Has Foreign Aid Helped Latin America and The Caribbean to Reduce HIV? The Need for Improved Metrics to Assess the Burden of Disease

Tuesday, June 14, 2016
Lobby (Annenberg Center)

Author(s): Dr. Juan J DelaCruz


This paper estimates the effects of foreign aid on health status using HIV as a main indicator in selected Latin American and Caribbean (LAC) countries. This study applies an econometric specification based on a random effects panel regression for 27 countries between 1990 and 2013, where changes in measures of sickness and wellbeing (HIV prevalence and life expectancy) are associated to variations in foreign aid flows, controlling for a set of social-structural variables. Although increases in foreign aid from industrial nations to LAC countries along with relatively lower price of antiretroviral therapy (ART) have improved access to medical care in low- and middle-income countries, HIV/AIDS remains one of the leading causes of death and disability around the world. The strongest effects have taken place in economies with limited resources. HIV prevalence is low in Latin America but high in the Caribbean (almost comparable to countries in Sub-Saharan Africa). This paper pays special attention to the uncertainty of the epidemic due to the lack of consistency in sentinel surveillance. Developing countries with HIV infections on the rise will require financial, public health and logistic resources to implement successful interventions, which are characteristic of industrial economies. This study determines whether the global funding for HIV treatment has improved health status in this region and sustains that, if well targeted, increases in foreign aid for HIV may help ease the burden of disease and improve health capital in the region.

Suitable allocation of foreign aid would lead to disease reduction and health promotion for almost 590 million people in LAC countries. Foreign aid should help improve both access to ART as well as HIV sentinel surveillance with demographic data, behavioral information and biomarkers in the LAC countries. There is an urgent demand for better HIV metrics to understand how to allocate scarce resources. Failure to adjust measurements for potential biases will produce spurious results that under- or over-estimate these calculations. As global access to ART upsurges briskly, not accounting for loss to follow-up in cohort studies causes underestimation in the number of HIV-related deaths. Reductions in HIV prevalence over time may be due to a lower number of new transmission or to a high HIV-related death ratio at the population level.