Determinants of government HIV/AIDS financing: a 10-year trend analysis from 125 low- and middle-income countries

Abstract

BackgroundTrends and predictors of domestic spending from public sources provide national authorities and international donors with a better understanding of the HIV financing architecture, the fulfillment of governments’ commitments and potential for long-term sustainability.MethodsWe analyzed government financing of HIV using evidence from country reports on domestic spending. Panel data from 2000 to 2010 included information from 647 country-years amongst 125 countries. A random-effects model was used to analyze ten year trends and identify independent predictors of public HIV spending.ResultsLow- and middle-income countries spent US$ 2.1 billion from government sources in 2000, growing to US$ 6.6 billion in 2010, a three-fold increase. Per capita spending in 2010 ranged from 5 cents in low-level HIV epidemics in the Middle East to US$ 32 in upper-middle income countries with generalized HIV epidemics in Southern Africa. The average domestic public spending per capita was US$ 2.55. The analysis found that GDP per capita and HIV prevalence are positively associated with increasing levels of HIV-spending from public sources; a 10 percent increase in HIV prevalence is associated with a 2.5 percent increase in domestic funding for HIV. Additionally, a 10 percent increase in GDP per capita is associated with an 11.49 percent increase in public spending for HIV and these associations were highly significant.ConclusionDomestic resources in low- and middle-income countries showed a threefold increase between 2000 and 2010 and currently support 50 percent of the global response with 41 percent coming from sub-Saharan Africa. Domestic spending in LMICs was associated with increased economic growth and an increased burden of HIV. Sustained increases in funding for HIV from public sources were observed in all regions and emphasize the increasing importance of government financing.

Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward

“…1,4,25-27 In 2010 for example, per capita domestic governmental spending on HIV ranged between less than five cents in the poorest to just over $1 in the richest countries in the region. 1,28 This placed the MENA at the bottom of the world regions in public fund spending on HIV. 1,28 As a result, most of the quality research conducted so far has mainly been funded by international funders such as the Global Fund to Fight AIDS, tuberculosis (TB), and Malaria (GFATM) which represents over 70% of the support for HIV/AIDS in the MENA.…”

“…1,28 This placed the MENA at the bottom of the world regions in public fund spending on HIV. 1,28 As a result, most of the quality research conducted so far has mainly been funded by international funders such as the Global Fund to Fight AIDS, tuberculosis (TB), and Malaria (GFATM) which represents over 70% of the support for HIV/AIDS in the MENA. 1,29 The US National Institutes of Health (NIH), Bethesda, MD, USA is another international funder that has recognized the need to scale up HIV research in the MENA and supported novel HIV research in Egypt, Lebanon, Morocco, and Tunisia.…”

Alternative financing mechanisms for ART programs in health facilities in Uganda: a mixed-methods approach

“…In the past decade, the dramatic expansion in antiretroviral therapy (ART) coverage in Sub-Saharan Africa (SSA) depended substantially on Global Health Initiatives (GHIs) notably The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) established in 2002 and The President’s Emergency Fund for AIDS Relief (PEPFAR) commissioned in 2003 [1, 2]. …”

Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa

“…From a social perspective, the cultural context that prohibits HIV related high-risk behaviors encourages ubiquitous stigma that affects access to available services in the MENA countries [4][5][6][7] . Availability and allocation of resources, on the other hand, has been threatened by ongoing conflicts and high rates of migration [8][9][10][11][12] . From a public health perspective, in many countries of the MENA lack of integrated data on HIV incidence rates and disease progression among known patients requires to be increased [8] .…”