Collin Mangenah

As donor funding flat lines increased domestic funding is vital for the sustainable HIV response. In addition community mobilization and KP-led health services may ensure none are left behind. Data on opportunity costs of community approaches which are key are however scarce due to focus on provider/facility level perspectives.

To enable countries such as Swaziland, Thailand and Uganda meet Fast Track targets, UNAIDS estimates approximately US$26.2 billion is needed for HIV responses in 2020. However countries such as Thailand, recently classified as middle income are transitioning out of GFATM, negatively affecting sustainability of CSO-implemented HIV programs. Domestic financing so far low due to poor targeting of scarce resources can be increased and structured to not leave anyone behind. Reduction in donor government funding for HIV has also made the critical role of community-based interventions and community health entrepreneurship in the fight against HIV more imperative. Funding to local communities urgently needs prioritisation if we are to meet funding commitments and ensure health system investments are optimised. A good understanding of the empirical costs of community mobilization is therefore critical to ensure that scarce resources for community mobilization are used to largest possible health and social benefit.

Shrinking donor HIV funding has made it imperative for governments to increase health budget allocations. Successful transition in Thailand has relied on ensuring better cooperation between governments, CSO’s and local communities. Participatory budgeting and good transitioning plans as well as strengthening of civil society and community dialogues will be important. There is need to ensure funding to the local community level reaches those directly benefiting but who have no access to health facilities. Understanding the opportunity costs of community mobilization can help ensure scarce resources are used to largest possible health benefit.