Financing the Response to HIV/AIDS in Low and Middle Income Countries: Funding for HIV/AIDS from the G7 and the European Commission

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Financing the Response to HIV/AIDS in Low and Middle Income Countries: Funding for HIV/AIDS from the G7 and the European Commission Presented at: Post G8 Briefing: Future Financing To Address The Global HIV/AIDS Epidemic Washington, DC July 21, 2005 Jennifer Kates Vice President and Director, HIV Policy Henry J. Kaiser Family Foundation

Chart 1 Acknowledgments & Methodology Data originally presented at: The Long-Term Financing Implications of the HIV/AIDS Pandemic: Building the International Effort to Deliver Resources Meeting convened by the Kaiser Family Foundation, the Royal African Society, and the Overseas Development Institute at Marlborough House, London, June 30, 2005 Data collected and analyzed as part of collaborative effort between UNAIDS and the Kaiser Family Foundation Direct data collection during first half of 2005 from G7 and EC governments and other DAC Members Other major data sources include: The Global Fund; UN agencies; OECD CRS, NIDI RFP Data for some governments are preliminary estimates Included are both funding commitments and disbursements for HIV/AIDS in 2004 (by donor FY) For Donor Governments, captures bilateral assistance and Global Fund contributions, representing prevention, care, and support; funding for international HIV research not included Global Fund contributions adjusted to represent an estimated HIV/AIDS share (60%)

Chart 2 G7 as Percent of Official Development Assistance (ODA), 2004 Other DAC 28% G7 72% $78.6 billion Notes: Data are preliminary only. Figure includes aid provided to the European Union (EU) by the four G7 members who are also part of the EU. Source: OECD, April 11, 2005

Chart 3 Total G7/EC and Other Donor Government Commitments for HIV/AIDS, 2004 Bilateral Commitments & Global Fund* Contributions US$ Billions $3.6 $2.7 $0.86 Total Bilateral Global Fund* Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 4 G7/EC as Combined Share of Total HIV/AIDS Commitments by Donor Governments, 2004 Bilateral Commitments & Global Fund* Contributions Other DAC, 13% G7/EC, 87% $3.6 billion Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 5 G7/EC as Share of Total HIVAIDS Commitments by Donor Governments, 2004 Bilateral Commitments & Global Fund* Contributions Japan, 4.1% Italy, 0.4% U.K., 16.6% Germany, 4.2% France, 3.9% U.S., 45.4% EC, 7.7% Canada, 5.3% Other DAC, 13.2% $3.6 billion Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 6 G7/EC as Share of Bilateral Commitments and Disbursements for HIV/AIDS, by Donor, 2004 Commitments Disbursements Japan, 3.5% Italy, 0.5% U.K., 20.5% U.S., 49.6% Japan, 4.4% Italy, 0.6% Germany, 4.6% U.K., 22.2% U.S., 40.3% Germany, 3.5% France, 1.2% France, 0.9% EC, 4.3% Canada, 4.1% Other DAC, 13.1% EC, 5.5% Canada, 5.7% Other DAC, 15.5% $2.7 billion $1.9 billion Notes: Funding for HIV/AIDS research not included. 2004 data for the U.K. and France are preliminary. Data for Japan, Austria, Belgium, Denmark, Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Disbursement data based on donor reports, analysis of government documents, and historical data. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 7 G7/EC as Share of Global Fund* HIV/AIDS Contributions by Donor Governments, 2004 Germany, 3.2% France, 13.2% EC, 18.5% Italy, 0.0% U.S., 32.2% Japan, 6.0% U.K., 4.2% Canada, 9.1% Other DAC, 13.6% $856 million Notes: *Global Fund contribution adjusted to represent HIV/AIDS share (60%). Italy s contribution to Global Fund for FY 2004 not yet provided, but primary channel of funding for Italy is through Global Fund. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 8 G7/EC Funding Channels for HIV/AIDS Commitments, by Donor, 2004 Global Fund Adjusted to Represent Estimated HIV/AIDS Share 24% 41% 57% 22% 35% 6% 17% 25% 81% 100% Global Fund Bilateral 76% 59% 43% 78% 65% 94% 83% 75% 19% Total Canada EC France Germany Italy Japan U.K. U.S. Other DAC Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Italy s contribution to Global Fund for FY 2004 not yet provided, but primary channel of funding for Italy is through Global Fund. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 9 Assessing Fair Share Complex, no single methodology Many important questions about what to take into account Must look at multiple methods, such as: Rank by total commitment; Rank by share of commitment compared to share of the global economy or share of developed country GDP; Rank by value of commitment compared with standardized measure of relative wealth, such as commitment per $1 million GDP or GNI; Share of total compared to the cost-sharing distribution negotiated for United Nations Member States. No one measure alone can answer the question

Chart 10 Example 1: Rank by Share of Total HIV/AIDS Commitments by Donor Governments, 2004 Bilateral Commitments & Global Fund* Contributions U.S. U.K. EC Canada Japan France Germany Italy Other DAC 16.6% 7.7% 5.3% 4.1% 3.9% 3.5% 0.4% 13.2% 45.4% Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Chart 11 Example 2: Rank by Total HIV/AIDS Commitment per US$1 Million, Gross National Income (GNI) Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. GNI data imputed from: OECD, April 2005. Japan adjusted to represent average 2003-2004 GNI. Other DAC governments not included in GNI analysis Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria. Bilateral Commitments & Global Fund* Contributions U.K. $274 Canada $194 U.S. $137 France Germany Japan $46 $33 $69 Italy $8

Chart 12 Example 3: Share of Global Resources Available for HIV/AIDS Compared to Share of World GDP, 2004 Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Disbursement data based on donor reports, analysis of government documents, and historical data. GDP data from: International Monetary Fund, World Economic Outlook Database, April 2005 Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; UNAIDS/PCB(14)/03, Conference Paper 2a, June 2003; UNAIDS/PCB(14)/03.3, April 29, 2003; The Global Fund to Fight AIDS, Tuberculosis and Malaria. Bilateral Disbursements & Global Fund* Contributions U.S. Japan Germany U.K. France Italy Canada 17.4% 11.5% 2.3% 6.7% 1.9% 5.2% 7.7% 5.0% 2.2% 4.1% 0.2% 2.4% 3.1% 28.9% Share of World GDP Share of Global HIV/AIDS Resources

Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Disbursement data based on donor reports, analysis of government documents, and historical data. GDP data from: International Monetary Fund, World Economic Outlook Database, April 2005 Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; UNAIDS/PCB(14)/03, Conference Paper 2a, June 2003; UNAIDS/PCB(14)/03.3, April 29, 2003; The Global Fund to Fight AIDS, Tuberculosis and Malaria. Chart 13 Example 4: Share of Donor Government Resources Available for HIV/AIDS Compared to Share of Advanced Economies GDP, 2004 Bilateral Disbursements & Global Fund* Contributions U.S. Japan Germany 14.5% 4.9% 8.4% 4.2% 36.4% 37.8% Share of Advanced Economies GDP U.K. France 6.6% 6.3% 4.9% 16.7% Share of Donor Government HIV/AIDS Resources Italy 5.2% 0.4% Canada 3.1% 6.7%

Chart 14 But is the Need Being Met? Resources Available Compared to Estimated Need Notes: Includes bilateral assistance and Global Fund contributions. *Global Fund contributions adjusted to represent an HIV/AIDS share (60%). Greece, Luxembourg, Netherlands, New Zealand, Norway, Portugal and Spain estimated based on 2003 data. Disbursement data based on donor reports, analysis of government documents, and historical data. Sources: UNAIDS & Kaiser Family Foundation Analysis, June 2005; The Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS, 2004 Report on the Global AIDS Epidemic, July 2004; UNAIDS, Resource Needs for an Expanded Response to AIDS in Low and Middle Income Countries, PCB17 Conference Paper, June 27-29, 2005 Additional Gap to be Filled 2004 Gap 2004 Resources Available, All Sources 13.7 6.7 2.2 2.2 2.2 6.1 6.1 6.1 2004 2006 2008 $8.3 billion $15 billion $22 billion

The Henry J. Kaiser Family Foundation 2400 Sand Hill Road Menlo Park, CA 94025 Phone: (650) 854-9400 Fax: (650) 854-4800 Washington Office: 1330 G Street, NW Washington, DC 20005 Phone: (202) 347-5270 Fax: (202) 347-5274 www.kff.org Additional copies of this publication (#7347) are available on the Kaiser Family Foundation's website at www.kff.org. The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the health care community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.