For the past decade, global AIDS donors have responded to HIV/AIDS in sub-Saharan Africa as an emergency and have mobilized health workers from weak and understaffed workforces. They must begin to address the long-term problems underlying the shortages and the effects of their efforts on the health workforce more broadly.
Billions of dollars have been allocated to fight HIV/AIDS in poor countries over the past decade, yet less than half of those requiring treatment receive it, and for every two people put on treatment, five more become infected. Donors have to do more with available funds. Now is the time to link funding decisions to performance.
Few people doubt that gender inequality influences the spread of HIV/AIDS, yet public health efforts tend to focus on changing individual behavior rather than addressing structural factors—social, economic, physical and political—that influence the spread and effects of HIV and AIDS. This brief shows how three of the biggest donors to global HIV/AIDS programs can go beyond their stated commitments to address gender inequality and more effectively combat HIV and AIDS.
HIV/AIDS is one of the largest challenges facing the global community. The disease has reduced life expectancy by more than a decade in the hardest hit countries and slashed productivity, making it even harder for poor countries to escape poverty. Global HIV/AIDS and the Developing World, a CGD Rich World, Poor World brief, provides an overview of the impact of HIV/AIDS in the developing world and the U.S. response. Learn more about Rich World, Poor World: A Guide to Global Development
Zimbabwe has experienced a precipitous collapse in its economy over the past five years. The government blames its economic problems on external forces and drought. We assess these claims, but find that the economic crisis has cost the government far more in key budget resources than has the donor pullout. We show that low rainfall cannot account for the shock either. This leaves economic misrule as the only plausible cause of Zimbabwe’s economic regression, the decline in welfare, and unnecessary deaths of its children.
New medicines are usually financed by a mixture of public funding by governments, philanthropic giving, and investment by private firms. Private investment is especially important in paying for and managing the later stages of clinical trials, regulatory approval, and investment in manufacturing capacity. But for diseases that mainly affect people in developing countries, the prospective sales market is tiny—and not sufficient to justify commercially the large scale investment that is needed to develop new products.
An advance market commitment to accelerate the development of vaccines for diseases concentrated in developing countries, donors could make a binding commitment to pay for a desired vaccine if and when it is developed. This advance market commitment would mean firms could invest in finding a vaccine with the confidence that if they succeed there would be a market for the product.
This Brief is based on the CGD book Millions Saved: Proven Successes in Global Health. The book book features 17 success stories. These cases describe some large-scale efforts to improve health in developing countries that have succeeded - saving millions of lives and preserving the livelihoods and social fabric of entire communities.