In a commentary published on the Health Affairs Blog on December 14, and based on a more detailed technical report (available at http://centerforpolicyimpact.org/donor-transitions-hiv/), Pharos staff and colleagues from Duke University point to the serious risks of declining donor aid in many middle-income countries for the sustained success of HIV programs, especially for stigmatized key populations including men who have sex with men, sex workers, transgender people, and those who inject drugs.
Over $500 billion has been spent on HIV programs in low- and middle-income countries over the past two decades, and major gains have been achieved in lowering new infections, illnesses and deaths, and mitigating other negative impacts of AIDS on society. However, when donor funding ends and countries transition to domestically-funded responses, they often struggle to maintain these programs, particularly for key populations.
Drawing on a series of country examples, we highlight lessons learned and make recommendations that can help countries to mitigate future transition risks and improve the impact of their HIV investments, thereby protecting the health of their populations and safeguarding the gains they have achieved to date in their fight against AIDS.