World Bank/UNAIDS Economics Reference Group Request For Proposals
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| Posted | 06/22/2009
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| Description |
UNAIDS/World Bank Economic Reference Group (ERG)
Call For Proposals
Summary
Research proposals are called for that will explore the impact of the Global Economic Crisis on HIV/AIDS and HIV/AIDS programs in developing countries. Proposals will be made through the members of the UNAIDS/World Bank HIV/AIDS Economic Reference Group (ERG). Preference will be given to highlyfocused, country level analyses with budgets of no more than $45,000. Work must be completed by December 31st, 2009
Background
The April 2009 meeting of the ERG in Washington DC focused on the economic crisis and its potential impact on the response to HIV/AIDS. The financial crisis that started in the most developed economies has become a global economic crisis which threatens gains in health and poverty reduction in developing countries. Advanced economies are projected to suffer deep recessions in 2009 with their GDP contracting by 5% on average the first such fall in 60 years. This is generating fears that official development assistance and in particular resources for social sector spending, including funding for HIV services and commodities, would remain flat during the next few years.
How might country vulnerabilities affect prospects for continued improvements in access, effectiveness and sustainability of HIV/AIDS programs?
· These programs are put at risk both by country specific vulnerabilities to the economic crisis (exacerbated by limited fiscal and institutional capacity to deal with downturns) and by the level of resource needs (for HIV/AIDS programs) relative to the country’s income, especially those afflicted with chronic poverty;
· Most of the high and medium incidence countries are moderately to highly vulnerable on the fiscal side and about half of these are also highly vulnerable to large exogenous effects of the crisis;
· Many of these countries are also highly dependent on external funding for HIV programs, and this is compounded by the reality that these funders are themselves vulnerable to the crisis;
· Thus the economic crisis poses a serious danger to existing programs and the objective for ‘Universal Access’ because it compromises both external and internal resource availability, effectiveness and sustainability.
What are the perceptions of the dangers and risks in going forward?
· The predominant perception is that the crisis has had, hitherto, little impact on HIV treatment, and only a minority of (WB/UNAIDS/WHO) country officers expect significant impacts on treatment in the coming months; but 50% expect a significant impact on prevention.
· The impacts are expected to occur through budgetary cuts, reductions in aid, reduced export revenue owing to falls in demand, increased import costs of essential goods due to depreciation attributed to currency instability and conditions relating to domestic economic contractions.
· The main concern is whether current financing for ART will continue when the twothirds of current contracts that expire over the next three years are replaced.
What are the likely impacts of the crisis on HIV Programs?
· Historically, health care budgets have been protected in economic downturns (by both governments and donors).
· The major multilateral funders will remain constant in their funding levels over the next year;
· Countries may be able to keep up HIV treatments over the next year because of a significant stock of undisbursed aid; there is less confidence about prevention programs.
The situation is likely to deteriorate for treatment and prevention if the crisis lasts beyond 2010. · Furthermore, there may be a lag before stability in developed countries is transferred the developing world.
· Prevention efforts appear especially under threat. In a recent survey conducted by WHO, UNAIDS and the World Bank, respondents in 34 countries representing 75% of the people with HIV expect prevention programs for people most at risk of infection to be affected. This is far more than the percentage of respondents who expect treatment programs to be affected.
· Respondents say that prevention efforts for mostatrisk groups are especially vulnerable because they are politically easier to cut. This is extremely worrisome – less prevention that results in more new infections will mean greater future treatment needs with large cost implications. The welfare and economic costs to affected families are obviously very high.
In summary, countries need to reprioritize their spending towards social goals such as health, while tapping a diverse and innovative mix of financing sources. They will also have to make existing funding work harder and donors will need to provide more secure longterm financing as well as assistance in dealing with the economic crisis. The current crisis offers an opportunity to reevaluate the approach and effectiveness of current practices in the delivery of ART and prevention.
There was agreement at the April 2009 ERG meeting that the economic crisis, responses to it and the consequences thereof should be high on the agenda for the next meeting of the Group. It was also acknowledged that there is a dearth of data on the subject, and the ERG needs to rapidly commission research to inform the provision of policy advice and decision making. It is against this backdrop that this Request For Proposals is made.
Funding has been made available for the Economics Reference Group to commission research into five main topics within the theme of the Economic Crisis. Preference will be given to highlyfocused, country level analyses involving assembly or collection of data in countries (support for travel may be requested). Proposals are sought for papers which address one of more of these topics:
1. Addressing the impact of increased quality and efficiency of existing programs, using an illustrative country example.
2. An assessment of the vulnerability of prevention programs (particularly those targeted to vulnerable groups such as drug users and men who have sex with men) and how this vulnerability affects choices that are made with regard to resource prioritization, as well as the consequences of such choices on prevention efforts.
3. An assessment of the particular vulnerability of treatment programs to interruptions in funding – potentially including degree of awareness of this amongst policy makers. The impacts of such interruptions (morbidity, mortality, loss to followup, drug resistance, loss of human resources etc.) and ways of reducing negative consequences.
4. The impact of the economic crisis on children affected by HIV.
5. The impact of the economic crisis on civil society capacity – for example through funding for community associations or associations of people living with HIV/AIDS.
ERG members are invited to submit proposals, and are also be asked to circulate this RFP to nonERG members as appropriate.
Proposals must be submitted to: Jacqui Hadingham, ERG Secretariat, on hadinghamj@ukzn.ac.za.
Proposals should be a maximum of 3 pages (excluding annexures) and should include:
i. Background
ii. Rationale
iii. Methodology
iv. Research team member(s) – and CVs as annexures
v. A simple budget not exceeding $45,000 which includes only
Consultant(s) time in days
Travel
Proposals will be scored and research allocated on the basis of a scoring system. The proposals will be circulated to all ERG members and Steering Committee with a score sheet. Successful proposals will be contracted through and funded by the World Bank.
Deliverables
1. Draft paper for comment/review in November 2009;
2. Presentation of this paper, incorporating review comments, to the ERG at the meeting in Amsterdam in December 2009;
3. Final paper, incorporating comments and suggestions received at the ERG meeting, submitted electronically to the World Bank by 31st December 2009.
Time frame
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