Financing essential HIV services: a new economic agenda

Abstract

Anna Vassall and colleagues discuss the need for, and challenges facing, innovative and sustainable financing of the HIV response.

Please see later in the article for the Editors' Summary

Figure 1. Growth and taxation rates in low- and lower middle-income countries.

Governments' capacity to generate revenue is higher than reflected in tax revenue estimates, particularly in oil-producing countries that directly collect profits from oil production. However, most of these countries had data on tax revenue expressed in percent of non-oil GDP only and were therefore excluded for comparability (e.g., Chad, Republic of Congo, Gabon, Ghana, Mauritania). The remaining countries where oil was a source of revenue were Cameroon and Cote d'Ivoire, although for the latter, most of the oil revenue was through taxes (except a small contribution from oil company dividends). Sources: International Monetary Fund World Economic Outlook Database and Country Reports . Tax revenues are from the latest year available between the five-year period from 2007 to 2011. For Uganda and Madagascar, this meant using the IMF projected estimates for 2007, rather than the actual value, while for Kenya, it meant using the IMF estimate for 2009–2010. Average annual GDP per capita growth rates (2011–2017) are authors' calculations from IMF GDP per capita estimates (in constant prices national currency).

Figure 2. Share of domestic financing in HIV and health expenditures.

Countries with the largest numbers of people living with HIV (UNAIDS 2011 estimates) were selected, up until the point where all countries with double-digit HIV prevalence rates were included. Sources: WHO's Global Health Expenditure Database and UNAIDS AIDSinfo database . Countries are ordered from lowest to highest adult HIV prevalence (2011 estimates). HIV spending is from the latest year available (2005–2011), while health expenditure data are 2011 estimates.

Figure 3. Per capita HIV spending in relation to wealth and disease burden.

Countries with the largest numbers of people living with HIV (UNAIDS 2011 estimates) were selected, up until the point where all countries with double-digit HIV prevalence rates were included. Sources: World Bank's World Development Indicators Database and the UNAIDS AIDSinfo database . Adult HIV prevalence and GDP per capita are 2011 estimates, while HIV per capita spending is from the latest year available (2005–2011), but it is unclear from AIDSinfo which currency year is used.

Figure 4. Prioritisation of health in government expenditures.

Sources: WHO's Global Health Expenditure Database (2011 estimates for health) . Countries are ordered from lowest to highest adult HIV prevalence (UNAIDS 2011 estimates).