Background: Achieving fast-track results of ending HIV will need an increased participation from government''s resources for HIV/AIDS. Domestic spending on HIV from public sources is reported by countries to UNAIDS during the annual reporting process. While more than 55 countries report on average, many countries have not been regularly reporting these data.
Other countries, even while not reporting regularly to UNAIDS perform in-depth HIV resource tracking, e.g. National AIDS Spending Assessments (NASA).
Understanding the predictors of domestic public spending on HIV helps in estimating aggregates by income level of countries or regions and serve as input to project it for sustainability and transition analyses.
Methods: Country reported domestic public AIDS spending data from Global AIDS progress reporting and existing published NASA reports were considered. A panel data from 2005-2016 from 112 low-and-middle-income countries were used for the analysis including 933 country/year data points. Estimates result from panel data random effects models.
Results: There are significant positive relations between the GDP per capita of a country (1.082), ART coverage (16.5) and HIV prevalence (0.063) with the domestic public spending on HIV on current US dollars. The overall R-squared for the model was 0.68.
The domestic public spending by income level of countries has increased from $121 MN, $231 MN and $2415 MN for Low, Lower-Middle and Upper-Middle Income countries (LICs, LMICs and UMICs respectively) in 2006 to $256 MN, $980 MN and $6887 MN in 2016.
The domestic public spending has increased 60% between 2010 and 2016. Almost all regions increased their domestic resources. Asia Pacific region witnessed 132% increase in domestic resources between 2010 and 2016 while Eastern & Southern Africa increased by 57%. At 33%, Eastern Europe and Central Asia witnessed the lowest increase among regions.
Conclusions: Domestic resources currently constitute 57% of the global AIDS response, mainly public. With the flat lining or decrease of international resources, sustained increase in domestic public spending will be key in achieving fast-track targets to end AIDS as a global public health threat by 2030. Trends and projections of domestic public spending will be of significant use in projecting trends for transition and financial sustainability.