A health system is the sum total of all the organizations, institutions and resources whose primary purpose is to improve health. As such, a health system needs staff, funds, information, supplies, transport, communications and overall guidance and direction. It therefore needs to provide services that are responsive and financially fair, while treating people decently .
Health systems financing refers to the generation (or collection), pooling, management and spending of funds (purchasing/providing of services) for health systems. The purpose of health financing is to ensure that adequate funding is available and the right financial incentives are in place to guarantee that all individuals have access to needed preventive and personal health care.
“All countries need to be able to track how much is spent on health, who is spending the funds, on what funds are spent and who benefits. They also need to be able to identify which interventions contribute most to improving health and reducing inequalities in access to the available resources, to estimate how much it will cost to scale up coverage of health services and to monitor the impact of the system on financial catastrophe and impoverishment. A health financing information system is therefore a critical part of the overall health information system” .
In the context of HIV/AIDS, given its impact upon all levels of society, which is often catastrophic at household level, and the enormous resources required for a comprehensive response, the above statement applies critically. There have been rapidly increasing allocations of funds to HIV/AIDS at international and national levels, with mobilisation of efforts to respond effectively and efficiently to the demands, particularly in scaling up the delivery of treatment, however an important funding gap remains. Now the challenges of slow funding mechanisms, bottlenecks, strict conditionalities and reporting requirements, poor financial and information systems and management skills, and generally limited absorptive capacity, are becoming more apparent. Hence it is the strengthening of the health systems generally, and the financial aspects particularly, that has become a critical prerequisite for the successful expenditure and impact on HIV/AIDS.
This background paper seeks to provide some overview of the key issues with regard to the financial aspects of the response to HIV/AIDS, including the consideration of the urgent need for adequate, sustainable and equitable sources of finances for HIV/AIDS. The paper shall identify key literature, actors and activities in the field of financing for health generally and HIV/AIDS more specifically.
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