Co-financing HIV programmes improves overall development results: RethinkHIV Policy Brief

Rethink HIV-Policy Brief.pdf

Policy-makers need to stop taking a ‘silo’ approach to budgeting, where one sector’s gain is another sector’s loss. An investment such as paying for girls’ schooling can benefit  education and health more broadly.

Drawing on STRIVE researchers’ innovative co-financing approach, this brief outlines an alternative to single-outcome cost-effectiveness analyses. Conventionally, the costs of programmes are related to their direct HIV outcomes, such as infections averted or ‘life years’ saved. By contrast, a co-financing model examines whether the overall social benefits generated by an intervention warrant its costs.

In a paper in AIDS, Michelle Remme et al applied the co-financing model to a structural intervention to keep adolescent girls in school in Malawi. They concluded that the programme was cost effective if different sectors both contributed and benefited.

What would this mean for the HIV sector?

  • Embedding HIV responses into broader national priorities would further encourage domestic ownership and sustainability.
  • HIV programmes should actively seek opportunities to co-finance development efforts that have been shown to produce direct HIV benefits.

The brief was produced by RethinkHIV and funded by RUSH Foundation. The two-page document:

  • defines structural interventions
  • compares cost-effectiveness models (conventional vs multi-benefit)
  • summarises the Malawi example
  • examines challenges and options for putting a co-financing approach into practice

Table: Short-term cross-sectoral outcomes from the Zomba cash transfer trial, taken from the RethinkHIV Policy Brief.

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