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Cost Sharing for the Sustainability of the HIV Response in the Dominican Republic

The Dominican Social Insurance System (DSIS) does not cover the costs of ARVs to patients living with HIV who are insured by a subsidized or pre-paid insurance plan. The National HIV and AIDS Council and the Superintendence of Health and Labor Risks were instructed to change this but they faced a challenge: ARVs are procured internationally within a joint mechanism in one annual order to reduce costs, and DSIS’s decentralized design does not cover drugs or supplies purchased centrally from foreign suppliers.

To tackle this issue, SHOPS Plus supported the finalization and adoption of a new operational model that would be financed by DSS and maintain the scale of the MOH's existing procurement mechanism. Additionally, the Health Finance and Governance project provided technical assistance to establish a national technical group to develop an operational model that identified the legal and institutional reforms required for allowing ARVs to be financed by DSIS while maintaining the international pooled procurement at the central level.

This poster was shared virtually at the 23rd International AIDS Conference.