AIDS funding landscape in Asia and the Pacific

Ishdeep Kohli – CNS
A number of countries in the Asia and the Pacific are showing commitment and leadership by increasing domestic investments for HIV. Malaysia currently funds 97% of its own AIDS response, China 88% and Thailand 85%; India too has committed to increase domestic funding to more than 90% in its next phase of the AIDS response.

Yet many countries in the region still depend heavily on external funding. As the global economic crisis continues, international funding for AIDS is declining. The symposium ‘AIDS Funding Landscape in Asia Pacific’, brought together government officials from Indonesia, Myanmar, Pakistan, Papua New Guinea, Thailand and Viet Nam, along with The Global Fund, the Asian Development Bank and civil society representatives, to discuss AIDS investment funding decisions for the future. 

Chairman of the session, Dr JVR Prasada Rao, UN Secretary General’s Special Envoy on HIV/AIDS for Asia and the Pacific, helped participants understand the current global funding scenario, and announced that to understand projections for the next 10 years UNAIDS, the World Bank and the Kirby Institute have jointly embarked on a pioneering initiative to analyse the situation. An independent multi-stakeholder, high-level advisory panel 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 its ongoing study ‘Evaluation & cost-effectiveness of HIV prevention in Asia’. The objective of the study is to improve the effectiveness of HIV prevention in Asia’s concentrated HIV epidemics. The study is providing evidence on the epidemiological impact of HIV prevention programmes and their cost-effectiveness, based on the systematic design and conduct of impact evaluation trials, collection of data, modelling, health economic analyses and assessment of potential mismatches that exist between investment in targeted preventions and HIV epidemiology.

Such studies have become important analytical tools to understand what HIV investments have bought, whether the interventions averted new infections and AIDS deaths, and at what cost.

Dr Osamu (Sam) Kunii from The Global Fund explained the new funding model that allows more strategic investments, achieves greater impact, and engages implementers and partners more effectively. The new funding model provides countries that implement grants with more flexibility around when they apply for funds, as well as more predictability on the level of funding available, while still encouraging countries to clearly express how much funding they need to effectively treat and prevent HIV and AIDS, tuberculosis and malaria.

The new model allows the Global Fund to focus on countries with the highest disease burden and least ability to pay. Transition to the new funding model is already underway. Access to funding in the transition phase is by invitation, and special consideration will be given to countries in a position to achieve rapid impact, those at risk of service interruptions, and those currently receiving less than they would under the new funding model’s allocation principles. Full implementation will begin in late 2013, once the level of available funding for the 2014–2016 cycle is clear. 

The Asian Development Bank explained its ‘Cooperation Fund’ established for fighting HIV. Its main goal is to assist ADB developing member countries (DMCs) in their fight against the epidemic. The objective is to support and strengthen the efforts of DMCs in developing comprehensive responses to the HIV/AIDS epidemic with a focus on current and new areas where partnership with ADB will be of strategic value. Priority is given to activities that occur in sub-regions, countries, or communities that are especially poor and vulnerable to, or affected by, HIV. This includes activities that can be appropriately integrated into ADB programmes and projects and are consistent with ADB’s country strategy.

Roy Wadia, Vice Chair of APCOM, shared an innovative fundraising initiative, ‘End AIDS India’ being launched under the auspices of the International HIV/AIDS Alliance and its linking organizations across India. The campaign shares a bold vision – an end to AIDS in India. It is a direct marketing approach, targeted to the general population, inspired by polio-free India, and other sensitive approaches such as for cancer, girl children and education. It is about resource mobilization at the ‘people level’.

Moi Lee Liow, Executive Director of APCASO, described the CAI-IF project. The AIDS Investment Framework (IF) is a model for HIV and AIDS investment and prioritization for maximum impact. The IF advocates for a short-term increase in HIV funding in order to reduce funding requirements over the long term. Community Advocacy Initiative (CAI) is a regional partnership programme that aims to strengthen the advocacy capacity of HIV civil society groups and networks in Asia and the Pacific with funding from the Australian Government.

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

Ishdeep Kohli, Citizen News Service – CNS
November 2013

Note: This article was first published in 11th ICAAP INSIGHT, the official daily conference newspaper of 11th International Congress on AIDS in Asia and the Pacific (11th ICAAP) in Bangkok, Thailand. This newspaper was managed by Inis Communication and CNS.