New Data Highlights Concerns in HIV/AIDS Funding
Recent Report Indicates Additional Challenges in an Already Resource-Constrained Environment
A new report from the Kaiser Family Foundation and UNAIDS, Donor Government Funding for HIV in Low- and Middle-Income Countries, shows that donor governments decreased contributions to fight HIV and AIDS by $200 million between 2018 and 2019. This is particularly disheartening news in an already challenging time for the fight against HIV and AIDS.
This report serves as a reminder that resources to fight HIV and AIDS were far from adequate well before the COVID-19 crisis. Both government and private funding has eroded in recent years. FCAA’s latest resource tracking report shows that global philanthropic funding to fight the epidemic has been flat, with only a 2% ($651 million) increase between 2017 and 2018. Even this modest increase was driven by relatively few funders and belies the reality of the steady retreat from HIV by broader philanthropy. Over the course of six years, roughly 30 of the once leading funders have left or significantly decreased their investments in HIV, taking approximately $130 million in resources with them. At the same time, the need in low- and middle-income countries — where the number of people living with HIV increased 25% over the past 10 years — is growing. UNAIDS’ recent Seizing the Moment report indicates that, not only will the 2020 targets not be met, but 3.5 million more people have become infected with HIV and 820,000 have died from AIDS-related illnesses since 2015.
Funding is only part of the picture, however. Under the Trump administration, the U.S. government—historically the largest funder of the fight against HIV and AIDS—has rolled out ill-informed policies that make our work even more challenging. The expansion of the Mexico City Policy, or Global Gag Rule, has caused broad and severe impacts around the world. Just last week, the U.S. Supreme Court upheld the “anti-prostitution loyalty oath” (APLO), requiring organizations to have a policy explicitly opposing sex work in order to receive funding from the President’s Emergency Plan for AIDS Relief (PEPFAR). Yet, sex workers are 13 times more at risk of HIV compared to the general population and receive only roughly 2% of private HIV-related philanthropy.
The global struggle to beat back COVID-19 only exacerbates these issues. While the full impact of the coronavirus on HIV and AIDS won’t be understood for some time, progress will inevitably be delayed, if not rolled back entirely. In a recent FCAA Connect webinar, we heard about vulnerable populations most impacted by HIV and AIDS. As a result of COVID-19, many individuals are unable to get their basic needs met, have lost access to crucial medication, and are experiencing human rights violations under the pretense of public health. Access to pre-exposure prophylaxis, or PrEP, has been disrupted as a result of the pandemic, as has the ability to get testing and treatment.
There are other COVID-19 related impacts to consider. A recent survey of Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) programs across 106 countries shows widespread disruptions to HIV, tuberculosis, and malaria service delivery as a result of the pandemic. As Peter Sands, Global Fund Executive Director has explained, “We have seen similar effects before in Ebola outbreaks, and we know that if lifesaving HIV, TB and malaria programs are interrupted, additional deaths from those diseases could well outstrip the deaths from COVID-19 itself.”
For our part, FCAA is working to identify the areas where private philanthropy can step up and work more efficiently and effectively. For example, our HIV 2020 session, The Dollars and Sense of Effective Grantmaking, taking place this Thursday (July 9th), will convene representatives of funders and key populations to discuss the intersectional nature of HIV and the importance of having key populations involved in program design and funding. As the fallout from COVID-19 strains our economies and communities, the world cannot afford to lose more donor government and philanthropic funding for HIV and AIDS. The time to act is now.