Economics of AIDS

Sources of AIDS funding and AIDS spending of countries in the region from the 2010 UNGASS Report.

According to the latest available estimates, there are currently about 2.5 million people living with HIV or AIDS in India, corresponding to a HIV prevalence rate of 0.36 percent for the population ages 15–49 (IIPS 2007). While HIV prevalence thus remains relatively low, there are sev- eral factors that are unique to India’s HIV epidemic, and need to be taken into account when assessing the impact of HIV and AIDS.

In order to conduct a cost analysis of a project or programme, it is crucial to understand how a project functions. This section provides an introduction to dif- ferent HIV prevention strategies and highlights factors that are important to the collection of the cost data. Under the heading of established strategies, exam- ples of nine strategies are presented.

The National HIV/AIDS Action Plan and Budget for 2005-2006 was produced following extensive consultation about the extent of the problem, and what needs to be done about it. Stakeholders – i.e. government officials, representatives of beneficiary groups, broader civil society actors, and donor partners – are all agreed that the Action Plan provides the single point of reference for the HIV/AIDS response in Nepal.

From UNAIDS’ launch in 1996 until 2005, available annual funding for the response to AIDS in low- and middle-income countries increased 28-fold, from US$ 300 million to US$ 8.3 billion. Existing pledges, commitments and trends suggest the rate of increase may be declining and that available funds will be US$ 8.9 billion in 2006 and US$ 10 billion in 2007.

Widespread prevalence of diseases such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome or HIV/AIDS, malaria, and tuberculosis are a significant constraint to development in low- and middle-income countries. The impact of HIV/AIDS has been especially devastating in sub-Saharan Africa where some countries are now seeing declines in life expectancy of up to 20 years as a result of the disease taking on pandemic proportions in the continent. Globally, HIV/AIDS is now the leading cause of adult mortality (WHO 2004). In 2004, an estimated 4.9 million deaths worldwide were attributable to HIV/AIDS (UNAIDS and WHO 2004). Given an average lag of 10 years between infection and death, the morbidity effects for an estimated 39.4 million people now living with HIV/AIDS are also substantial.

This paper introduces the conceptual framework of interrelated consequences of the economic crisis on HIV/AIDS pre- vention and control. On the basis of docu- ment research and in-depth interviews with officials at national and provincial levels, we explain how the Government of Thailand has dealt with the AIDS epi- demic during the period of economic hardship. The paper describes how programme managers at national and pro- vincial levels have responded to budget cuts and discusses the impact the cuts may have on the effectiveness of programmes. The state of government finance and agree- ments with the International Monetary Fund have led to many policy adjustments and budget amendments.

Cost-effectiveness analysis is a tool which enables programme managers and planners dealing with HIV/AIDS to make informed decisions about resource allocation. By measuring and comparing the costs and consequences of various interventions, their relative efficiency can be assessed and future resource requirements estimated.