Zimbabwe's national AIDS levy: A case study

Area of Science:

• Public Health
• Health Economics
• Development Studies

Background:

• The Zimbabwe National AIDS Trust Fund (AIDS Levy) was established in 1999 as a domestic financing mechanism for the national HIV and AIDS response.
• This case study examines the operationalization and impact of the AIDS Levy.

Purpose of the Study:

• To evaluate the Zimbabwe National AIDS Trust Fund (AIDS Levy) as a model for domestic government financing of HIV and AIDS programs.
• To assess the effectiveness, challenges, and potential improvements of the AIDS Levy.

Main Methods:

• A mixed-methods approach was employed, including a comprehensive literature review (139 sources) and grey literature search.
• Key informant interviews were conducted with 20 representatives from the Zimbabwean government, civil society, and international organizations.
• Review of government documents from the Zimbabwe National AIDS Council (NAC) provided further data.

Main Results:

• The AIDS Levy, a 3% tax on income and profits, generated substantial revenue, reaching US$38.6 million by 2014.
• At least 50% of funds are allocated to antiretroviral medications, with other spending on prevention, administration, and M&E.
• Key informants viewed the Levy as a successful "homegrown" solution promoting ownership but highlighted needs for improved transparency, accountability, and revenue generation.

Conclusions:

• The Zimbabwe AIDS Levy has proven effective in generating significant resources for the HIV and AIDS response, exceeding US$35 million annually.
• The Levy demonstrates a strong national commitment, potentially enhancing the attraction of international donor funding.
• The AIDS Levy is considered a potential best practice model for other countries seeking sustainable domestic financing for HIV and AIDS programs.