Africa: funding for the fight against HIV-AIDS at half mast

The report "Triple Dividends: The Health, Social and Economic Gains of Financing the HIV Response in Africa" ​​released on April 12 highlights the benefits of investing in the fight against HIV/AIDS in Africa

Africa: funding for the fight against HIV-AIDS at half mast

The report "Triple Dividends: The Health, Social and Economic Gains of Financing the HIV Response in Africa" ​​released on April 12 highlights the benefits of investing in the fight against HIV/AIDS in Africa. Produced by Economist Impact of the English press group The Economist and supported by UNAIDS, this report presents the results of a study carried out in 13 African countries*. Together it assesses health, demographic, social and economic impacts. Its results are all the more interesting since these 13 countries account for nearly 50% of new HIV infections worldwide in 2021.

The report compares two scenarios: first, fully funded HIV/AIDS with the goal of ending the epidemic by 2030 as a public health threat, second, where Funding levels would be maintained at their current levels (Business as Usual – BAU).

The results are striking:

- "Under the scenario of fully funding the response to HIV, millions of lives will be saved and the positive impact will be considerable on health, of course, but also on education and economic growth", underlines the report. Depending on the country, 40% to 90% of new HIV infections could be prevented, the report says, adding that investments in the HIV epidemic would also promote education, especially for young women and girls, reduce gender inequalities and stimulate economic growth.

Because it is girls and women who are at higher risk of contracting HIV, they are also the ones who will potentially benefit most from increased investment in the HIV response. In a 100% funding scenario, maternal and child mortality declines as does the number of orphans, which will also subsequently increase the number of children and youth in school, the report explains.

Taken together, advances in health and education cascade through the economy and increase the productivity of current and future generations, contributing to broader economic benefits. The report estimates that meeting these financing targets would, for example, result in an additional 2.8% increase in GDP in South Africa and 1.1% in Kenya in 2030.

- On the other hand, on a BAU scenario the price is heavy. Cascading effects too, but in negative terms!

“This report comes at a crucial time. The evidence it provides should serve as a catalyst for policy decisions to ensure full funding for HIV,” insists UNAIDS Executive Director Winnie Byanyima. "Now is a good time to remind governments and international investors, such as the World Bank and the IMF," she added during the conference organized on the occasion of the launch of the report.

The current context is far from favorable. Since the Covid-19 pandemic, funding for the fight against HIV-AIDS has indeed dropped and is struggling to take off again. The crises follow one another: the war in Ukraine caused an energy crisis and a destabilization of the world markets with a food crisis, generalized inflation and the rise in interest rates... All these major upheavals weighed on financing in health and hampered efforts to address the HIV epidemic and health sector financing more broadly.

Winnie Byanyima, points to the threat of a context that has become very difficult linked to the indebtedness of African countries: "Debt servicing has swallowed up investments in the areas of health, education, social protection". Last year, Kenya spent 53% of its revenue on debt servicing. This figure rises to 70% for Malawi and Zambia. Invited to participate in the roundtable, Mthuli Ncubele, Minister of Finance of Zimbabwe, insisted: "Health expenditure is not only expenditure but also investment, adding that in the most affected countries in Africa, the return on investment is 20%. »

UNAIDS estimates that low- and middle-income countries will need to invest $29 billion each year to meet targets to end AIDS as a public health threat by 2030. The organization projects more than $7 million deaths from AIDS, but half can be avoided if the response is fully funded and supported by effective policies. Funding up to the set targets "will have broad socio-economic implications and will be a step for African countries towards building health systems that are more resilient and better prepared to prevent future pandemics", argues Winnie Byanyima.

“The HIV epidemic is not an isolated problem and must be seen in the broader context of governments' health and social programs. For example, investing in the HIV response can address inequalities in educational outcomes, as this study demonstrates. Conversely, inequalities in access to education can lead to vulnerability to HIV. Understanding these complex links is important for creating broader political commitment,” details the report, which hopes, through its findings, to play a catalytic role in financing the fight against HIV. At the end of the report, a graphic balance sheet is given for each country studied. The funding gap between the two scenarios – 100% coverage and BAU – also varies significantly across countries, from just 17% for Botswana to 91% for Cameroon, 48% for Ghana and 31% for Côte d'Ivoire. Figures that also show the disparity of situations.

* List of 13 countries studied: South Africa, Botswana, Cameroon, Ivory Coast, Ghana, Kenya, Malawi, Mozambique, Nigeria, Uganda, Tanzania, Zambia, Zimbabwe.