In the last decade, an increasing number of donors are withdrawing their support for healthcare. This has been especially true for middle-income countries, where the growth of domestic resources was one of the triggers for donor funding reduction. The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) has termed this process as “transition”.
In 2018 the Open Society Foundations, through the Eurasian Harm Reduction Association (EHRA), initiated the project Budget Advocacy and Monitoring in countries of South East Europe. It provided funding to three transitioning countries in the Balkan region – Bosnia and Herzegovina, Montenegro, and Serbia – through the sub-regional network organization, Drug Policy Network South East Europe (DPNSEE), to support budget advocacy for harm reduction services. The local coordinating organisations are Margina, Juventas and Prevent.
The case study looks at the implementation of this project as one of the demonstrations of the SBF mechanism, with the objectives to:
Document the pilot in 3 Balkan countries and to analyse the strengths and weaknesses of this approach and to develop suggestions for improvement; and,
Document the results, successes, and challenges of the budget advocacy projects supported through this approach.
Our project serves as a pilot for the Sustainability Bridge Funding (SBF), an idea that has been discussed among donors and civil society organizations as a way of mitigating the negative effects of transition and in providing support for key essential services for communities and key populations. As a safety net mechanism, it should respond to gaps in funding and mitigate adverse effects of donor funding withdrawal.
On October 2 – 3, the coordination meeting of the multi-country #sos_project, managed implemented by the consortium led by the Alliance for Public Health was held in Skopje, North Macedonia. The project team met with colleagues from the Balkan region to discuss budget advocacy issues, further interaction and strengthening of cooperation between EECA and the Balkans.
The priority areas of the cooperation are:
Implementation of WHO protocols with the inclusion of assisted and self-tested HIV testing.
ART price optimization.
Development of regulatory changes to improve the quality of HIV services.
Popularization of PrEP in the region of Southeast Europe.
DPNSEE President Vlatko Dekov and Board member Denis Dedajić presented our work on budget advocacy and monitoring in countries of South East Europe, supported by the European Harm Reduction Association and Open Society Foundations.
The Project Planning Meeting of the Budget Advocacy and Monitoring in countries of South East Europe project, supported by the Open Society Foundations and the Eurasian Harm Reduction Association, was held on Friday 3 August 2018 in the DPNSEE Office in Belgrade. The aim of the meeting is to gain mutual understanding and full ownership of the project and operationalize the plan of actions.
Organisation of training, national in all three participating countries Bosnia Herzegovina, Montenegro and Serbia, and regional was most discussed. Profile and recruitment of consultancy teams, preparing national programs of actions and management of the budget were at the table too.
Dates and venues for the trainings are as follows:
The regional training for all three national Consultancy teams will be held from 3 to 5 September in Sarajevo, Bosnia Herzegovina
The training in Bosnia Herzegovina will be held from 5 to 7 September in Sarajevo
The training in Serbia will be held from 24 to 28 September
The training in Montenegro will be held from 1 to 5 October in Podgorica
Preparing for the regional dialogue with donors, civil society organisations from South East Europe met in Belgrade, Serbia on 17 January 2018. The aim of the meeting is to discuss current developments regarding the work of the South East Europe Regional Coordinating Mechanism (RCM) and preparation process of the multi-country application, possible cooperation with EECA regional networks as well as opportunities for advocacy funding initiatives sustaining HIV prevention services in South East Europe. Around 30 representatives of the civil society organisations (CSOs) from all SEE countries participated.
Ana Filipovska, the RCM Coordinator and Milutin Milošević, DPNSEE Executive Director, presented recent work of the RCM and the call for multi-country application to the Global Fund to fight HIV, tuberculosis and malaria. The presentations and discussions following then helped to clarify some misunderstandings. Two regional initiatives for the project to the Global Fund were presented – Alliance and EHRA, ECOM, SWAN.
CSOs were invited to actively contribute to the work of Country Coordinating Mechanisms in expressing the country needs and designing a regional project.
The meeting was organised by HERA and Zaedno Posilni, supported by the Open Society Foundations.
The Senior Level Policy Dialogue “Addressing HIV and TB Challenges: from Donor Support to Sustainable Health Systems” was organised in Tallinn, Estonia on 12 and 13 December 2017 as an official event in the programme of the Estonian Presidency of the Council of the European Union.
The event, organised by the Ministry of Social Affairs and National Institute for Health Development from Estonia, WHO European Region, UNAIDS, and the Global Fund, brought together representatives of the health and financial ministries of Europe, the Balkan and Eastern Partnership countries, representatives of the European Commission, international organisations, as well as community representatives and institutions involved in funding programmes and offering services to tackle HIV and TB.
In Eastern Europe the fight against HIV and tuberculosis has largely been funded through international organisations (such as the Global Fund to Fight AIDS, Tuberculosis and Malaria). However, this kind of funding is not sustainable in the long term.
The participants searched for ways to smoothly transition from funding through foreign aid programmes to sustainable state funding. They outlined the best practices, challenges, opportunities and risks related to integrating HIV and TB programmes into a national health system. The discussions included the role and responsibility of various institutions and organisations in stopping the HIV and TB epidemics.
DPNSEE and 4 participating member organisations representatives (Cazas, Juventas, Margina and Viktorija) actively contributed to the meeting, including two panellists who gave a specific insight in the situation of the region. Both the experiences from South East Europe and challenges we face were presented, emphasized and mentioned by many participants. The meeting was also a good opportunity to establish contacts and generate ideas for future cooperation.
Participation of the SEE representatives was made possible by generous support from the Open Society Foundation.