UNAIDS and African Development Bank convene high-level meeting on AIDS financing
How can African countries ensure a financially sustainable response to HIV?
UNAIDS Executive Director Michel Sidibé explored this topical issue in a breakfast briefing on 27 March with African Ministers of Finance and other high-level participants from the region. Co-convened by UNAIDS and the African Development Bank, the round-table discussion was held on the sidelines of the African Union Conference of Ministers of Economy and Finance.
During the briefing, Mr Sidibé congratulated African Ministers of Finance for their increased engagement in HIV responses across the continent. He underscored that HIV investments have yielded prevention dividends, including a more than 25% reduction in new infections in 22 African countries. More than 5 million people in sub-Saharan African are currently receiving antiretroviral therapy, noted Mr Sidibé—up from just 50 000 in 2002.
Mr Sidibé cautioned, however, that progress would stall without a shift in the current HIV funding architecture. “Dependency on foreign technologies, foreign drugs, foreign regulatory systems, and foreign production lines are holding the continent hostage,” he said. “Global solidarity is essential, but it must be complemented by a new financing paradigm—one that is reflective of the regional context, inclusive in its design and predictable in its implementation.”
An estimated two-thirds of HIV expenditures in Africa are currently financed through external aid, according to the UNAIDS issues brief “AIDS dependency crisis: sourcing African solutions.” The vast majority of life-saving antiretroviral medicines prescribed in Africa are imported from generic manufacturers.
Several participants in the round-table discussion emphasized the importance of viewing AIDS through the twin lens of health and economic development. “We cannot reach any type of sustained growth if our human capital is not healthy and productive,” said Lamin Barrow, Ethiopia Country Director for the African Development Bank.
“Health is a fundamental component of a strong and productive labor force,” said the Ethiopian State Minister of Finance, Ahmed Shide, echoing Mr Barrow’s remarks. “Developing a sustainable framework for financing is the missing gap in the health sector,” he added.
Others highlighted the need for home-grown solutions to ensure sustainable HIV responses in Africa. Pedro Couto, Deputy Minister of Finance for Mozambique, urged the African Development Bank to support local and regional investments in the production of HIV medicines through the use of soft loans.
UNAIDS Executive Director highlights global inequities in the AIDS response
In a meeting on 28 March with Ambassadors for African and BRICS (Brazil, Russia, India, China, South Africa) countries, Mr Sidibé described AIDS as a metaphor for inequality. While nearly 400 000 babies in Africa are born each year with HIV, virtually all children in developed countries are born HIV-free, he noted.
Mr Sidibé added that while a staggering number of people continue to die of AIDS in sub-Saharan Africa—an estimated 1.8 million each year—AIDS-related deaths in the West have been largely curtailed through universal access to antiretroviral treatment. “I ask you to dream about a world where social justice and social inclusion prevail over inequality and exclusion,” he said.
African countries should team together to negotiate more favourable prices for HIV drugs and ensure wider access to medicines, said Mr Sidibé. A single African drug regulatory agency could ensure the faster roll-out of quality assured antiretroviral drugs, he added.
During the meeting, Mr Sidibé called for innovative solutions to Africa’s HIV funding shortfall, such as a tariff on the use of mobile phones or a tax on alcohol and cigarette consumption. He said that through strengthened partnerships with BRICS nations, African countries could benefit from the exchange of scientific knowledge and technical expertise.
UNAIDS estimates that Africa will require between US$ 11-12 billion for its AIDS response by 2015—US$ 3-4 billion more than the current expenditure.