The global financial crisis is affecting all aspects of socio-economic development in many countries and various economies. Consequently, many governments and organizations have cut their healthcare budget, including countries in Sub-Saharan African and donor governments. Tanzania, first to declare a budget cut, announced a 25% decrease in its annual HIV/AIDS funding. This has led to commotion in the health sector, where up until 2009, there had been a steady increase in funding for HIV/AIDS. In 2008, approximately $15.6 million globally was spent on HIV funding, a substantial increase from the estimated $300 million in 1996.
The four categories of funding include: national governments, multilateral organizations, private philanthropy and domestic spending. Government aid has by far been the greatest contributor toward HIV/AIDS, funding approximately 50% of all the aid received for the epidemic in 2009. The United States Government has been the largest contributor over the years, accounting for over half of all national government funding. According to the Global Health Council, by 2006 HIV funding accounted for 80% of all American aid towards health/population issues. Yet, some fear that there is little to show for the millions of dollars being pumped into the disease. One source states that “AIDS has yielded nothing more than a big and complicated industry, which has become one of the most lucrative and fertile sources of donor income”. The HIV/AIDS epidemic also resulted in an entire UN chapter separate from the World Health Organization (WHO)- UNAIDS. This begs the question as to whether various multilateral organizations such as UNAIDS, World Bank, UNICEF, and the WHO among others, contributing towards the same cause, can effectively coordinate their efforts.
Recently, there has been a rise in concerns as to whether HIV/AIDS is being put on a “pedestal”, and whether the global HIV/AIDS crisis is disproportionately overblown. Some have argued that the HIV/AIDS industry has not only been overblown, but has taken away from many other diseases and big killers, particularly in Sub-Saharan Africa. While there is no cure for HIV, the virus has become manageable in many areas, with many patients being able to live a full life. Thus, some health experts have suggested that the funding towards HIV/AIDS is taking away from Malaria (still a deadly killer in Africa) and pneumonia, and that more funding and attention needs to be directed towards such illnesses, since now “more people have access to free anti-retroviral treatment”.
HIV has become an industry alone, towering over other public health issues such as tropical diseases, not too mention the rise of non-communicable diseases. Over 25% of global health aid is allocated to HIV/AIDS, although in low-income countries HIV/AIDS comes after respiratory infections, heart disease, and diarrhoeal diseases as a leading cause of death. Rather than benefiting the millions of infected people that need long term healthcare and access to ARVs, it seems that the money is benefiting those in the industry- higher salaries for workers, more frequent/well funded campaigns, and prominent speakers advocating for behavioral changes. Some countries, such as the UK, argue that closing the UNAIDS chapter would allow more room in their annual $200 million budget for other diseases such as pneumonia, which kills more children worldwide in a year that AIDS, malaria and measles combined.
On the flip side, other health officials and experts assert that HIV/AIDS funding does not take away from other diseases. Sujata Rao, head of the National AIDS Control Organization, states in an interview;
“I don’t think there is a substitution effect. Nor do I believe HIV/AIDS is taking away money from other diseases. You must not forget that it has no cure. Therefore, in a quantum sense it is more expensive to treat than other diseases. Tuberculosis can be cured within six months and the cost of the medicines is much less than that of HIV/AIDS. AIDS is a much more complex disease to treat”.
Similarly, the UNAIDS Deputy Executive Director, Paul De Lay declares that the “solution is not to reshuffle resources but to boost them”, as decreased funding from HIV/AIDS does not necessarily increase funding in other areas, but instead may depreciate quality in the health sector as a whole. AIDS advocates say funding helps strengthens other programs by providing basic health services, education, and long term health care.
Although there have been numerous debates and studies on whether or not AIDS Funding is benefiting or hurting developing countries’ health economies, the research presented does not show a clear cut path as to the effects of AIDS funding on other diseases. Despite the attention allocated towards HIV/AIDS, a similar focus is needed on air/water borne diseases, as well as NCDs – the biggest killers and blows to developing economies.