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Costing and National Strategic Planning: Generating Resources for Health

2010–2011 || U.S. Agency for International Development


Costing estimates for national health strategies are an important component in countries' long-term budgeting and financial planning activities. In settings such as Angola where the government's limited financial resources are in demand, costing strategic plans can provide the justification for supplementing national budgets for critical programs such as those for public health and HIV/AIDS prevention. Assistance provided by Deloitte Consulting LLP under USAID's Health Systems 20/20 project supported the Government of the Republic of Angola (GRA) in their efforts to complete costing estimates for their 2011-2014 National Strategic Plan (NSP) for sexually transmitted infections (STIs) and HIV/AIDS. It further contributed to the Government's successful Round 10 proposal to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The Challenge

In 2010, the approaching expiry of the GRA's NSP for STIs and HIV/AIDS as well as its Round 4 Global Fund grant presented a considerable challenge to the fight against AIDS in the country. The anticipated termination of external funding would disrupt critical national HIV/AIDS prevention programming including Prevention of Mother to Child Transmission (PMTCT) packages and integrated reproductive and maternal child health activities. Confronting this challenge required careful costing estimates to support both the development of the 2011-2014 NSP and a Round 10 Global Fund proposal to extend HIV/AIDS programming. Without an estimate of total cost to continue these programs, the GRA lacked the financial projections to justify the need for increased external resources that would fill funding gaps.

How We Helped

In collaboration with the Instituto Nacional de Luta Contra SIDA (INLS), Deloitte and the Health Systems 20/20 project provided assistance to the GRA to carry out costing activities aimed at shedding light on the total resource requirements involved in continuing HIV/AIDS prevention, care, and treatment programs implemented by the GRA. The activity produced measurable, correlated estimates for the unit cost requirements associated with the delivery of specific program activities in the NSP for STIs and HIV/AIDS. Review and feedback processes incorporating local stakeholders and working groups helped to strengthen the assumptions behind the costs.


The sustainability of health programs depends on identification of resource requirements and subsequent funding. Accordingly, increasing the transparency of costing efforts strengthens governments' ability to advocate for needed resources. The Health Systems 20/20 costing effort for Angola enabled the GRA to submit a successful application and receive Global Fund approval for US$69 million in funding to increase the availability, uptake, and quality of much-needed PMTCT services for HIV-positive expectant mothers and their children. The activity underscores the significant link between costed strategic plans and mobilizing resources to finance heath service delivery.

Deloitte's work in Angola under Health Systems 20/20 is carried out under a subcontract with Abt Associates Inc., prime contractor for the Health Systems 20/20 cooperative agreement. Health Systems 20/20 is funded through the generous support of the American people through the U.S. Agency for International Development (USAID). The project helps USAID-supported countries address health system barriers to the use of life-saving priority health services. In the process, the project works to strengthen health systems through integrated approaches to improving financing, governance, and operations, and building sustainable capacity of local institutions.

As used in this document, “Deloitte” means Deloitte Consulting LLP, which provides strategy, operations, technology, and human capital consulting services, Deloitte Financial Advisory Services LLP, which provides financial advisory services, and Deloitte & Touche LLP which provides governance and risk oversight and reporting advisory services. These entities are separate subsidiaries of Deloitte LLP. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

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