Resource Requirements for ScaledUp Response Montenegro

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Resource Requirements for Scaled-Up Response-
Montenegro -

• Rajko Strahinja
• 3rd Regional GFATM Conference,
• 15-17 December 2008,
• Prno, Montenegro

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Montenegro - context

• Low prevalence setting (lt 0.1)
• 86 registered /388 estimated (1989 index case)
• Sexual mode of transmission predominant
• 50 hetero
• 25 homo (bi-)
• 4-6 IDUs, 2 blood, 2 MTCT
• RDS (2008) 56 IDUs HCV
• 2007 9 new cases (8 males, 6 MSM)
• High middle income country - ?

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R5 vs. R9 Proposal

• 2,4Mil EUR
• Strategy for HIV/AIDS
• No data (assumptions)
• Financial gap analysis
• Capacity gap superficial
• CD comp. as part of Project activities
• 2nd gen surveillance to be established
• New interventions to be introduced
• To develop protocols (Tx,VCT,STIs, Univ. prec.)

• 5-6 Mil EUR
• Strategy for HIV/AIDS/TB
• Baseline data (exception MSM)
• Financial gap analysis
• Cap. Ass. (IPH, SHLD,NGO) CD PlanBudget
  (integrated into the Proposal)
• MTR of Strategy for HIV/AIDS
• BCC Strategy Action Plan
• HSS (Clinic for inf. Dis.)
• Community strengthening

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Strategic frame

• National Health Strategy until 2020
• HIV/AIDS Strategy
• TB Strategy
• Reform of the (P)HC System
• Reform of Primary education system
• National strategic response to drugs
• Law on evidences in health
• Law on antidiscrimination

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R9

• Vulnerability reduction
• Policy change supportive environment
• Prevention (MSM, SWs, IDU, PLHIV)

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R 9

• National response vs. project approach
• Community strengthening integration into
  comprehensive public health system
• To scale-up (already existing) activities and
  maximize service delivery points
• HSS
• Costing-financial gap analysis (CCM, HIF,
  Clinical Center, Government)

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R9

• Capacity assessment of potential future PRs
• IPH
• SHLD
• NGO
• Role of UNDP in Capacity development of the
  national institutions!

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What would we like to accomplish?

• To keep low prevalence of HIV and establish
  sustainable control system for TB
• To introduce/incorporate positive models into the
  system ( program/project management and public
  health interventions as an example for other
  priority areas)
• To contribute to the development of the Public
  Health System as national response instead of
  medical model

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What would we like to accomplish?

• To strengthen surveillance system on HIV/AIDS,
  STIs and TB
• Evidence-based planning
• Tailoring interventions according to actual
  situation
• Results-based management
• To upgrade ME system
• (Project ME ? ME of the National Response)

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What would we like to accomplish?

• Regional cooperation
• Using CD resource centers
• Sharing resources and best practices
• Sub-Regional projects (UNDP initiative)
• 2007 CRO, MNT, BH 2nd Generation Surveillance
• 2008/9 CRO,MNT,BH,SER HIV and role of national
  Parliaments

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• THANK YOU ?
• Any questions?