International AIDS Assistance: "New" Money?

All credible formulae for addressing HIV and AIDS in the developing world assume a rising tide of financing from many sources in partnership. These include governments and philanthropies of the developed world, multilateral organizations, developing-country governments, the business community, and in some cases, individuals themselves. Funding for HIV/AIDS has been on the rise during the last decade. The question of additionality – the uncertainty as to whether new international financing is genuinely adding to existing international assistance funding – has remained a key concern in the U.S. response to the pandemic. Additionality has also been defined in terms of whether international assistance supplements or supplants what developing countries can and should do for themselves. Seen in either of these ways, a preliminary analysis of newly-available data on HIV/AIDS financing in 13 representative developing countries provides encouraging evidence:

• In all 13 countries, international HIV/AIDS assistance has increased, and all 13 have simultaneously increased their own domestic HIV/AIDS public spending.
• In all but one of the 13, these increases were additive to both total international assistance andtotal domestic public spending; in other words, HIV/AIDS spending growth did not drive offsetting cuts in other spending overall.