Financing essential HIV services: A new economic agenda

Anna Vassall, Michelle Remme, Charlotte Watts, Timothy Hallett, Mariana Siapka, Peter Vickerman, Fern Terris-Prestholt, Markus Haacker, Lori Heise, Andy Haines, Rifat Atun, Peter Piot PLOS Medicine, 2013; PLoS Med 10(12): e1001567. doi:10.1371/journal.pmed.1001567 Financing Essential HIV Services: A New Economic Agenda

We need an innovative new approach to meet the need for sustainable HIV financing.

The AIDS response faces both an economic recession and optimism about ending AIDS. However – as this paper establishes – the financing needs of the HIV response will remain substantial for many years to come.

Current commitments are becoming increasingly out of line with future fiscal liabilities. Reviewing options and opportunities, the authors outline a future agenda for research and for financing. They emphasise that a change in economic approach will be required, drawing on

  • increased domestic funding
  • improvements in efficiency
  • identification of innovative new funding streams

Earmarked external HIV funds have tended to create a sectoral “silo” mentality, which has led HIV programmes to miss out on the many potential synergies within health and with other development sectors.

Organisations providing HIV services must

  • critically examine and justify their costs and priorities
  • become increasingly involved in broader health systems strengthening
  • find ways to simultaneously support good governance and wider development objectives

There is need for a renewed economic case to now be made – alongside the moral one – for a reinvigorated response and a sustainable, long-term national and global commitment to ending AIDS.


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