An estimated two-thirds of AIDS expenditures in Africa come from international funding sources, according to a new UNAIDS issues brief titled “AIDS dependency crisis: sourcing African solutions.” The vast majority of life-saving antiretroviral medicines consumed in Africa are imported from generic manufacturers. While the costs of HIV drug regimens have declined significantly in recent years, they remain high and unsustainable, and prices must be further reduced to reach all people eligible for treatment.
“Africa is too dependent on external resources, especially for the AIDS response,” said Mr Sidibé. “This is a source of great risk and potential instability. The status quo cannot be sustained—it is time for a new development paradigm that is developed and owned by the leaders of Africa.”
The UNAIDS Executive Director outlined opportunities for strengthened ownership of development investments in Africa. A single African Medicines Regulatory Agency could expedite the roll-out of quality-assured HIV drugs, he said. The development of centers of excellence in Africa could catalyze the local production of high-quality HIV medicines and build Africa’s knowledge-based economy, he added.
Speaking alongside Mr Sidibé at a press conference on 28 January, Dr Ibrahim Mayaki, Chief Executive Officer of the New Partnership for Africa’s Development (NEPAD), said that reaching the 10 targets in the 2011 Political Declaration on HIV/AIDS would only be possible through increased investment in the HIV response by African countries. “The current development model is not sustainable, particularly in this global economic downturn. African leaders must take greater ownership of AIDS investments across the region,” he said.
UNAIDS estimates that Africa will require between US$ 11-12 billion for its AIDS response by 2015—US$ 3-4 billion more than the current expenditure. African countries could help bridge the continent’s AIDS resource gap by mobilizing funding from a range of sources. Revenue could be obtained by taxing alcohol and tobacco consumption or the use of mobile telephones. Additional funding could be leveraged through public-private partnerships with Africa’s increasingly powerful companies. African leaders could also explore the wider use of “soft loans” from the African Development Bank.
The new UNAIDS brief also emphasized the continued importance of shared responsibility in the HIV response—of countries and donors. Significant and sustained international investments will be required for the AIDS response in Africa, even if African countries meet the 2001 Abuja Declaration target of a 15% allocation of government revenue for the health sector.
“Increased investments are needed from both African and high-income countries,” said Mr Sidibé. “External aid is not going to disappear and African governments must negotiate more predictable, sustainable HIV investments from international partners.”