Donor Government Funding for HIV in Low- and Middle-Income Countries in 2016
- Donor government disbursements for HIV fell for the second year in a row, dropping from US$7.5 billion in 2015 to US$7.0 billion in 2016 (a $511 million or 7% decline), in current USD, bringing disbursements to their lowest level since 2010.
- This follows almost a decade of rapid rise, spurred on by the creation of new global HIV efforts. But increases hit up against the global economic crisis, resulting in flat funding for several years and, more recently, declines against a backdrop of constrained aid budgets.
- The 2016 decline is due to several factors: actual decreases in both bilateral and multilateral funding, accounting for an approximate net 50% of the decline; exchange rate fluctuations (20%); and the timing of U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria (30%), due to U.S. law that limits its funding to one-third of total contributions to the Global Fund. In constant (2014) dollars, overall disbursements also decreased, although by a smaller amount.
- In 2016, total disbursements decreased for 11 of 14 donors, in current USD, and increased or remained essentially flat for 3 donors. In currency of origin, the pattern was nearly identical.
- Bilateral disbursements declined by a net of US$108 million (2%) between 2015 and 2016, decreasing for 9 of 14 donors, although most decreases were minor. An increase in disbursements from the U.S. government of US$69 million offset much of the decrease.
- Multilateral contributions to the Global Fund and UNITAID were down by US$400 million or 22% (after adjusting for an HIV share). As noted above, some of this was an issue of timing on the part of the U.S. due to legislative limitations on Global Fund contributions (that funding was subsequently disbursed in 2017). However, some of the decline was due to donor decisions to front-load their funding early in the 2014-2016 Global Fund pledge period.
- The U.S. was the largest donor to HIV, providing $4.9 billion in 2016, followed by the U.K. ($645.6 million), France ($242.4 million), the Netherlands ($214.2 million), and Germany ($182.0 million). When standardized by size of its economy, however, the U.S. ranked third.
- The future outlook of donor funding for HIV remains uncertain, given recently proposed cuts to HIV funding by the U.S., amidst other competing demands on donor budgets more generally.