Donor Government Funding for HIV in Low- and Middle-Income Countries in 2017
- DONOR GOVERMENT DISBURSEMENTS FOR HIV INCREASED IN 2017. After two years of declines, donor government disbursements for HIV increased in 2017, rising to US$8.1 billion in current USD (a $1.1 billion or 16% increase over 2016). Both bilateral funding and multilateral contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and UNITAID increased in 2017. However, funding has not returned to its peak level in 2014. 1
- THE INCREASE WAS LARGELY DUE TO THE TIMING OF U.S. FUNDING AND IS NOT EXPECTED TO CONTINUE. Disbursements by the U.S. increased by more than US$1 billion, compared to 2016, but this was primarily an issue of timing, as it shifted funding appropriated in previous years to 2017. This trend is not expected to continue; U.S. appropriations have been flat for several years, and future disbursements will likely return to prior, lower levels. In fact, U.S. appropriations for HIV were again flat in FY 2018.
- MOST DONORS DECREASED OVERALL FUNDING IN 2017. Eight of 14 donor governments decreased overall disbursements (Australia, Denmark, Germany, Ireland, Japan, the Netherlands, Norway, and Sweden), although increases by the U.S. and 5 others (Canada, France, Italy, the U.K., and European Commission) more than offset these declines. In currency of origin, the pattern was nearly identical.
- BILATERAL FUNDING FOR HIV BY MOST DONOR GOVERNMENTS HAS BEEN ON THE DECLINE FOR SEVERAL YEARS AND MOST DECREASED IN 2017. Eleven of 14 donor governments decreased bilateral funding in 2017; only 2 donors, in addition to the U.S., increased. Without the U.S. increase, bilateral funding from all other donors declined by US$118 million.
- MULTILATERAL CONTRIBUTIONS HAVE FLUCTUATED OVER TIME, IN PART REFLECTING PLEDGE PERIODS TO THE GLOBAL FUND; IN 2017, THEY WERE UP. In 2017, contributions by donor governments to the Global Fund and UNITAID (after adjusting for an HIV share), increased by US$287 million, almost all of which was for the Global Fund. Six of 14 donors increased their multilateral contributions, while 4 decreased and 4 remained flat.
- THE U.S. REMAINS THE LARGEST DONOR TO HIV. In 2017, the U.S. disbursed US$5.9 billion, followed by the U.K. (US$744 million), France (US$268 million), the Netherlands (US$203 million), and Germany (US$162 million). For the first time, the U.S. also ranked first when standardized by the size of its economy, reflecting the increase in its disbursements in 2017. The U.K. was second, followed by Denmark, and the Netherlands.
- FUTURE FUNDING IS LIKELY TO FALL AGAIN, WITHOUT NEW COMMITMENTS. Given the unique circumstances of U.S. disbursements in 2017, which almost entirely drove the 2017 increase, future funding for HIV by donor governments is likely to return to lower levels, unless new commitments are made. However, because some other donors continue to face competing emergency demands for aid, such prospects are uncertain.