Disease burden, proportionality and the AIDS funding debate – Towards clarity on whether the world is spending ‘too much’ on HIV/AIDS
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There is currently considerable uncertainty surrounding the future of HIV/AIDS funding. With pressures from the recent financial crisis forcing donors to carefully review their spending priorities, some have claimed that HIV/AIDS receives too much money relative to its disease burden. This paper seeks to clarify this issue by examining the proportionality of HIV/AIDS funding to its disease burden in the year 2008 by measuring that percentage of total health expenditure spent on HIV/AIDS against that percentage of total disease burden attributable to the disease. It pays particular attention to a recently raised issue; namely, whether substituting OECD data for UNAIDS data has any significant effect on the number of countries spending above or below the level that is proportional to their HIV/AIDS disease burdens. Results indicate that the majority of countries in the dataset ‘overspend’ on HIV/AIDS relative to the most commonly employed measure of disease burden, the Disability Adjusted Life Year (DALY). This result, however, belies the fact that global ‘underspending’ is far more severe than overspending; while most countries ‘overspend’, the total amount in surplus of proportionality in overspending countries is dwarfed by the total amount still needed to reach proportionality in underspending ones. In other words, global HIV/AIDS resources are inadequate to bring all countries’ spending on the disease in line with their disease burdens.