It’s more important than ever for donors to coordinate on global investments towards achieving an AIDS-free generation, according to a report by the Kaiser Family Foundation, as part of an ongoing series of reports intended to shed light on the international donor landscape, as a tool for stakeholders in both donor and recipient countries.
Global HIV/AIDS attracts the greatest share of official development assistance of any global health program area, with funding by donor governments increasing more than six-fold between 2002 and 2008 – mainly thanks to the establishment of the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, TB, and Malaria. The report outlines that 37 different donors, including 26 bilateral donors and 11 multilateral donors, provided an average of $7.6 billion in global HIV/AIDS assistance to 143 recipient countries between 2009 and 2011.
Uncoordinated donor activities can reduce efficiency and result in missed opportunities to leverage partnerships, streamline processes, and share experiences – challenges that carry greater significance in our current era of economic uncertainty, according to the report. Improving donor coordination and leveraging existing funding and programs is more important than ever as international donor assistance has essentially been flat since the global economic crisis hit in 2008.
Improving donor coordination and fostering greater transparency is also key in supporting country ownership, a point raised by the Institute of Medicine in their recent evaluation of PEPFAR: the IOM reports that officials from countries receiving HIV/AIDS assistance often had difficulty tracking the funding and services supported by the various donor agencies present in their countries.
The report outlines both donor presence and magnitude in recipient countries by analyzing three years of data from the Organization for Economic Co-operation and Development (OECD), to map the geographic landscape of global HIV/AIDS donor assistance. Highlights of the report include:
- On average, each donor provided assistance to six different regions and 40 different countries, and each recipient received assistance from an average of 10 donors.
- The five donors with the greatest presence, as measured by number of recipient countries, were UNAIDS (119), UNICEF (114), Canada (108), the Global Fund (108), and Sweden (106).
- However, the five donors providing the greatest magnitude of assistance, as measured by annual average funding for global HIV/AIDS, were the U.S. (61 percent), Global Fund (19 percent), U.K. (four percent), UNAIDS (three percent), and the World Bank (2 percent).
- With 34 of the 37 donors providing assistance, sub-Saharan Africa has the greatest number of donors as well as receives the greatest share of assistance, with 57 percent of all funding. 12 of the top 15 recipient countries are also in Africa.
Together, the U.S. and Global Fund account for an average of 80 percent of all global HIV/AIDS assistance, and comprise more than 60 percent of funding received in all regions except Oceania, where Australia is the top donor.
With the U.S. and the Global Fund providing the greatest percentage of global HIV/AIDS assistance, the report points out a potential vulnerability to the global HIV response should the scope and/or magnitude of their funding commitments change in the future – a concern also raised in the recent IOM evaluation of PEPFAR.