Abstract #205  -  How the current economic crisis might impact HIV in low and middle income countries ?
Authors:   Presenting Author:   Mr Erik Lamontagne - UNAIDS
Additional Authors:  Dr Robert Greener, Dr Erik Lamontagne,
Aim: HIV programmes are financed from a variety of sources that vary from country to country. Globally, the largest sources of finance are domestic expenditures in the affected countries –including national budget and out-of-pocket spending by individuals-, and external financing –including direct bilateral cooperation, multilateral institutions, and private foundations. Each of these sources is vulnerable to the economic slowdown in a different way. There is a need to identify in which countries the HIV programme is at stake for the next two years in order to mitigate the impact among people living with HIV.
Method / Issue: Two methods to assess countries vulnerability and most-at-risk groups are used simultaneously by UNAIDS. First, for each country, we consider estimates of the resource needed by 2010 for the Universal Access to HIV prevention, care, treatment and support. Countries are then analysed using the criteria of CPIA analysis from the Poverty Reduction and Economic Management (PREM) Network to assess countries’ vulnerability to crisis in terms of their respective i) exposure to the crisis, ii) fiscal capacity and iii) institutional capacity. Second, a quick assessment survey is being conducted quarterly by the World Bank, UNAIDS and the World Health Organisation in 69 countries.
Results / Comments: We identified countries that show particularly high risks of not being able to implement their HIV activities. In March 2009, 11% of the countries surveyed are already facing shortages of antiretroviral drugs and an additional 32% is expecting impact over the coming year. Current results will be updated with the forthcoming August 2009 survey and a dynamic economic analysis will be presented in Gaborone.
Discussion: Universal Access to HIV prevention, care, treatment and support expanded rapidly for the last five years but two thirds of those in need of treatment still don’t get them and the economic crisis will most likely exacerbate the situation. The short term risk bears long term consequences for people living with HIV. Countries will be confronted to difficult choices and strong political support will be necessary in order to avoid severe cutback in prevention activities and activities in favour of some most-at-risk groups.
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