A Win for the Private Sector: Harmonizing Standards in the East African Community Partner States

Abstract Background Although there is broad consensus around the need to accelerate progress towards universal health coverage (UHC) in Sub-Saharan Africa, the financing strategies for achieving it are still unclear. We sought to leverage the lessons learned in financing HIV programs over the past two decades to inform efforts to advance the universal health coverage agenda in the East African Community. Methods We conducted a literature review of studies reporting financing mechanisms for HIV programs between 2004 and 2014. This review is further underpinned by evidence from a mixed-methods study entailing a survey of 195 health facilities across Uganda supplemented with 18 semi-structured interviews with HIV service managers. Results Our data shows that there are six broad HIV financing strategies with potential for application to the universal health coverage agenda in the East African Community (EAC); i) Bi-lateral and multi-lateral funding vehicles: The establishment of HIV-specific global financing vehicles such as PEPFAR and The Global Fund heralded an era of unprecedented levels of international funding of up to $ 500 billion over the past two decades ii) Eliciting private sector contribution to HIV funding: The private sector’s financial contribution to HIV services was leveraged through innovative engagement and collaborative interventions iii) Private sector-led alternative HIV financing mechanisms: The introduction of ‘VIP’ HIV clinics, special ‘HIV insurance’ schemes and the rise of private philanthropic aid were important alternatives to the traditional sources of funding iv) Commodity social marketing: Commodity social marketing campaigns led to an increase in condom use among low-income earners v) The use of vouchers: Issuing of HIV-test vouchers to the poor was an important demand-side financing approach vi) Earmark HIV taxes: Several countries in Africa have introduced ‘special HIV’ taxes to boost domestic HIV funding. Conclusions The lessons learned from financing HIV programs suggest that a hybrid of funding strategies are advisable in the quest to achieve UHC in EAC partner states. The contribution of the private sector is indispensable and can be enhanced through targeted interventions towards UHC goals.

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Regional Opportunities in East Africa

Industries without Smokestacks ◽

10.1093/oso/9780198821885.003.0018 ◽

2018 ◽

pp. 364-386

Author(s):

Stephen Karingi ◽

Ottavia Pesce ◽

Lily Sommer

Keyword(s):

Regional Integration ◽

Customs Union ◽

Community Partner ◽

East African ◽

Common External Tariff ◽

East African Community ◽

Supportive Environment ◽

African Community ◽

Policy Measures ◽

Trade Competitiveness

Significant progress has been made by the East African Community partner states in implementing the East African Community customs union. Trade within the East African Community is now free from import duties, and partner states have adopted a three-band common external tariff. This chapter assesses how the customs union has supported intra-regional trade, competitiveness, and industrialization, in particular through the development of smokestack-free industries. It concludes that regional integration has provided a supportive environment for the development of competitive smokestack-free industries and exports, but significant opportunities still exist within the region. Recommendations are provided on what policy measures should be taken to harness these opportunities.

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