Making strategic use of AIDS investments An important strategy for enhancing value for money is to maximize impact and cost-efficiency by focusing limited resources where the epidemic is most severe and on the populations in the greatest need—the spending pattern differs between regions and countries according to their type of epidemic. In some settings, investing more strategically requires focusing a larger share of prevention spending on the general population. In other countries, the focus needs to be on the key populations that represent the largest percentage of people newly infected. It is estimated that by 2015 the share of investment needs for basic prevention programmes, such as male circumcision, preventing mother-to-child transmission and key populations at higher risk, will have to be increased. For example, today, programmes to reach key populations receive only 4% of investments on basic HIV prevention and treatment programmes globally, but for an optimized HIV response in 2015, this share will need to be about 14%.
Closing the resource gap Multiple avenues will need to be pursued if the world is to reach the target of mobilizing US$ 22-24 billion annually for the response. Countries should ensure that HIV spending is focused on effective investments and take steps to further increase their domestic spending for the AIDS response, including developing innovative and sustainable AIDS funding sources. Efforts must be intensified to improve the efficiency of AIDS spending through such means as capturing productivity gains, continuing to reduce the price of antiretroviral medicines, integrating services and improving service delivery. Economic growth in low- and middle-income countries can help expand the fiscal space for HIV investment, and further efforts are needed to cultivate emerging economies as international AIDS donors. In the context of shared responsibility and global solidarity, current international donors must also remain engaged in closing the resource gap for countries in need. Only by applying the investment approach and working within a framework of shared responsibility will countries reach their 2015 goal.
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