THE PROBLEM

Despite the Government of Algeria’s commitment to increase domestic financing for HIV as part of its implementation of transition plans, there is still a large financial gap for the care of key and vulnerable populations (KVPs). Within the National Programme to Combat STIs/HIV/AIDS, the main activities for the benefit of KVPs been entrusted to civil society organizations that depend on donor funding.

For more effective advocacy with the Algerian authorities, the government needs to know the cost of the minimum package of services and the necessary funds to be mobilized over the next few years if the KVPs continue to be covered by CSOs but now financed by the government.

At the same time, if the government is going to assume financial responsibility for the care of KVPs, the government mustoptimize its allocations of resources for prevention and treatment. The Government of Algeria and the GF are particularly concerned with the efficiency of the purchase of antiretroviral medicines, which accounts for a significant part of total expenditure.

Hence, Pharos has been engaged by the Global Fund to define the cost of the minimum package of services for key and vulnerable populations and to estimate possible areas for savings. Programmatic data collected during the current Global Fund grant, as well as the Burnet Institute’s 2021 Optima study, which presents some program-specific estimates of key populations, can serve as an entry point for this study.

THE PHAROS SOLUTION

This project builds upon prior Pharos work building a transition strategy for the Algerian government in 2019.

Pharos has broken down this problem into two main objectives and underlying tasks:

Cost of a minimum package of services for key and vulnerable populations:

1. Identify the components and estimate the cost of the minimum package of services for key and vulnerable populations, as recommended in the official guidelines,
2. Estimate the annual amount needed to cover, for example , 20/40/60/80% of key and vulnerable populations.
3. Please describe the legal and institutional framework as well as the current mechanisms for programming, budgeting and monitoring domestic resources allocated to the financing of activities by health service CSOs.
4. Identify the conditions to be met and the steps for the establishment of a sustainable mechanism for the public support and financing of CSO activities.

Identify opportunities for savings in the purchase of key HIV health products

1. Collect data on health product supplies
2. Identify gaps in the availability of data to establish unit prices for ARVs and condoms for a year of treatment for an uncomplicated HIV case
3. Compare unit prices of ARVs and condoms with the average unit costs in the region and with international benchmarks.
4. Compare the volume of inputs (ARVs and condoms) acquired with the volume of inputs used and review procurement processes to identify if savings could be achieved.

LOOKING AHEAD

This project has four main deliverables: (1) the Technical Assistance Project Work Plan, (2) Estimated cost of the minimum service package for key populations (Objective I), (3) Report on the Procurement Efficiency of Key HIV Health Commodities (Objective II), and (4) Recommendations for future financing, based on estimating the cost of the basket of care for key and vulnerable populations and analyzing drivers of purchasing inefficiency. The first deliverable was completed in September 2022, and the rest of the deliverables will be completed throughout the remainder of 2022.

Status: Completed, September 2022 – December 2022

Team Members Involved: Robert Hecht, Miloud Kaddar, Brahim Foudi, Nathan Isaacs, and Grace Chen

For more information, contact Robert Hecht at [email protected].