The IMF's Role in the Fight Against HIV/AIDS
The HIV/AIDS epidemic poses a severe threat to global health, development, and security. The IMF collaborates with other organizations in the fight against this disease, most notably by supporting national poverty-reduction strategies that allocate additional spending to HIV/AIDS and other poverty-reducing programs. The IMF also provides advice to countries on the macroeconomic impact of HIV/AIDS, and how to effectively absorb large inflows of foreign aid.
Currently, some 33 million people worldwide are living with HIV/AIDS. In 2007, about 2.5 million were newly infected and more than 2 million died. Two-thirds of those infected live in sub-Saharan Africa, and the disease is spreading quickly in other regions of the world—especially in the former Soviet states, the Caribbean, and parts of East and South Asia.
HIV/AIDS is a major development crisis. Since the pandemic began, it has killed millions, separated families, and destroyed and impoverished communities. In some countries, life expectancy has fallen by more than 20 years. The scale of the epidemic is causing informal social safety nets to collapse. Overall health care is under pressure as health services struggle with mounting demand. Workforces are being decimated, with severe consequences for investment, production, and per capita income.
Call to action
In September 2000, at the United Nations Millennium Summit, world leaders agreed to eight specific and measurable development goals—now called the Millennium Development Goals (MDGs)—to be achieved by 2015. One of those goals is to halt and begin to reverse the spread of HIV/AIDS. In April 2001, United Nations Secretary-General Kofi Annan outlined a strategy for fighting HIV/AIDS, and called on the international community, governments, and the private sector to provide the resources needed to support the plan. This strategy includes:
(i) prevention—that is, a comprehensive education campaign; (ii) providing medication to block the transmission of infection from mother to child; (iii) access to humane treatment for the infected; (iv) additional research toward vaccines and a cure; and (v) protection for those made vulnerable by this disease, especially orphans.
He also called for the creation of a Global Fund to address not only the HIV/AIDS crisis, but also other critical health problems affecting developing countries, such as malaria and tuberculosis. Together, these diseases cause over six million deaths a year, accounting for a tenth of all deaths worldwide.
Under the umbrella of the United Nations, UNAIDS takes the lead in coordinating action by other UN agencies, disseminating knowledge that is fundamental to combating AIDS, and gathering and publicizing information on the evolving epidemic. Since 2001, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved a total of US$10.8 billion to more than 550 grants in 136 countries, of which US$5.5 billion has been disbursed. More than 60 percent of these resources is directed to HIV/AIDS. Over the last five years, the World Bank has committed US$1.9 billion in grants, loans and credits for HIV/AIDS programs worldwide. And the World Health Organization's 3x5 Initiative to substantially improve access to antiretroviral treatment in low-income countries reached 3 million patients in 2007.
Yet, while much has been achieved in recent years, further and expanded efforts are required to provide funding to help countries cope with and fight the epidemic, raise awareness of HIV/AIDS as a major development risk, and improve access to treatment and affordable anti-retroviral medication.
The IMF has an important role
The IMF has endorsed the call by the UN Secretary-General for this global campaign in the fight against HIV/AIDS, and has participated in the meetings of the Global Steering Committee of UNAIDS. The IMF is also collaborating with other organizations, most notably the World Bank, to expand country-level HIV prevention and treatment programs. Such programs are important components of many Poverty Reduction Strategy Papers (PRSPs), which are prepared by government agencies in collaboration with civil society and development partners. PRSPs provide the operational basis for concessional lending by the Fund and Bank and for debt relief under the Heavily Indebted Poor Countries (HIPC) Initiative. The IMF, in cooperation with the World Bank, is also helping poor countries to improve their public expenditure management systems and ensure that funds, including those for all health programs, are used efficiently and transparently.
In addition, HIV/AIDS features in the regular surveillance discussions the IMF holds with member countries. The severe economic impact that HIV/AIDS can have is a key factor that Fund staff consider when analyzing an affected country's economic outlook and providing policy advice. Many IMF country reports have addressed the macroeconomic and fiscal repercussions of HIV/AIDS, and Fund staff has prepared several working papers on the macroeconomic impact, access to health care, and the broad welfare implications of the disease. The IMF also published The Macroeconomics of HIV/AIDS, the most comprehensive study so far to focus on the macroeconomic and fiscal dimensions of the epidemic. Another component of surveillance discussions is to provide advice on how to effectively absorb large increases in foreign aid. The IMF is a vocal advocate for expanding Official Development Assistance from the industrial countries, including through new and increased contributions to the Global Fund. The IMF helps countries mobilize resources and create fiscal space for higher social spending. Moreover, IMF-supported programs support the full use of all available aid.
The international community faces many challenging battles ahead in the war against HIV/AIDS. As part of a global partnership, and within its mandate, the IMF is doing its share to help fight this disease and its devastating effect on human and economic development.