UNAIDS - June 21, 2001

* Two decades into the AIDS epidemic, examples of successful interventions are multiplying around the world.

A number of countries have shown that concerted, comprehensive HIV/AIDS programmes can stabilize the epidemic, and reverse its advance. But additional resources are needed to extend successful HIV/AIDS responses across the world.

* Current estimates (based in part on the successes of some countries) show that a global campaign against the epidemic needs US$7-10 billion annually for an effective response in low- and middle-income countries. This level of investment needs to be spent on HIV/AIDS prevention, care and support programmes - and that scale of effort will need to be maintained for at least a decade if the epidemic is to be reversed.

* A third to one-half of the total resources necessary to turn the epidemic around could come from domestic (private and public) sources. The balance, however, will need to come from international sources.

* AIDS-specific spending from private, national and international sources currently totals US$1.5-2 billion annually in low- and middle-income countries. Significant additional funding is therefore needed to mount an effective global campaign.

* These calculations are based on analyses of global resource needs done by UNAIDS, the Mexican National Institute of Public Health, the Futures Group International, the World Bank and the London School of Hygiene and Tropical Medicine.

* The study indicates that, as a best estimate, in 2005, US$9.2 billion will be needed to expand the global HIV/AIDS response to a point where the spread of the epidemic is reversed and its impact is eased significantly. Rapid increases in spending to that level must occur over the next five years. A best estimate of current annual spending and five-year projected annual costs of expanded HIV/AIDS prevention, care and support programmes in low- and middle-income countries (US$) Current (2001) Five-year Projection (2005) CARE & SUPPORT 1.0 billion 4.4 billion PREVENTION 0.8 billion 4.8 billion TOTAL 1.8 billion 9.2 billion

* The calculations are based on a range of critical (12 prevention and 7 care) interventions and on the real and estimated capacity of health systems to deliver services (based, for example, on their current capacity to supply tuberculosis treatment and vaccines for children).

* Slightly more than half the resources would go towards implementing effective prevention programmes, while the balance would be devoted to programmes that offer care and support to people who are living with HIV/AIDS, their families and children who have been orphaned by AIDS.

* About half the resources are required in sub-Saharan Africa and about one- quarter in South and South-East Asia.

The advanced stage of the epidemic in Africa means that the bulk (about two- thirds) of the resources needed there would be devoted to care and support. In Asia, about one-third of the resources would be targeted at care and support work

These estimates do not include the cost of improving and expanding health and education infrastructure in developing countries-an important ingredient of a successful AIDS response.

Nor do they include other socioeconomic interventions that are needed, such as programmes that enable children (especially girls) to complete their schooling, that improve the status of women and that combat poverty.
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