Country response to HIV/AIDS: National Health Accounts on HIV/AIDS in Brazil, Guatemala, Honduras, Mexico and Uruguay

Abstract

National expenditures on HIV/AIDS were estimated as summary indicators to assess the country's response to HIV/AIDS. The methodology is based on a matrix system describing the level and flow of health expenditures on HIV/AIDS: an adaptation of the National Health Accounts methods. The expenditures were classified by source (public, private, international), by the use of funds (prevention, care), by object, and by type of provider institution. The results are reported in US dollars using the official exchange rate for the year of estimation. For international comparisons monetary units were adjusted by the purchasing power parity (US dollars PPP). National HIV/AIDS total expenditures were: Guatemala US dollars PPP29.5 million, Uruguay US dollars PPP 32.5 million, Mexico US dollars PPP 257 million, and Brazil US dollars PPP 587.4 million during 1998, and Honduras US dollars PPP 33.9 million for 1999. The total HIV/AIDS expenditures per capita for 1998 were: Brazil US dollars 2.69, Mexico US dollars 1.25, Guatemala US dollars 1.08, Uruguay US dollars 6.63, and Honduras US dollars 3.6 for 1999. The 1998 distribution of the total HIV/AIDS expenditures in prevention and care were, respectively, Brazil 10 and 80%, Guatemala 15 and 70%, Mexico 29 and 66%, Uruguay 36 and 51%, and Honduras 28 and 65% for 1999. The share of total expenditures on antiretroviral drugs ranged from 52% in Guatemala to 75% in Brazil, even when the estimated coverage of antiretroviral therapy was close to 10% in Guatemala and universal in Brazil. The estimated flow from international sources per capita in 1998 was Uruguay US dollars 0.03, Brazil US dollars 0.24, Guatemala US dollars 0.11, Mexico US dollars 0.01, and Honduras US dollars 1.04 in 1999. The data allow international comparisons and provide critical information to improve equity and efficiency in the allocation of scarce resources. The National HIV/AIDS Accounts also constitute a powerful tool to describe the country's response to HIV/AIDS.

Levels of Spending and Resource Allocation to HIV Programs and Services in Latin America and the Caribbean

“…These countries have conducted systematic and standard resource tracking of AIDS spending since the mid 1990s [6].…”

Classification of Health Care Functions (ICHA-HC)

“…Country-level analyses have also focused on disease-specific sub-accounts, specifically HIV/AIDS, highlighting both overall allocations, the distribution of spending between preventive and curative care, and patterns of international financing (see e.g. Avila-Figueroa et al, 2002). The reporting of expenditure on HIV/AIDS is now a global effort and is part of the annual UNGASS report.…”

Aids: prevenção e assistência

“…Isto representava uma média de 1% do total de gastos com saúde do Brasil. Nesse ano, 56% dos gastos do governo com HIV/Aids destinaram-se à compra de medicamentos antirretrovirais (Izazola-Licea et al, 2002).…”