This paper outlines some trends in South Africa’s economic situation, its national and provincial health allocations generally, HIV and TB allocations and spending, and then take a closer look at spending trends at provincial and sub-programme levels in 2016/17. Our analyses are based on 2015/16, 2016/17, 2017/18 and 2018/19 budget and expenditure documents, 2016/17 provincial HIV CG Evaluation Reports, and CG quarterly reports.
The paper notes some achievements in the HIV and TB spending in SA. The reported improvements in service delivery and health outcomes would not have been possible without the increasing political and financial commitment of the South African government, and continued support from funding and implementing partners.
Some improvements in actual spending were made in 2016/17 after the provincial health HIV and TB finance and programme managers were provided with training and technical support by the FINCAP Project of CEGAA/ HE2RO to improve costing of the Conditional Grant (CG) business plans and management of provincial finances. More accurate costing was promoted to ensure reasonable targets in line with available resources and real expenditure. Provinces were encouraged to accelerate their recruitment process of key personnel required for the expansion of the treatment programme, and to ensure that procurement and payment for services were done in line with the business plan timeframes. The FINCAP Project, in partnership with the National Department of Health and special support from Strategic Development Consultants (SDC), has contributed vastly to these improvements.
FINCAP was a successful five-year (2013 – 2017) partnership project between CEGAA and HE2RO as part of HE2RO’s INROADS Programme, with funding from USAID. It was extended for another year in 2018 to deepen its interventions at district level.