Donor Government Funding for HIV in Low- and Middle-Income Countries in 2021
Key Findings
UNAIDS, “Global AIDS Update Report”, July 2022.
UNAIDS, “Global AIDS Update Report”, July 2022.
In 2021, some donor governments provided COVID-specific emergency contributions to the Global Fund and UNITAID in addition to their contributions for core activities. Specifically, Canada, France, Germany, Italy, Japan, and Norway provided COVID-specific funding to UNITAID, while Canada, Germany, Luxembourg, the Netherlands, Norway, Switzerland, and the U.S. provided COVID-specific funding to the Global Fund. For the purposes of this report, these COVID-specific amounts have been excluded as they cannot be attributed to a specific area, such as HIV.
Donor government contributions to the Global Fund and UNITAID have been adjusted for an HIV-share to account for the fact that these multilateral organizations address other diseases and areas (see Methodology).
In 2021, the U.S. Congress appropriated an additional $3.5 billion in funding (beyond its regular contribution supporting HIV, TB, and malaria activities, which was flat in 2021 compared to the 2020 amount) to support the Global Fund’s efforts to address the COVID-19 pandemic. This funding is not included because it is for COVID-specific activities and cannot be attributed to HIV.
U.K. Foreign Commonwealth & Development Office (FCDO), “Statistics on International Development: Provisional UK Aid Spend 2021,” April 2022.
In addition to the $5.5 billion disbursed for HIV in 2021 (provided through regular appropriations for bilateral programs as well as the HIV-adjusted share of contributions to the Global Fund and UNAIDS), the U.S. disbursed an additional $4.3 million for bilateral HIV activities from emergency supplemental funding that was provided in response to the COVID-19 pandemic through the “American Rescue Plan Act of 2021” (see KFF analysis of “Global Funding Across U.S. COVID-19 Supplemental Funding Bills”).
UNAIDS, “Global AIDS Update Report”, July 2022.
OECD, “COVID-19 assistance to developing countries lifts foreign aid in 2021”, April 2022.
United Nations Secretary-General, “Deputy Secretary-General’s statement on cuts to Official Development Assistance (ODA)”, May 2022.
Global Fund, “Seventh Replenishment Investment Case: Fight for What Counts”, 2022.
Report
Donor government disbursements are a subset of overall international assistance for HIV in low-and-middle-income countries, which also includes funding provided by other multilateral institutions, UN agencies, and foundations.
UNAIDS, “Global AIDS Update Report”, July 2022.
UNAIDS, “Global AIDS Update Report”, July 2022.
UNAIDS estimates that US$21.4 billion was available for HIV from all sources (domestic resources, donor governments, multilaterals, and philanthropic organizations) in 2021, expressed in 2019 USD. For purposes of this analysis, this estimate was converted to 2021 USD, or $22.6 billion. In addition, while the amounts presented in this analysis include donor contributions to multilateral organizations, the UNAIDS estimate of total available resources for HIV includes the actual disbursements made by multilateral organizations in 2021 rather than the donor government contributions to these entities.
The donor share of total available resources includes bilateral disbursements as well as an adjusted share of Global Fund and UNITAID disbursements (the donor government share of contributions to each of the multilaterals in 2021 is applied to the disbursements from these multilaterals for the same year).
The UNAIDS resource needs estimate is expressed in 2019 USD.
In addition to the $5.5 billion disbursed for HIV in 2021 (provided through regular appropriations for bilateral programs as well as the HIV-adjusted share of contributions to the Global Fund and UNAIDS), the U.S. disbursed an additional $4.3 million for bilateral HIV activities from emergency supplemental funding that was provided in response to the COVID-19 pandemic through the “American Rescue Plan Act of 2021” (see KFF analysis of “Global Funding Across U.S. COVID-19 Supplemental Funding Bills”).
Personal communication with PEPFAR, July 2022.
UNAIDS, “World AIDS Day Report, 2021”,
Global Fund, “Results Report 2021”, April 2022.
WHO, “Third round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic”, February 2022.
IMF, “World Economic Outlook: War Sets Back the Global Recovery”, April 2022.