Economics of AIDS

Sources of AIDS funding and AIDS spending of countries in the region from the 2010 UNGASS Report.

HIV has devastated numerous countries in sub-Saharan Africa and is a dominant health force in many other
parts of the world. Its undeniable importance is reflected in the establishment of Millennium Development Goal No. 6. Unprecedented amounts of funding have been committed and disbursed over the past two decades. Many have argued that this enormous influx of funding has been detrimental to building stronger health systems in recipient countries. This paper examines the funding share for HIV measured against the total funding for health.

Source: Amico P, Aran C, Avila C (2010) HIV Spending as a Share of Total Health Expenditure: An Analysis of Regional Variation in a Multi-Country Study. PLoS ONE 5(9): e12997. doi:10.1371/journal.pone.0012997

According to the latest available estimates, there are currently about 2.5 million people living with HIV or AIDS in India, corresponding to a HIV prevalence rate of 0.36 percent for the population ages 15–49 (IIPS 2007). While HIV prevalence thus remains relatively low, there are sev- eral factors that are unique to India’s HIV epidemic, and need to be taken into account when assessing the impact of HIV and AIDS.

The global economic crisis threatens recent gains in health and poverty reduction in developing countries. What is the effect of the crisis on HIV programmes, especially in high HIV prevalence countries? What are the possible consequences? What can be done to avoid negative impacts? Information collected in late March 2009 from respondents in 71 countries

The National HIV/AIDS Action Plan and Budget for 2005-2006 was produced following extensive consultation about the extent of the problem, and what needs to be done about it. Stakeholders – i.e. government officials, representatives of beneficiary groups, broader civil society actors, and donor partners – are all agreed that the Action Plan provides the single point of reference for the HIV/AIDS response in Nepal.

This paper has two objectives. The first is to examine the robustness of two different epidemiological models; these models were used to determine the impact of IDU interventions in Nepal when interventions are scaled-up to reach 60% of IDUs, as recommended by UNAIDS. The second objective is to disseminate the outcome of two cost- effectiveness analyses of IDU interventions in Nepal. These analyses used identical data sets to determine the cost-effectiveness ratios under various scenarios of intervention coverage.

From UNAIDS’ launch in 1996 until 2005, available annual funding for the response to AIDS in low- and middle-income countries increased 28-fold, from US$ 300 million to US$ 8.3 billion. Existing pledges, commitments and trends suggest the rate of increase may be declining and that available funds will be US$ 8.9 billion in 2006 and US$ 10 billion in 2007.

Widespread prevalence of diseases such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome or HIV/AIDS, malaria, and tuberculosis are a significant constraint to development in low- and middle-income countries. The impact of HIV/AIDS has been especially devastating in sub-Saharan Africa where some countries are now seeing declines in life expectancy of up to 20 years as a result of the disease taking on pandemic proportions in the continent. Globally, HIV/AIDS is now the leading cause of adult mortality (WHO 2004). In 2004, an estimated 4.9 million deaths worldwide were attributable to HIV/AIDS (UNAIDS and WHO 2004). Given an average lag of 10 years between infection and death, the morbidity effects for an estimated 39.4 million people now living with HIV/AIDS are also substantial.

At its first opportunity following the United Nations General Assembly special session on HIV/AIDS, the Commission, at its fifty-eighth session in April 2002, adopted as its theme topic for the fifty-ninth session “Integrating economic and social concerns, especially HIV/AIDS, in meeting the needs of the region”.

Cost-effectiveness analysis is a tool which enables programme managers and planners dealing with HIV/AIDS to make informed decisions about resource allocation. By measuring and comparing the costs and consequences of various interventions, their relative efficiency can be assessed and future resource requirements estimated.