Amsterdam 2015
Amsterdam 2015
Abstract book - Abstract - 2343
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Abstract #2343  -  Costing the epidemic
Session:
  9.3: Costing the epidemic (Symposium) on Wednesday @ 11.30-13.00 in 202 Chaired by Anne Cockroft,
Alexander Pastoors

Authors:
  Presenting Author:   Mr Gavin Surgey - HEARD, South Africa
 
  Additional Authors:   
Aim:
To consider the spending adequacy of ARVs so as to inform future planning with respect to meeting the newly implemented guidelines of CD4<500 and future implications of 90 90 90 targets. The aim includes illustrating: 1) how much funds should be set aside for the provision of ARVs at 500CD4 (in 2015/16) and how much should have been set aside in 2014/15 at 350CD4 2) What amounts were allocated provincially for ARVs from the public purse 3) What donors contribute to ARV financing 4) Is the allocated funding sufficient to meet the current targets.
 
Method / Issue:
Globally 13 million people are on treatment with approximately 2.5 million of those in South Africa. South Africa spent in excess of 1.2 billion USD (2013/14) in the response to the HIV/AIDS epidemic, the greatest proportion of which went towards Anti-Retroviral Treatment (ART). The single largest cost component is that of the Anti-Retroviral Drugs (ARV). In order to conduct this analysis a triangulation of data sources is undertaken. Expenditure analysis is conducted on the South African Basic Accounting System (BAS) which records all expenditure transactions taking place nationally, conditional grants – which is the primary mechanism for allocating public funds to ARVs, and an expenditure analysis is conducted on reports related to donor funds.
 
Results / Comments:
Results are still preliminary as the financial year had not been completed at the time of writing. Previous financial periods indicate that total expenditure on drugs in 2013/14 was USD329 million, of which donor funds only account for 6% of expenditure.
 
Discussion:
South Africa has the largest treatment programme in the world. Expenditure on ARVs in South Africa is substantial given the high number of people on treatment. This puts a substantial strain on the resource requirements to meet these targets. A detailed understanding of how the budgeting takes place is needed and what these estimates of need are, as this informs public budgets, and donor funding priorities. This is essential as the transition is made to reach the 90 90 90 targets.
 
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