The economic growth of developing countries, with growing numbers moving from “low” to a “middle income” category, coupled with the slow recovery of developed (donor) countries after the recent economic crisis, has changed traditional development assistance models. Many bi-lateral and multi-lateral donors have been rethinking their assistance strategies and moving towards establishing development partnerships with middle-income countries (MICs) rather than maintaining traditional donor-recipient relationships. As a result of these changes, some donors have significantly reduced their allocations and revised their priority areas for development aid. An important part of the debates focused on this process has looked at elements of donors’ withdrawal and the need for exit strategies to be agreed on between donor and recipient country. There seems to be a common understanding that when decisions are made to stop supporting programs, funding should be phased out in a planned and predictable way.
The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) adopted the Eligibility and Counterpart Financing Policy, designed to optimize funding based on economic and health indicators in 2013. Eligibility was determined by income level and disease burden in a specific country context. The rationale behind this approach was that relatively well performing economies, in particular with moderate burdens of disease, can and should assume responsibilities for funding programs addressing these diseases. With the introduction of the New Funding Model (NFM), the Global Fund’s allocations for 2014-2017 for countries in Eastern Europe and Central Asia (EECA), many of which are middle-income countries, have been reduced by 15% in comparison with 2010-2013 disbursements. The Global Fund has been gradually scaling down or fully withdrawing its support from many countries in EECA.
People who inject drugs (PWID) represent a major risk group for HIV transmission in the region. UNAIDS estimates that 57% of all new HIV infections in Eastern Europe are attributed to the sharing of injection equipment. As stated in the Global Fund Investment Guidance for Eastern Europe and Central Asia, “the Global Fund’s vision for the EECA region is to stabilize the prevalence and reduce the incidence of HIV, and to contain the spread of drug-resistant TB. The aim is to ensure that EECA will no longer be the region with the highest rate of HIV growth and the highest levels of multidrug-resistant TB in the world”. Access to key target groups (affected or high risk of infection) such as PWID, sex workers (SW), and men who have sex with men (MSM), and adequate coverage of prevention, treatment and care programs are critical to achieving these aims.
This report by the Eurasian Harm Reduction Network aims to:
- Assess the readiness of countries in the region for transition from Global Fund funding for HIV responses to national funding; and/or
- Experience of countries related to the process of transition planning and implementation.
Eleven countries with relatively diverse economic and health landscapes were selected for this analysis.
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