASA found that

the actual annul funding made available was 79% of the estimated need. When compared with the

intended NSF proportional allocations to the NSF goals, the funding allocations were generally comparable.

Only prevention activities were being significantly under-funded; having approximately 8% of the public

expenditure, when the NSF intended it to be 10-13%. A follow up NASA for 2006/07 is currently underway

and will further the institutionalization of the process and provide trend data for the initial ramping up of

PEPFAR funding.

Objectives

1.To develop country estimates of total flows of financing and expenditures for HIV/AIDS, from all

international and public (domestic and private) sources of financing for GOB financial year 2007/08.

2.Expand the scope and details of financial information collected to include:

a.Government

b.Development partners

c.Private

d.Out of pocket expenses

3.Improve the robustness of data collated from government and development partners

4.Provide refresher and on the job training to Government of Botswana staff in the execution of national

HIV/AIDS accounts and further institutionalize the government fiscal data capturing process.

08-X1416: NACA - PEPFAR Administration Support

The GOB has a Cooperative Agreement with HHS/CDC for five years from September 15, 2005 to

implement a significant multi-disciplinary initiative targeting HIV/AIDS. This is the most significant financial

agreement managed by HHS/CDC/BOTUSA with $14.8 million from COP05, $22.2 million from COP06,

and $17.9 million from COP07. This agreement therefore has substantial programmatic management,

monitoring and reporting requirements which must be maintained.

The National AIDS Coordinating Agency (NACA) under the Office of the President has been charged in

government to provide strategic oversight and management to all HIV/AIDS related activities in Botswana.

NACA, using Pepfar funds has a full time ‘Principal Program Planning Officer' to conduct the routine

business management of the GOB Cooperative Agreement on behalf of the government.

The purpose of this activity is to continue financial support to the post, which can, in collaboration with

HHS/CDC/BOTUSA and the ministries, provide comprehensive financial and programmatic support to the

implementing partners under the GOB CoAg. The post will supply high quality oversight and transparency

documentation to the GOB Principal Investigator, business official and HHS/CDC/BOTUSA in a routine and

timely manner.

In addition to the HR support, PEPFAR funds will be used to conduct the annual financial cooperative

agreement audit as required by 45CFR 74.26(d).