Researchers with the RethinkHIV consortium have given new insights into the moral and fiscal implications of antiretroviral therapies for HIV in Africa. With AIDS now a controllable disease, they urge countries and donors to focus on financing treatment and investing in prevention, if we really are to see the “End of AIDS”.
Despite the availability of generic and discounted drugs in low-income countries, the cost of treatment is too high for sufferers who are poor, and too high for poor societies to bear on their behalf. Finding the funding for antiretroviral therapies poses many issues. However, RethinkHIV researchers argue that to avoid the risk of a medical disaster turning into a potential fiscal calamity, a shift in the treatment and prevention of HIV/AIDS from health ministers to finance ministers needs to take place. Their research suggests that committing additional resources to HIV prevention, while initially costly, could in fact save a country money overall.
In an article for IMF magazine, based on a paper published as part of the work of RethinkHIV, BSG’s Sir Paul Collier (Professor of Economics and Public Policy) and Richard Manning (Senior Research Fellow), with Olivier Sterck, postdoctoral Fellow at the Centre for the Study of African Economies (CSAE), examine the prevalence of HIV and its future fiscal implications for eight African countries. Their research finds that for some countries – such as Lesotho, Uganda and Malawi – the fiscal liabilities of treatment far exceed the capacity of the government to bear them. The results demonstrate the need for donors and governments to renegotiate agreements for sharing the burden of treatment and prevention costs. Despite the many billions of dollars spent to date on HIV/AIDS, the basic principle of incentive-compatible financing has not been recognised, let alone implemented, and this will be key to forming effective prevention strategies.
RethinkHIV is a consortium of leading health, economics, and development experts from several institutions, including BSG, with funding from The Rush Foundation, to respond proactively to the challenge of HIV. Generating both academic and policy dialogue, it aims to inform country-level planning and resource-allocation for the long-term management of HIV/AIDS.
BSG Working Paper, "The Economy Wide Impact of HIV/AIDS and the Funding Dilemma in Africa"
(Photo Credit: UN Photo/Albert Gonzalez Farran, El Fasher, Sudan)