Donor government funding in support of HIV prevention, care, and treatment in low- and middle-income countries totaled $8 billion in 2018, little changed from 2017 and roughly equivalent to the amount disbursed a decade ago, a report from the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS) finds.
According to the report, Donor Government Funding for HIV in Low- and Middle-Income Countries in 2018 (17 pages, PDF), the United States, with $5.8 billion in disbursements in 2018, continues to be the largest donor to HIV efforts, even after adjusting for the size of its economy, followed by the UK ($605 million), France ($302 million), the Netherlands ($232 million), and Germany ($162 million). Since 2010, funding from donor governments other than the U.S. has declined more than $1 billion, with support falling again in 2018 (to $6.2 billion, from $6.3 billion in 2017). The report also found that while donor governments have upped their support for the Global Fund to Fight AIDS, Tuberculosis, and Malaria over the past decade, the increase has not been enough to offset the drop in bilateral support. When factoring in how the Global Fund divides its resources among the three diseases as well as reduced funding for UNITAID, multilateral support for HIV overall has dropped since 2010.
According to estimates from the broader UNAIDS report Communities at the Centre, which examines all sources of funding for HIV, a year-over-year decline of $1 billion, adjusted for inflation, leaves a gap of $7 billion between current needs and resources.
"Donor contributions are vital for the AIDS response, particularly in East and South African countries…where the majority of countries rely on donors for 80 percent of their HIV responses," said interim UNAIDS executive director Gunilla Carlsson. "It is disconcerting that in 2018, total available resources for HIV declined by $1 billion. I call on all countries — domestic and donors to urgently increase their investments and close the $7 billion funding gap for the AIDS response."
"Since the global financial crisis a decade ago, donor governments’ support for HIV has flattened and funding from donors other than the U.S., which has held steady, has gone down," said KFF senior vice president Jen Kates. “Unless this calculus changes, efforts to prevent and treat HIV globally will need to rely increasingly on other sources of funding."