Government funding for HIV/AIDS

Export Indicator

Amount of national funds disbursed by governments in low- and middle-income countries
What it measures

National AIDS Accounts: Comprehensive approach to monitoring HIV/AIDS spending across all sectors
HIV/AIDS Budget Analysis: 1. To track national HIV/AIDS budget allocations and analyse the budget from an HIV/AIDS perspective. 2. To compare the amounts of state and donor funding to HIV/AIDS activities. 3. To use allocations in the national budget as indicators of human rights achievements or violations.

Rationale
Numerator

Not applicable

Denominator

Not applicable

Calculation
Method of measurement

At present, there are two methodologies used to thoroughly monitor HIV/AIDS resources in low- and middle-income countries which are collectively termed as HIV/AIDS National Spending Assessments(NSAs).
1. National AIDS Accounts in the context of National Health Accounts.
2. Stand-alone National AIDS Accounts.
Efforts have been made to harmonize National AIDS Accounts in the context of National Health Accounts and the stand alone National AIDS Accounts. Any of these two approaches provide information on prevention and public health, care and treatment, mitigation, infrastructure and administration. Other approaches, such as HIV/AIDS-budget analysis, have been limited to the description of budgets. Amendments will be made to ensure that expenditures are also accounted for. In the meantime, it might be a useful proxy measurement of the public expenditures as shown in the list on page 23. There are also surveys on fi nancial resource fl ows conducted by the Resource Flows Project (joint UNFPA/UNAIDS/NIDI project); however, these need to be thoroughly analysed to assess their completeness for HIV/AIDS since the major focus of such surveys is on reproductive health. Those reports might not be based on standard methodologies, meaning that they might not include estimates of public expenditures which are not clearly identifi ed in the public budgets. For countries that have access to information or databases on public budgets, careful attention is required in assessing that the budgets are actually spent using the same budget lines as described in the original budget. Also, it is essential to ensure the inclusion of expenditures which are not traditionally included within explicit budget lines (e.g., treatment of opportunistic infections is not a single budget item; yet it is usually paid for using public resources within hospital budgets). Countries that do not have developed any of the tools described above (NSA, AIDS-budget analysis or special surveys on fi nancial resource fl ows) may provide information on this indicator using the executed public budgets. However, again, they should supplement this information with the costing of other activities not included explicitly in budget items. In a number of countries, most of the expenditures might occur at the health facilities and not be clearly labelled as HIV/AIDS e.g., t

Measurement frequency

Ad hoc

Disaggregation

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

Efforts have been made to harmonize National AIDS Accounts in the context of National Health Accounts and the stand alone National AIDS Accounts. Any of these two approaches provide information on prevention and public health, care and treatment, mitigation, infrastructure and administration. Other approaches, such as HIV/AIDS-budget analysis, have been limited to the description of budgets. Amendments will be made to ensure that expenditures are also accounted for. In the meantime, it might be a useful proxy measurement of the public expenditures as shown in the list on page 23 of the UNGASS Guidelines document. Resource Flows Project (joint UNFPA/UNAIDS/NIDI project); however, these need to be thoroughly analysed to assess their completeness for HIV/AIDS since the major focus of such surveys is on reproductive health. Those reports might not be based on standard methodologies, meaning that they might not include estimates of public expenditures which are not clearly identifi ed in the public budgets. For countries that have access to information or databases on public budgets, careful attention is required in assessing that the budgets are actually spent using the same budget lines as described in the original budget. Also, it is essential to ensure the inclusion of expenditures which are not traditionally included within explicit budget lines (e.g., treatment of opportunistic infections is not a single budget item; yet it is usually paid for using public resources within hospital budgets). Countries that do not have developed any of the tools described above (NSA, AIDS-budget analysis or special surveys on fi nancial resource fl ows) may provide information on this indicator using the executed public budgets. However, again, they should supplement this information with the costing of other activities not included explicitly in budget items. In a number of countries, most of the expenditures might occur at the health facilities and not be clearly labelled as HIV/AIDS e.g., treatment of opportunistic infections in public hospitals, etc. To include these public expenditures as part of the indicator, there are no options but to cost the provision of these services and acknowledge the source of the funding to differentiate public and private expenditures. It is also important to include in the total public expenditures relevant costs on non-health areas derived from budgets of different ministries. This indicator should not be limited to data from the National AIDS Commission or the National AIDS Programme within the Ministry of Health. The methodology: • allows for cross country, regional and international comparison of data; • identifi es how resources are being mobilized within a country: a. Who pays? b. Who fi nances? c. Under what schemes? • identifi es how resources are being managed within a country; • identifies who provides HIV/AIDS services and who benefi ts from these services; • measures additionality; and • provides possibility to conduct benefi ciary analysis.

Further information