Asian countries look to increase domestic funding for HIV

At an international conference in Thailand, a number of countries in Asia Pacific are showing their commitment to domestic investment for HIV

A number of countries in Asia Pacific are showing their commitment and leadership responsibility by increasing domestic investments for HIV.

Among countries most impacted by HIV, Malaysia funds 97% of its own response, China 88% and Thailand 85%. India has also committed to increase domestic funding to more than 90% in its next phase of the HIV response. Yet many other countries in the region depend heavily on external funding. At the same time a global economic crisis continues and international funding for HIV is declining.

On the first day of the 11th International Congress on AIDS in Asia and the Pacific (18-22 November 2013)  government officials from Indonesia, Thailand, Pakistan, Papua New Guinea, Vietnam, Myanmar, along with The Global Fund, Asian Development Bank and civil society representatives came together to discuss the funding landscape in Asia Pacific, including future decisions for investing in the response to HIV.

Ten year study on HIV prevention programmes

Chairman of the session Dr JVR Prasada Rao, UN secretary general special envoy on HIV/AIDS for Asia and the Pacific announced that UNAIDS, the World Bank and Kirby Institute have jointly embarked on a pioneering 10-year study and analysis to understand the HIV situation.

An independent, multi-stakeholder advisory panel also chaired by Dr Rao has been convened. Panel members include leading economists, national programme managers, policy makers, civil society representatives and development partners across the region.

Dr Lei Zhang from the Kirby Institute explained that the objective of the ongoing study is to improve the effectiveness and efficiency of HIV prevention responses in Asia’s concentrated HIV epidemic settings. The study is providing evidence on the epidemiological impact of HIV prevention programmes. This includes conducting impact evaluation trials, collecting data, modeling, health economic analyses and assessment of potential mismatches that exist between investment in targeted preventions and HIV epidemiology.

Studies support improvements to HIV services

Such studies are increasingly important to understand what HIV investments have bought, whether the interventions averted new infections and AIDS deaths, and at what cost. They can support decision making and prioritization intervention strategies and target groups within the HIV response with its overall goals of minimizing the burden of disease and maximizing health outcomes.

In Asia, the HIV epidemic is concentrated, driven by the prevalence of risky practices such as injecting drug use and unprotected sex among sex workers and their sexual contacts.

Drawing from data and experiences from countries in East Asia and the Pacific the  ten-year study will contribute to the improvement of the effectiveness and efficiency of HIV prevention responses in Asia’s concentrated HIV epidemic settings.

Funding the HIV response

The Global Fund to Fight AIDS, TB and Malaria continues to be a key funder of programmes and the organisation says its new funding model allows it to invest more strategically, achieve greater impact and engage partners more effectively. Dr Osamu Kunii from the Global Fund explained that the new model will also focus on countries with the highest disease burden and least ability to pay.

End AIDS India is a new innovative fundraising initiative being launched by the International HIV/AIDS Alliance and its linking organizations across India. The campaign will use direct marketing as it works towards its bold vision – an end to AIDS in India. It is targeting the general population, inspired by polio free India, and other campaigns on issues like cancer and girl’s education.

The Asian Development Bank explained about its ‘Cooperation Fund’ established for fighting HIV. Priority is given to activities that occur in sub-regions, countries, or communities that are especially poor and vulnerable to, or affected by, HIV.

Urgent need for innovative funding

Moi Lee Liow, executive director, APCASO (Asia Pacific Council of AIDS Service Organisations), talked about the HIV Investment Framework (IF), explaining that it advocates for a short-term increase in HIV funding in order to reduce funding requirements over the long term. The IF project is run by Community Advocacy Initiative (CAI), a regional partnership programme which helps strengthen advocacy by HIV civil society groups and networks in the Asia and Pacific region with funding from AusAID.

Countries in Asia Pacific need to urgently explore innovative sources of funding to bridge the gap in global resources for HIV, including a financial transaction tax to fund critical health and development programmes. Countries also need to revise and reprioritize HIV investment as well as national HIV strategies to deliver maximum results and value for money.

Continued domestic and international investments, sustained and country-owned efforts, as well as shared responsibility are needed to successfully get to the three zeroes for HIV: zero new infections, zero new deaths and zero discrimination.