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The Global Fund's resource allocation decisions for HIV programmes: addressing those in need
Olga Avdeeva1, Jeffrey V Lazarus, Mohamed Abdel Aziz
1The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, CH-1214 Vernier, Geneva, Switzerland. Avdeeva.Olga@theglobalfund.org
Journal of the International AIDS Society
|October 28, 2011
Summary
The Global Fund significantly increased HIV funding, prioritizing low-income nations and those with high HIV burden. However, prevention for most-at-risk populations needs greater focus.
Area of Science:
- Global Health
- Infectious Disease Epidemiology
- Health Economics
Background:
- The Global Fund to Fight AIDS, Tuberculosis and Malaria substantially increased HIV investments between 2002 and 2010, reaching US$12 billion.
- This study assesses the targeting of Global Fund HIV program investments concerning disease burden and national income.
Purpose of the Study:
- To evaluate the allocation of Global Fund HIV financing across different countries and populations.
- To identify factors influencing Global Fund investment patterns in HIV programs.
Main Methods:
- Analysis of Global Fund HIV grants approved in Rounds 1-10 (2002-2010) across 145 countries.
- Utilized the UNAIDS National AIDS Spending Assessment framework and stepwise backward regression analysis.
- Examined funding per capita in relation to adult HIV prevalence, prevalence in most-at-risk populations, and gross national income per capita.
Main Results:
- Approximately 52% of Global Fund HIV funding targeted low- and low-middle-income countries, with 56% directed to sub-Saharan Africa.
- Major funding allocations were for HIV treatment (36%) and prevention (29%), with significant portions for health systems strengthening (22%).
- Global Fund investment correlated positively with national adult HIV prevalence, but only 10% of prevention funds targeted most-at-risk populations.
Conclusions:
- Global Fund HIV support has scaled up, effectively targeting countries with higher disease burden and lower income.
- Prevention efforts for most-at-risk populations remain inadequately prioritized in recipient countries.
- The Global Fund has revised criteria to better target key populations and is providing guidance for strategic financing in resource-limited settings.
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