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Calculating indirect costs from international PEPFAR implementing partners
Brian Honermann1, Alana Sharp1, Jennifer Sherwood1
1amfAR, the Foundation for AIDS Research, Washington, DC, United States.
Plos One
|October 30, 2018
Summary
Indirect costs for global HIV programs, like PEPFAR, range from 8.30% to 19.51% of international partner funding. This analysis quantifies these hidden costs, urging a review of current policies for better HIV program efficiency.
Area of Science:
- Global Health
- Health Economics
- Public Health Policy
Background:
- Global HIV investment needs in low- and middle-income countries (LMICs) are substantial, yet international financing has stagnated.
- Evaluating HIV programs for greater efficiencies is crucial, especially as indirect costs remain unquantified.
- This study focuses on estimating indirect costs within the President's Emergency Plan for AIDS Relief (PEPFAR).
Purpose of the Study:
- To develop and present a method for estimating indirect costs in PEPFAR programs.
- To quantify the range of indirect costs incurred by international organizations and universities funded by PEPFAR.
- To inform policy discussions regarding indirect cost recovery and program efficiency in global HIV funding.
Main Methods:
- Utilized PEPFAR Country Operational Plan (COP) funding data from 2007-2016 for international organizations and universities.
- Calculated modified total direct costs to apply indirect cost rates.
- Applied a range of plausible indirect cost rates (10%-36.28%) to estimate total indirect costs.
Main Results:
- Between $1.85 billion (8.30%) and $4.34 billion (19.51%) of PEPFAR international partner funding was spent on indirect costs from 2007-2016.
- $157-$369 million in indirect costs were estimated for 2016 alone.
- Identified a lack of transparency in indirect cost rates for non-university international partners.
Conclusions:
- This is the first analysis to quantify indirect costs for major PEPFAR implementing partners.
- The opacity of indirect costs necessitates a re-examination of current policies and return on investment.
- Findings support a review of indirect cost recovery policies to enhance PEPFAR program efficiency and accountability.
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