The fight against HIV and AIDS has become a massive exercise. Twenty years ago, the AIDS epidemic was solely a topic of medical and public health concern in most societies. Today the pandemic and donor support to fight the pandemic are foreign policy, national security, and macroeconomic issues, summoning the attention of ministers of finance and the secretary-general of the United Nations. Presidents and prime ministers debate the nuances of the pandemic in their G8 summits, and military leaders fret over the rates of HIV infection among their troops.
Had political leaders better understood twenty years ago what tragic directions the pandemic would take, their policies might have been better—or so the AIDS advocates argue. In the spirit of looking forward and developing scenarios for policymakers, the aids2031 project has aimed at forecasting what the pandemic will look like fifty years after it was first noticed in gay men in the United States—and what critical actions must be taken now and over the next several years in order to create a brighter future for AIDS two decades from now. The Council on Foreign Relations’ Global Health program was asked to contribute to the aids2031 project, focusing on the future of donor financing for HIV prevention and treatment program.
This Working Paper is the product of that contribution. It 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.