Funding AIDS programmes in the era of shared responsibility: an analysis of domestic spending in 12 low-income and middle-income countries |

Publisher: The Lancet, Volume 3, No. 1, e52–e61, January 2015

As the incomes of many AIDS-burdened countries grow and donors’ budgets for helping to fight the disease tighten, national governments and external funding partners increasingly face the following question: what is the capacity of countries that are highly affected by AIDS to finance their responses from domestic sources, and how might this affect the level of donor support? In this study, we attempt to answer this question.

Nearly all 12 countries studied fall short of the proposed expenditure benchmarks. If they met these benchmarks fully, domestic spending on AIDS would increase by 2.5 times, from US$2.1 billion to $5.1 billion annually, covering 64% of estimated future funding requirements and leaving a gap of around a third of the total $7.9 billion needed. Although upper-middle-income countries, such as Botswana, Namibia, and South Africa, would become financially self-reliant, lower-income countries, such as Mozambique and Ethiopia, would remain heavily dependent on donor funds.