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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Financing the response to HIV in low-income and middle-income countries
Journal of Acquired Immune Deficiency Syndromes, Volume 52, No. SUPPL. 2, Year 2009
Notification
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Description
Objectives: To describe levels of national HIV spending and examine programmatic allocations according to the type of epidemic and country income. Methods: Cross-sectional analysis of HIV expenditures from 50 low-income and middle-income countries. Sources of information included country reports of domestic spending by programmatic activity and HIV services. These HIV spending categories were cross tabulated by source of financing, stratified by type of HIVepidemic and income level of the country and reported in international dollars (I$). Results: Fifty low-income and middle-income countries spent US $ 2.6 billion (I$ 5.8 billion) on HIV in 2006; 87% of the funding among the 17 low-income countries came from international donors. Average per capita spending was I$ 2.1 and positively correlated with Gross National Income. Per capita spending was I$ 1.5 in 9 countries with low-level HIV epidemics, I$ 1.6 in 27 countries with concentrated HIV epidemics and I$ 9.5 in 14 countries with generalized HIV epidemics. On average, spending on care and treatment represented 50% of AIDS spending across all countries. The treatmentto- prevention spending ratio was 1.5:1, 3:1, and 2:1 in countries with low-level, concentrated and generalized epidemics, respectively. Spending on prevention represented 21% of total AIDS spending. However, expenditures addressing most-at-risk populations represented less than 1% in countries with generalized epidemics and 7% in those with low-level or concentrated epidemics. Conclusions: The most striking finding is the mismatch between the types of HIV epidemics and the allocation of resources. The current global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency. Mapping HIV expenditures provides crucial guidance for reallocation of resources and supports evidence-based decisions. Now more than ever, countries need to know and act on their epidemics and give priority to the most effective programmatic services. Copyright © 2009 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Izazola-Licea, José Antonio
Switzerland, Geneva
Unaids
Wiegelmann, Jan
Switzerland, Geneva
Unaids
Arán, Christian
Switzerland, Geneva
Unaids
Guthrie, Teresa
South Africa, Cape Town
Centre for Economic Governance and Aids in Africa (cegaa)
de Lay, Paul R.
Switzerland, Geneva
Unaids
Av́ila-Figueroa, Carlos
Switzerland, Geneva
Unaids
Statistics
Citations: 53
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1097/QAI.0b013e3181baeeda
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study