In the last decade, many countries in Latin America and the Caribbean have experienced economic growth with a simultaneous reduction in their HIV burden. Consequently, the Global Fund’s “Sustainability, Transition and Co-financing policy” requires that these countries should develop plans to achieve the sustainability of their National HIV Responses and to prepare for eventual transition towards full national financing. Starting in early 2018, Pharos has been working in three countries of the region where the Global Fund is investing in the HIV response with special focus on key populations (men having sex with men, transgender persons, sex workers, injecting drug users, migrants): the Dominican Republic, Colombia and Ecuador. The different realities in the three countries are striking but they face similar transition and sustainability challenges in three main areas: service delivery, financing and governance.
To solve these challenges and building on our core team’s experience with transition from Cambodia and prior work with Gavi and PEPFAR, our methodology in the 3 countries follows a similar approach:
The Sustainability and Resilience Strategy for the Dominican Republic
In collaboration with the National HIV Council, the Sustainability and Transition Commission in the DR, Pharos is using its global expertise to facilitate the development of the Sustainability and Resilience Strategy Report for the DR that will contain the main risks to sustainability of the HIV Program and the specific strategies and activities needed to mitigate those risks. This Sustainability Strategy will be part of the new National Strategic Plan for HIV/AIDS 2019-2023 and will include a solid roadmap to guide the country to achieve sustainability in the next five years. Many lessons will be extracted from this experience and we expect this work to be a useful tool for the country stakeholders and for other countries.
Building on our work with local stakeholders in these LAC countries, and with the appropriate leadership, political support, advocacy efforts, and investment in innovative co-financing mechanisms, LAC countries have an opportunity to strengthen their HIV programs to reach the most vulnerable groups and meet the 90-90-90 goals. The analytical and consultation tools being honed in these countries may have application more widely in other transitioning countries. It may also be possible to harvest wider lessons that could be useful to the Global Fund, other global health initiatives, and middle income countries in other regions that face similar challenges.
Status: Ongoing January – July 2018
Team members: Diana Gonzalez, Robert Hecht, Claudia Valdez