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Haiti

Significant funding has been allocated to HIV/AIDS prevention, care, and treatment services in Haiti. Major initiatives financing service expansion include the U.S. government’s President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria which is administered by La Fondation Sogebank in Haiti. Domestic financial contributions to HIV/AIDS programs, however, remain low.

To effectively address the sustainability of the national HIV/AIDS program and maintain services with respect to estimated financing levels, stakeholders should have analytical tools and strategic information to estimate present and future recurrent costs and resources required. These data will enable PEPFAR and the Ministère de la Santé Publique et de la Population (MSPP) to effectively weigh the implications of current policy decisions on the overall sustainability of services.

To assist in estimating program costs and resources, Health Systems 20/20 has undertaken the following two activities in Haiti:

1. Use of HIV/AIDS Program Sustainability Analysis Tool (HAPSAT) to carry out a sustainability analysis of the Haitian HIV/AIDS program. HAPSAT is a Microsoft Excel-based tool used to forecast and analyze the sustainability of HIV/AIDS programs. HAPSAT synthesizes detailed epidemiological, demographic, and economic data to generate a country-specific HIV policy model which can be used to simulate alternative policy scenarios.

Analysis of data collected in December 2009 will:

• Determine the average cost of providing anti-retroviral treatment (ART) and other services (prevention of mother-to-child-transmission, orphans and vulnerable children care, etc.)
• Determine what level of human resources is required to provide those services
• Compare the current cost and level of human resources with the funding and human resources known to be available over the next five years in order to produce a 'gap' or sustainability analysis

The HAPSAT analysis was scheduled for review and discussion with in-country stakeholders in the first week of February, but given the current humanitarian crisis in Haiti, next steps are yet to be determined. Generally, post-discussion and review of the data in country and a stakeholder scenario development workshop is held to determine what different scenarios the MSPP, USAID, and the Global Fund would like to see costed, such as scaling up the number of patients, increasing the number of OVCs receiving care, etc.

2. HIV Services Costing - USAID supports five implementing partner networks that are known to provide different packages of care to their ART patients with some being more resource intensive than others. Services at each network are to be costed so that USAID has a clear and detailed understanding of what care is being provided by its implementing partners, how much it costs to provide that care, and whether costs vary with different patient/population groups (i.e., sicker, indigent, rural versus urban, etc.) or outcomes (treatment drop-out rates.) This analysis will utilize HAPSAT costing data as well. This study was due to begin data collection at the end of January.

Media

Listen to a clip of 'Haiti Pap Kraze' by Haitian musician 'T-Vice' and view Health Systems 20/20's photos from a December 2009 trip to Haiti.

Photo Credit: Asha Sharma