The East African Community and its Partner States are committed to the related policy objectives of Universal Health Coverage and Ending AIDS in 2030. However, the funding landscape for health and HIV is set to change dramatically over the coming 10 to 15 years. The policy question this work tries to answer is: How can EAC Partner States achieve the high level policy objective of universal coverage for health and HIV services within a changing fiscal landscape?
To answer this question we first examine the EAC political, epidemiological and economic context. We then determine the cost of achieving UHC and Ending AIDS in 2030, and benchmark that against the fiscal space for health and HIV generated over the next 15 years by the current funding strategies in each of the Partner States. We conclude that this would leave Partner States short of financial resources to achieve universal coverage for health and HIV. We then explore which initiatives Partner States can take to increase fiscal space. Apart from assessing the fiscal dimensions of the health and HIV response, we look into ways to reduce the cost of achieving UHC through focussing on a more limited package of cost-effective services, and ways to deliver these services with maximal efficiency.