Tracking development assistance for HIV/AIDS by program area: 1990 - 2015

Millennium Development Goal (MDG) six focused on halting the spread of HIV/AIDS. Since this goal was established, more resources have been devoted to combat HIV/AIDS in low- and middle-income countries than any other cause of illness. To better understand the global response to combating the HIV/AIDS pandemic, this study sets out to track development assistance for HIV/AIDS at a more granular level than ever before and to quantitatively identify donor priorities.  

We extract data from the Institute for Health Metrics and Evaluation’s Financing Global Health 2015 report. This report systematically tracks development assistance for health (DAH) from 1990 to 2015, splitting DAH into more than 20 health focus areas, and drawing data from all major international development agencies. Budget documents and project descriptions are used to track donors’ priorities and categorize investments. The sources of the funds, primary channels of delivery, and country recipients of DAH are reported. From 1990 to the establishment of the MDGs in 2000, DAH for HIV totaled $5.1 billion. Since 2000, $100.4 billion of DAH has been provided for HIV/AIDS, a growth of 1,761% from the previous decade. In 2014 alone, $10.9 billion was disbursed. Between 2000 and 2010, DAH for HIV/AIDS grew at an annualized rate of 23%. Since 2010, the annualized rate of growth has been less than 1%. The United States government was the largest source of DAH for HIV/AIDS during the MDG era, providing 56% of the total. Donors provide resources to broad and diverse sets of HIV/AIDS program areas. The US government prioritizes treatment (40% of their fund in 2015) and prevention (31%), while the Global Fund to Fight AIDS, Tuberculosis, and Malaria splits its investments between prevention, health system strengthening, and treatment. UNAIDS focuses more than 60% of their programmatic assistance on health system strengthening. Across all recipient countries, an average of $3,600 of HIV/AIDS DAH per HIV/AIDS disability-adjusted life-year was disbursed between 2000 and 2015.

Overall, the scale up of development assistance for HIV/AIDS, specifically since the ratification of the MDGs, has been both remarkable and diverse. However, since 2009 and the global economic crisis, funds have plateaued. Between 2010 and 2015, DAH for HIV/AIDS increased at only 1.6% annually. Because of this, it is more critical than ever to understand spending patterns and how comparative advantages of each donor and agency can contribute to the international efforts to prevent and treat HIV/AIDS.