Despite a broad commitment to combating the spread of HIV/AIDS on the continent, African governments spend far too little of their own funds on intervention programmes, a new study has found. A review of national budgets included in 'Funding the Fight: Budgeting for HIV/AIDS in Developing Countries' showed that while many had developed strategic plans to tackle the virus, these were "poorly costed and budgeted". Sub-Saharan Africa remains by far the region worst affected by the AIDS epidemic - it has just over 10 percent of the world's population, but is home to two-thirds of all people living with HIV, according to UNAIDS.
Resource allocation and health financing
Greater commitment, more funding urged for HIV/AIDS treatment
Health financing to promote access in low income settings
"In this article we outline research since 1995 on the impact of various financing strategies on access to health services or health outcomes in low income countries. The limited evidence available suggests, in general, that user fees deterred utilisation. Prepayment or insurance schemes offered potential for improving access, but are very limited in scope. Conditional cash payments showed promise for improving uptake of interventions, but could also create a perverse incentive. The largely African origin of the reports of user fees, and the evidence from Latin America on conditional cash transfers, demonstrate the importance of the context in which studies are done."
Earmarked donor funding and resource allocation
It should not be assumed that earmarked donor funding automatically increases the allocation of developing-country resources towards programmes that yield the greatest health benefits. Sometimes it does, sometimes it does not - how the funding is designed can influence this. This is true particularly in the longer term, once the earmarked funding has ended. This is according to an article in Volume 82, Number 9, of the Bulletin of the World Health Organization.
Resource tracking estimates for HIV/AIDS expenditure in low- and middle-income countries
This UNAIDS report summarises the most recent data available on spending from all sources of AIDS programmes in low- and middle-income countries. Its purpose is to identify the magnitude of global resources available relative to the estimated resource needs. The report also reviews and compares the methodological approaches used to track HIV/AIDS expenditure at global and national levels, and identify gaps in HIV/AIDS financial information and present ways they can be addressed.
The Prevention of Mother-to-Child HIV Transmission - Costing the service in South Africa
The maturity of the HIV/AIDS epidemic in South Africa has brought competing agendas for prevention and impact mitigation to the table. Given the resource constraints it is imperative that any interventions are thoroughly assessed for their efficacy, costs and benefits. The challenge to succeed with primary prevention of new infections remains the key long-term solution to the epidemic. Ensuring the availability of resources for delivering this intervention in a cost-effective and sustained manner remains a challenge. This report contributes to this by providing an assessment of the cost side of this equation. This research is part of a larger evaluation of the pilot PMTCT programme in South Africa, and has been commissioned by the Health Systems Trust on behalf of the Department of Health.
Financing HIV/AIDS Prevention and Care in Low- and Middle-Income Countries
In the past two years, the political commitment to respond to the HIV/AIDS pandemic has increased substantially. In this policy environment, the importance of information on resources allocated to HIV/AIDS prevention and care has increased. In order to avoid resource misallocation, policy makers need information on the level and flow of current resource allocations to HIV/AIDS. They need to know where money for HIV/AIDS prevention and care is coming from, the services and commodities that are purchased with these funds, and the population coverage of the implemented interventions. At the same time, to identify needs and plan strategically, policy-makers require information on the scale of resources required to prevent the further spread of HIV and to provide adequate care for those people living with HIV/AIDS.
Tracking resource flows for HIV/AIDS
This PRHPlus article outlines the key advantages of using the National Health Accounts (NHA) Subanalysis to track resource flows for HIV/AIDS. In light of the HIV/AIDS epidemic, many countries are facing increased pressure to expand health care resources with limited and unreliable public funding. While global initiatives have responded in part to these concerns, there is growing need to use available funds efficiently, and to track resources which promote transparency and accountability. The authors maintain that financial indicators to track resource use, which link to health outcomes, are an integral part of the monitoring and evaluation strategy.
Estimating Resource Needs for HIV/AIDS Health Care Services in Low-Income and Middle-Income Countries
This paper presents a model for estimating HIV/AIDS health care resource needs in low- and middle-income countries. The model presented was the basis for the United Nations' call for US$9.2 billion to address HIV/AIDS in developing countries by 2005 with US$4.4 billion to address HIV/AIDS health care and the rest to deal with HIV/AIDS prevention. The model has since been updated and extended to produce estimates for 2007. This paper details the methods and assumptions used to estimate HIV/AIDS health care financial needs and it discusses the limitations and data needs for this model.
** Fair financing in health systems
Abstract Of Paper Presented At The Equinet Conference, Durban, 8-9 June 2004, by Lucy Gilson, Centre for Health Policy, University of the Witwatersrand
The starting point of this paper is to briefly discuss alternative definitions of ‘fair financing’. The term ‘fair financing’ was popularised by the WHO in their 2000 World Health Report, which set about evaluating and ranking health systems around the world. The WHO has defined this concept as individuals paying for health services in proportion to their income. Others suggest that a more ‘progressive’ definition of fair financing would be appropriate. The focus of the paper is to review the key findings of work relating to health care financing that has been supported by Equinet over the past few years. In addition, other striking health care financing trends in the SADC region will be referred to.
Further details: /newsletter/id/30458
Community-Based health financing: An overview
In the context of inadequate public expenditure in the health sector, many countries have installed cost recovery systems, such as user fees, as a supplementary financing approach for health care services. This practice has raised concerns over equity and access to health care for the poor, and the search for complementary financing solutions continues. A 1997 review identified 81 documented CBHF schemes from throughout the world, with the majority in sub-Saharan Africa and Asia. This document aims to answer basic questions on CBHF that might be posed by policymakers and technical assistance providers interested in this topic.