While donor funding for HIV programs has increased rapidly over the past decade, the increase has raised some questions about whether other health services in the recipient-country health systems have been diminished or strengthened as a result.
Karen Grépin of the Robert F. Wagner Graduate School of Public Service has closely investigated the impact of increased HIV donor funding on non-HIV health services in Sub-Saharan Africa during 2002-09. Her inquiry found evidence of both impacts: HIV aid in some countries has crowded out the delivery of childhood immunizations, especially in countries with the lowest density of health-care providers, while it may have positively affected some maternal health services, such as prenatal blood testing.
Grépin, assistant professor of global health policy, reported on her findings in the July issue of the journal Health Affairs, which was devoted to assessing President Obama’s Emergency Plan for AIDS Relief, the program of bilateral U.S. assistance begun in 2003 to support countries in their battle against HIV/AIDS, which has been described as the largest program of U.S. aid since the Marshall Plan.
The mixed impact found
by Grépin suggests that international HIV-focused donors should be more attentive to domestic resource constraints in recipient countries, such as limited numbers of health workers. Grépin also argues that donors should integrate more fully with existing health systems, and should address these constraints up front to limit possible negative effects on the delivery of other health services.