Dissemin is shutting down on January 1st, 2025

Published in

Project HOPE, Health Affairs, 7(31), p. 1519-1528

DOI: 10.1377/hlthaff.2012.0216

Links

Tools

Export citation

Search in Google Scholar

Countries Where HIV Is Concentrated Among Most-At-Risk Populations Get Disproportionally Lower Funding From PEPFAR

Journal article published in 2012 by Ashley L. Grosso ORCID, Khai Hoan Tram ORCID, Khai Hoan Tram, Owen Ryan, Stefan Baral
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Red circle
Preprint: archiving forbidden
Red circle
Postprint: archiving forbidden
Red circle
Published version: archiving forbidden
Data provided by SHERPA/RoMEO

Abstract

The legislation reauthorizing the President's Emergency Plan for AIDS Relief (PEPFAR) in 2008 recognized the need for HIV/AIDS programs directed to most-at-risk populations, including men who have sex with men and people who inject drugs. To examine whether that goal is being met, we analyzed data from PEPFAR's Operational Plans for fiscal years 2009 and 2010. The eighteen countries in our study accounted for nearly two-thirds of overall PEPFAR financing for those fiscal years and approximately 60 percent of the total number of people living with HIV in the world in 2010. After controlling in each country for the number of people living with HIV, total population, and per capita income, we found that countries where HIV transmission occurs primarily among men who have sex with men and people who inject drugs received on average $235 million less in 2009 and 2010 than countries with widespread HIV epidemics among the general population. These findings raise questions about whether the country allocations of PEPFAR fully address needs based on the epidemiology of HIV infection in individual countries. Administrators should ensure that funding allocations directed to various countries reflect the best epidemiological data and latest science and best practices, and are devoid of bias against most-at-risk populations; they should also be more transparent about where PEPFAR's dollars go. Otherwise, it is unlikely that PEPFAR will realize its established goal of achieving an AIDS-free generation.