The End of AIDS: All About the Money?

According to today’s New York Times, UNAIDS officials have estimated that stopping the HIV/AIDS pandemic will require $22 billion annually by 2008, and perhaps more in subsequent years. Of this $22 billion, $11 billion will be needed for prevention efforts, and $5.5 billion for care and treatment of infected people, with the rest used to support program costs and efforts to support orphans and vulnerable children. According to United National Secretary General Kofi Annan, this dramatic increase in resource demands (more than triple the current financial commitment) is a result of the delay in global mobilization to address AIDS and the fact that the disease “has spread further, faster and with more catastrophic long-term effects than any other disease.”

In my opinion, there is no doubt that as a result of the enormous number of people already infected with HIV/AIDS, as well as the relative high-cost of rolling-out and sustaining ARV treatment services, stopping the pandemic will require large-scale financial commitments for years to come. However, it is overly simplistic to assume that mobilizing more resources is the best or only solution. Instead, might we think about better ways to use the resources that are already committed? Might we think about how to improve aid effectiveness as well as aid volume?

CGD is launching a new initiative, called the HIV/AIDS Monitor, to examine aid effectiveness questions within HIV/AIDS programming, with special attention to the three new, large-scale donor programs: the Global Fund, PEPFAR and the World Bank Multi-Country AIDS Program. These donor programs support projects in many of the same countries and have the same broad objectives (including prevention, care and treatment of HIV/AIDS), although they use very different methods and means to achieve them. It is far from clear which of these approaches (or more likely, combinations of these approaches) will prove to be most effective in which circumstances.

How effective are these aid programs in achieving their goals - or are they missing the mark? What does their performance tell us about the most effective ways to finance the battle against HIV/AIDS? What can we learn from these donor programs about the delivery of development assistance more generally?

We look forward to your thoughts and comments as we proceed with this important initiative. Stay tuned!