Local effort being made to increase spending on HIV – UNAIDS Report highlights

Jul 22, 2017 News

---

Funding is an issue that countries across the Caribbean continue to face in relation to the fight against HIV. However, some countries in the Region have managed to increase domestic funding. Guyana is among the countries that have been credited with this. This was underscored in the latest UNAIDS report ‘Ending AIDS: Progress Towards The 90-90-90 Targets’, which was released on Thursday.
It was revealed that after a drop in donor funding, Guyana has increased its domestic spending on HIV, following the signing of a grant agreement with the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2014 that included willingness-to-pay requirements.
Willingness to pay or [WTP] speaks to the maximum amount an individual is willing to sacrifice to procure a good or avoid something undesirable. It was only this year that Government announced that it will give its backing to the Ministry of Public Health to maintain its HIV gains, in the wake of plans by donor agencies to withdraw health funding.
Guyana was, even before this, lauded for being proactive in putting measures in place to fill the gap. United Nations Special Envoy, Dr. Edward Greene, had publicly stated that the Government of Guyana has exhibited the right attitude in terms of financing.
“When we met the Minister of Finance [Winston Jordan] in late January [2016], I must say he was very sensitive to the need to sustain the investment in health, and particular in HIV, where it is important,” said Dr. Greene.
He pointed out that unlike many other diseases, there is no vaccine for HIV, thus the need to sustain the support for infected people. This, he noted, is designed to ensure that they remain on affordable medicine, even as efforts to educate and emphasise prevention methods are fast-tracked.
”What is a good thing is that your [Guyana] Minister of Finance, unlike some Ministers of Finance, is not saying that we have so many other things to do. There is recognition that unless we sustain the investment in health and HIV/AIDS we will not overcome, but we will increase and reverse the trends,” Dr. Greene emphasised.
Guyana’s increased domestic spending was highlighted in the section of the report that detailed the Caribbean’s HIV performance.
But it was also highlighted in that section too, that several Caribbean countries are contending with diminishing external funding for their HIV programmes.
According to the UNAIDS Report, “while there is wide recognition of the need to increase domestic funding, the fiscal space for doing so is cramped in a region with many small island developing states under considerable economic stress.”
Caribbean countries, according to the Report, funded 21 percent of an estimated total of US$367million allocated to HIV responses in the region in 2016. As such, it was highlighted that donor dependency is higher for prevention with proven impact, in particular for the prevention services focused on key populations such as sex workers, transgender people, people who inject drugs, prisoners, gay men and other men who have sex with men.
However, it is noted in the Report too that reducing dependence on external funding across the Region will require new resource mobilization approaches, improvements in allocating and tracking HIV resources, and increases in efficiencies and cost savings.
In this regard, it was noted that Caribbean countries have explored ways to reduce the costs of HIV treatment, including revising tendering and purchasing processes, diversifying suppliers, using pooled procurement and improving drug quantification and forecasting.
“An example of this is the Pharmaceutical Procurement Scheme of the Organisation of Eastern Caribbean States, which pools procurement and management of pharmaceuticals and medical supplies to increase the bargaining power of its member states and achieve economies of scale,” the Report states. Such strategies, the Report adds, can give governments the ability to cover larger shares of antiretroviral costs.
There also is a strong case for investing more in health system strengthening as the health profile in the Caribbean reflects a high burden of chronic illnesses and the need for greater community involvement in health-care provision.
However, resources available for AIDS responses in the region remain considerably lower than what is needed to achieve Fast-Track Targets by 2020, the Report states.
According to the Report, the number of people living with HIV on treatment in the Caribbean has more than doubled in six years, from 69,900 [61,500–72,700] in 2010 to 162,000 [143,000–169,000] in 2016. This scale-up, it added, translated into an increase in coverage from 24 percent [18–28 percent] in 2010 to an estimated 52 percent [41–60 percent] in 2016.
Sustained increases over the next four years, according to the Report, would likely achieve the 2020 target of 81 percent of all people living with HIV being on treatment.

---

---