Funding for HIV from donor governments decreased in 2015, by more than $1 billion, compared to 2014, according to a report just released by the Kaiser Foundation and UNAIDS. The report said that funding declined in 13 of 14 donor governments assessed.
According to the report, the decline is due to a complex set of factors. These include the significant appreciation of the U.S. dollar. However, the report said, even in their currencies of origin, funding declined for 11 of 14 governments. Other factors include a delay in disbursements by the U.S. government. Still, even after accounting for these factors, the report said, funding went down in 2015.
Source: Financing the Response to HIV in Low- and Middle-Income Countries
The report was discussed at a satellite session on the Collapse of AIDS Funding at the 21st International AIDS Conference in Durban, South Africa, on 19 July.
Between 2014 and 2015, bilateral funding declined by $715 million, or 11%. The decline occurred in all 14 countries and in 12 of the 14 currencies of origin. Multilateral contributions were down for 12 of 14 governments.
According to the report, contributions to the Global Fund were down by $305 million. Some of this decline was due to unique factors, including a subset of donors who front-loaded their contributions to the Global Fund in 2014 as part of a three-year, 2014-2016 pledge made during the Fund’s last replenishment period. Donor government contributions to UNITAID were also down.
In 2015, three quarters of HIV funding (74%) was provided bilaterally, primarily driven by the size of U.S. bilateral disbursements. Seven donors provided most of their funding through bilateral channels – Australia, Denmark, Ireland, the Netherlands, Norway, the U.K., and the U.S. Seven donors – Canada, France, Germany, Italy, Japan, Sweden, and the European Commission – provide most of their HIV funding through the Global Fund.
The U.S. remains the largest donor to HIV, the report said. In 2015, the U.S. accounted for two-thirds (66.4%) of donor government disbursements for HIV. The U.K. was the second largest donor (13.0%), followed by France (3.5%), Germany (2.7%), and the Netherlands (2.3%).
Kaiser and UNAIDS said that drop in funding for HIV marks the first decline in five years. “Whether this decline remains a single year event or a harbinger of more to come remains to be seen, although donor governments are facing many competing funding demands, including humanitarian emergencies and the refugee crisis, all against a backdrop of fiscal austerity in a number of countries.” The two organizations said that with UNAIDS estimating that in- country resources for HIV, including from donor governments, will need to increase by at least $7.2 billion by 2020 to put the world on a trajectory to end AIDS by 2030, it will be critical to monitor donor government spending going forward.