Long-term Funding Critical to Sustained Effort Against HIV/AIDS

April 27, 2009

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“The current economic crisis threatens to erase many of the gains made in global health and development, as wealthy nations turn inwards in hopes of rescuing their own economies,” warn Council on Foreign Relations’ Global Health Program’s Kammerle Schneider and Laurie A. Garrett, in a new paper, The Evolution and Future of Donor Assistance for HIV/AIDS. “In such a scenario a profound political mobilization would be required to garner continued and adequate support of all types of foreign assistance, including HIV/AIDS treatment programs. Even in the less grim scenario, philanthropic giving from governments, foundations, and corporations is expected to sharply decline as the world tightens its belt in a global recession.”

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The rise of new economic and political powers as well as the growing influence of non-state actors will, over the next twenty years, transform the world’s power structures and global institutions, write Schneider and Garrett.  “The effects of climate change, resource scarcities, population growth, youth bulges in developing countries, aging wealthy world populations, and urbanization will pose profound challenges. The future configuration of the donor community may look vastly different than that of today. China, India, Russia, and Brazil will play a powerful role in the global economic and political agenda.”

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Health Policy and Initiatives

This paper examines the evolution and impact of donor resource mobilization for HIV/AIDS; the potential effect of the current economic crisis on HIV/AIDS funding; immediate and long-term challenges and opportunities for donor assistance; and policy recommendations to the donor community and national governments to ensure steady, long-term funding for HIV/AIDS and alleviate the impact of future challenges.

“The past twelve years have witnessed a spectacular forty-fold increase in the amount spent on HIV/AIDS efforts in low- and middle-income countries—from a mere $250 million in 1996 to $10 billion in 2007,” explain the authors.  However, “the next five to ten years will be critical in shaping the long-term future response to HIV/AIDS.”

In this paper, Schneider and Garrett lay out steps to secure long-term funding and transform emergency responses into sustainable engagements through 2031, fifty years after the first HIV/AIDS pandemic, and beyond. Recommendations include:

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•   Increasing funding coordination at the donor and national levels and with the private and NGO sector;

•   Expanding funding and support for research and innovation;

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Health Policy and Initiatives

•   Solidifying linkages with the Millennium Development Goals and larger health and development agendas;

•   Investing in building the capacities and physical numbers of skilled health workers within developing and developed countries;

•   Encouraging strong leadership at all levels—from national health ministries to multilateral agencies.

For full text of the report, visit www.cfr.org/donor_assistance_for_hivaids.


Kammerle Schneider is currently the assistant director of the Global Health Program at the Council on Foreign Relations. Previously she had been a Refugee/Internationally Displaced Persons program officer for the USAID-funded Extending Service Delivery Project where she managed the agency’s activities to extend reproductive health and family planning services. There she also served as the liaison between her agency, USAID, and the International Centre for Migration and Health in Geneva. She served as a Peace Corps volunteer in Guatemala from 2001 until 2003. Schneider holds a master of international affairs with a concentration in Health and Development from Columbia University, and a BA from the University of Washington.


Laurie A. Garrett is senior fellow for global health at the Council on Foreign Relations. Garrett was the president of the National Association of Science Writers during the mid-1990s. She is the only writer ever to have been awarded all three of the Big ‘‘Ps’’ of journalism: the Peabody, the Polk, and the Pulitzer, and she has been honored with two doctorates in humane letters honoris causa, from Weslayan Illinois University and the University of Massachusetts, Lowell. Her expertise includes global health systems, chronic and infectious diseases, and bioterrorism. Garrett is the best-selling author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance and Betrayal of Trust: The Collapse of Global Public Health. She is also author of the recent CFR Working Paper Food Failures and Futures. She lives in Brooklyn, New York.


The Council on Foreign Relations is an independent, nonpartisan membership organization, think tank, and publisher dedicated to being a resource for its members, government officials, business executives,  journalists, educators and students, civic and religious leaders, and other interested citizens in order to help them better understand the world and the foreign policy choices facing the United States and other countries.



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