Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Integrated Regional Information Networks - November 12, 2009
A recent analysis of national spending on HIV/AIDS found a correlation between prevalence and the amount countries spent on the disease, but a mismatch between how the money was spent and the areas of greatest need.
Researchers from the AIDS Financing and Economics Division at UNAIDS and the Centre for Economic Governance and AIDS in Africa (CEGAA) used a tool developed by UNAIDS to track and report how much domestic and international funding was spent in eight different areas of HIV programming by 50 countries in 2006.
Their findings are published in a December supplement of the AIDS journal, which focuses on progress in achieving global HIV targets.
The data lends weight to recent calls by AIDS experts to concentrate dwindling resources for HIV/AIDS on well-managed interventions that have a strong evidence base.
Several countries with the highest HIV prevalence were found to be most dependent on external funding sources - and therefore the most vulnerable to potential cuts by donors in the economic downturn.
In the 17 low-income countries included in the analysis, 87 percent of HIV funding came from international donors, with bilateral assistance financing 53 percent of antiretroviral treatment.
Middle-income countries that rely mainly on domestic budgets to fund their HIV programmes, such as Botswana and Brazil, may also be forced to do more with less as their national revenues take a hit in the global financial crisis.
Botswana, with the second highest HIV prevalence in the world, had by the far the highest per capita spending on HIV in 2006 (US$70.40), followed by Swaziland ($17.30), while the remaining sub-Saharan African countries spent an average of $5.90 per capita.
Treatment and care absorbed large shares of overall HIV funding in many countries, leaving prevention initiatives underfunded; stigma and a lack of accurate HIV surveillance data on minority groups meant they were most often overlooked.
Countries with generalized epidemics (more than one percent of the population is HIV-positive) spent twice as much on treatment as on prevention, with about 30 percent of overall HIV expenditure going on prevention efforts.
Countries with concentrated epidemics (HIV infection is mainly confined to certain groups, such as injecting drug-users or sex workers) often spent most of their prevention budgets on broad programmes that missed the most at-risk populations.
In Latin American countries, for example, where an estimated 60 percent of people living with HIV are men who have sex with men, only 0.5 percent of funds for prevention were targeted at this group.
The researchers concluded that most governments were not basing the allocation of HIV resources on a thorough understanding of their country's epidemic, nor were they opting for the most effective, evidence-based approaches.
"The global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency," they commented. "More than ever, countries need to know their epidemic, and both resource allocations and their HIV programmes need to reflect those data and analyses."
091112
IR091122
Copyright © 2009 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.
Always watch for outdated information. This article first appeared in 2009. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980 – 2009. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .