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Health Policy and Planning Advance Access originally published online on December 21, 2007
Health Policy and Planning 2008 23(2):95-100; doi:10.1093/heapol/czm045
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Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2007; all rights reserved.

Has donor prioritization of HIV/AIDS displaced aid for other health issues?

Jeremy Shiffman

Associate Professor of Public Administration, The Maxwell School of Syracuse University, Syracuse, NY 13244–1020, USA. Tel: +1 315–443–4928. Fax: +1 315–443–9734.

E-mail: jrshiffm{at}maxwell.syr.edu

Advocates for many developing-world health and population issues have expressed concern that the high level of donor attention to HIV/AIDS is displacing funding for their own concerns. Even organizations dedicated to HIV/AIDS prevention and treatment have raised this issue. However, the issue of donor displacement has not been evaluated empirically.

This paper attempts to do so by considering donor funding for four historically prominent health agendas—HIV/AIDS, population, health sector development and infectious disease control—over the years 1992 to 2005. The paper employs funding data from the Organization for Economic Cooperation and Development's (OECD) Development Assistance Committee, supplemented by data from other sources.

Several trends indicate possible displacement effects, including HIV/AIDS’ rapidly growing share of total health aid, a concurrent global stagnation in population aid, the priority HIV/AIDS control receives in US funding, and HIV/AIDS aid levels in several sub-Saharan African states that approximate or exceed the entirety of their national health budgets. On the other hand, aggregate donor funding for health and population quadrupled between 1992 and 2005, allowing for funding growth for some health issues even as HIV/AIDS acquired an increasingly prominent place in donor health agendas. Overall, the evidence indicates that displacement is likely occurring, but that aggregate increases in global health aid may have mitigated some of the crowding-out effects.

Key Words: Donor aid, HIV/AIDS, health priority-setting, population, health sector development

Accepted for publication 31 October 2007.


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