Abstract

Where did the money go? HIV and AIDS spending in Trinidad and Tobago between 2002 and 2009

A. Fearon¹, C. Alexis-Thomas², K. Pratt³, A. Kollipara⁴, D. Aran Mantero<sup>5

1</sup>Office of the Prime Minister, Port of Spain, Trinidad and Tobago, ²Consultant, Port of Spain, Trinidad and Tobago, ³Consultant, Georgetown, Guyana, ⁴Futures Group, Pretoria, South Africa, ⁵Consultant, Montevideo, Uruguay

Issues: Tracking the expenditure and the impact on vulnerable populations for HIV enables an assessment to be made on the programmatic coverage reached and facilitates effective policy and strategic planning with reference to the Governments National HIV Strategic Plan.
Description: The assessment utilises the UNAIDS National AIDS Spending Assessment (NASA) methodology re-profiled to the configuration of the Governments National Strategic Plan for HIV & AIDS. Cumulative information reports allow the tracking of internal decisions, influences on HIV & AIDS spending and how expenditure impacts vulnerable populations.
Lessons learned: There has been an overall increase in funding over the period but the economic slowdown significantly reduced expenditure from 2008. Prevention expenditure suffered the most especially that targeted towards vulnerable populations with expenditure rising faster in the good times and dropping drastically in the bad times. Expenditure on treatment has increased year on year as a result of both the free access to ARV medication and the increasing population of people living with HIV and AIDS. Whilst the domestic economy still permits 'universal access' to medication civil society remains skeptical on the governments ability to maintain the commitment. Low expenditure on Advocacy & Human Rights and Surveillance & Research reflects the comparative priority placed on this area of the response.
Next steps: Without good data on expenditure and how this impacted vulnerable populations, strategic and policy planning remains challenging and lacks sincerity. Many monitoring & evaluation systems do not consider the impact that programme coverage has on policy implementation which in turn affects outcome and impact indicators. Greater emphasis on the identification of expenditure and the location of where and who receives the resource flows can greatly assist in the monitoring and evaluation of programmes and enables improved strategic planning. The presentation will elaborate on the lessons learned from 2002 on where the money went.