The 7th meeting of the Budget and Expenditure Monitoring Forum was held on 21 and 22 November 2011 in Johannesburg. The purpose of the meeting was to develop a clear picture of where South Africa is at in terms of its financing, budgeting and expenditure for the response to HIV/AIDS. The key points of discussion and findings of the meeting were:
- The findings of the National AIDS Spending Assessment (NASA), which amongst other things showed that South Africa spent more than R13 billion on the response to HIV/AIDS and TB in 2009/10. The meeting heard that while expenditure was on the increase this was inequitably spread between provinces with those provinces with the highest incidence rates often spending the least per person living with HIV.
- Provincial departments of health have consistently underspent on allocations for HIV/AIDS programmes over the last three years. Poor financial management, which results in unauthorized and irregular expenditure are then compounding this poor spending performance.
- Even though the costing of the NSP 2012-2016 has been the most complete to-date, full funding of the response to HIV/AIDS, TB and STIs will require detailed costings of provincial strategic and/or operational plans. These costings must then be integrated into provincial budget processes in order to ensure that allocations are based on achieving the targets outlined in the plans and are not made on an incremental basis.
- Funding for all social sector services, including health, are going to be severely constrained over the next three years due to the impact of the global economic crisis. Provision is being made, however, to ensure that sufficient resources are being made available for the response to HIV/AIDS. However, with the Global Fund cancelling round 11 this will not be the case for the rest of the region and many countries face the possibility of having their programmes collapse
- Overcoming the funding crisis will require a shift in the way in which we invest in health generally and HIV/AIDS more specifically. One possible mechanism would be to implement the New Investment Framework put forward by UNAIDS. Another would be the implementation of a Financial Transaction Tax (FTT) which could raise between 200 and 300 billion US$ for global development efforts.