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Consolidated Spending on HIV and TB in South Africa (2014/15–2016/17)

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Consolidated Spending on HIV and TB in South Africa (2014/15–2016/17) CONSOLIDATED SPENDING ON HIV AND TB IN SOUTH AFRICA (2014/15–2016/17) Health Economics and Epidemiology Research Office HE2RO Wits Health Consortium University of the Witwatersrand August 2018 This publication was produced for review by the Government of South Africa, the United States Agency for International Development, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. It was prepared by Teresa Guthrie, Kavya Ghai and Michael Chaitkin of the Health Finance and Governance Project; Nthabiseng Khoza, Nomkhosi Mbukiso Zulu, and Vincent Madisha of the National Department of Health; Nhlanhla Ndlovu, Silindile Shezi, Joshua Karume, Portia Motsoeneng and Siphethelo Simelane of the Centre for Economic Governance and Accountability in Africa; and Gesine Meyer-Rath, Sithabiso Masuku and Lise Jamieson of the Health Economics and Epidemiology Research Office at the University of the Witwatersrand The Health Finance and Governance Project USAID’s Health Finance and Governance (HFG) project helps to improve health in developing countries by expanding people’s access to health care. Led by Abt Associates, the project team works with partner countries to increase their domestic resources for health, manage those precious resources more effectively, and make wise purchasing decisions. The six-year, $209 million global project is intended to increase the use of both primary and priority health services, including HIV/AIDS, tuberculosis, malaria, and reproductive health services. Designed to fundamentally strengthen health systems, HFG supports countries as they navigate the economic transitions needed to achieve universal health care. August 2018 Cooperative Agreement No: AID-OAA-A-12-00080 Submitted to: Scott Stewart, AOR Office of Health Systems Bureau for Global Health Recommended Citation: Guthrie T, Chaitkin M, Khoza N, Zulu N, Madisha V, Ndlovu N, Shezi S, Karume J, Motsoeneng P, Simelane S, Meyer-Rath G, Masuku S, Jamieson L, and Ghai K. 2018. Consolidated Spending on HIV and TB in South Africa (2014/15–2016/17). Pretoria: National Department of Health; Washington, DC: Health Finance & Governance Project, Results for Development Institute. Abt Associates Inc. | 6130 Executive Boulevard | Rockville, Maryland 20853 T: 301.347.5000 | F: 301.652.3916 | www.abtassociates.com Avenir Health | Broad Branch Associates | Development Alternatives Inc. (DAI) | | Johns Hopkins Bloomberg School of Public Health (JHSPH) | Results for Development Institute (R4D) | RTI International | Training Resources Group, Inc. (TRG) CONSOLIDATED SPENDING ON HIV AND TB IN SOUTH AFRICA (2014/15–2016/17) DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development (USAID) or the United States Government. The views described herein are the views of this institution, and do not represent the views or opinions of the Global Fund to Fight AIDS, Tuberculosis and Malaria, nor is there any approval or authorization of this material, express or implied, by the Global Fund to Fight AIDS, Tuberculosis and Malaria. CONTENTS Contents .................................................................................................................. i Acronyms ............................................................................................................... v Acknowledgments ............................................................................................... vii Executive Summary ............................................................................................. ix 1. Introduction ............................................................................................. 1 1.1 Background ........................................................................................................................ 1 1.2 Purpose of this Report .................................................................................................... 1 1.3 Capacity Building and Automation ................................................................................ 2 2. Methodology ............................................................................................ 3 2.1 Scope ................................................................................................................................... 3 2.2 Sources of data and assumptions applied .................................................................... 3 2.3 Exclusions ........................................................................................................................... 5 2.4 Classification of the ‘TB/HIV’ spending according to disease area ........................ 6 2.5 Financial years .................................................................................................................... 6 2.6 Exchange rates ................................................................................................................... 6 2.7 Crosswalking approach and categories........................................................................ 7 3. Findings .................................................................................................... 9 3.1 Overall spending on HIV, TB and TB/HIV over the three years .......................... 9 3.2 Total HIV and TB spending over the three years by source/department ........ 10 3.3 Expenditure on HIV in South Africa .......................................................................... 11 3.4 Expenditure on TB in South Africa ............................................................................ 51 3.5 Comparison of HIV and TB spending with the National Strategic Plan (NSP) cost estimates ................................................................................................................. 60 4. Summary and Conclusions ................................................................... 63 4.1 Key findings ..................................................................................................................... 64 4.2 Conclusions ..................................................................................................................... 66 4.3 Looking ahead ................................................................................................................. 67 5 References ............................................................................................. 69 Annexes ................................................................................................................ 71 Annex 1: Total spending on HIV and TB by SAG, USG and Global Fund by focus and year (2014/15–2016/17, R) .................................................................................. 71 Annex 2: Total HIV and TB spending by source (2014/15–2016/17, R) .................... 71 Annex 3: Funder share of total HIV and TB spending (2014/15–2016/17, %) .......... 72 Annex 4: Total HIV spending by source (2014/15-2016/17, R) ................................... 72 Annex 5: Funders relative contribution to HIV intervention categories (2016/17, %) .................................................................................................................... 72 Annex 6: HIV expenditure by funder and activity (2016/17, R) ................................... 73 Annex 7: DOH spending by budget mechanism (2016/17, R) ...................................... 74 Annex 8: Combined PDOH HIV spending by sub-programme (2014/15–2016/17, R) ................................................................................................... 75 Annex 9: PDOH HIV sub-programme spending, CG and voted funds (2016/17, R) .................................................................................................................... 76 Annex 10: DOH HIV spending and number of PLHIV by province (2016/17, R) .... 77 Annex 11: HIV expenditure by district and funder, with PLHIV population (2016/17, R) .................................................................................................................... 77 i Annex 12: NDOH HIV sub-programme spending (2016/17, R) .................................. 79 Annex 13: NDOH HIV cost category spending (2016/17, R) ...................................... 79 Annex 14: Combined DOH, Global Fund and PEPFAR spending on ART and number of patients remaining in care (2014/15–2016/17, R) .............................. 80 Annex 15: DOH total ART spendingwith number of patients remaining in care,PLHIV, and DOH spending per person on ART and per PLHIV (2016/17, R) .................................................................................................................... 80 Annex 16: PDOH ART spending by cost category and province (2016/17, R)........ 81 Annex 17: ART spending by funder and district, with PLHIV population (2016/17, R) .................................................................................................................... 82 Annex 18: DOH and PEPFAR spending on Condom programme (2014/15–2016/17, R) ................................................................................................... 83 Annex 19: DOH spending on Condom programme and spending per condom distributed (male and female) (2016/17, R) ............................................................ 84 Annex 20: DOH spending on male condoms and spending per male condom distributed (2016/17, R) ............................................................................................... 84 Annex 21: DOH spending on female condoms and spending
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