Debt Crisis Threatens To Derail HIV Response In Sub-Saharan Africa, Says UNAIDS

New York, NY – A new report from UNAIDS has painted a stark picture of the impact of growing public debt on sub-Saharan Africa’s fight against HIV/AIDS.

The report, titled “Domestic Revenues, Debt Relief and Development Aid: Transformative Pathways for Ending AIDS by 2030 Eastern and Southern Africa/ Western and Central Africa,” warns that the region’s progress in reducing new HIV infections could be reversed if countries are unable to secure the necessary financial resources.

The report highlights that the combination of rising debt payments and austerity measures imposed by the IMF is severely limiting fiscal space for HIV services.

In several countries, including Angola, Kenya, Malawi, Rwanda, Uganda, and Zambia, debt servicing now accounts for over 50% of government revenue.

Even after debt relief, Zambia will still be dedicating two-thirds of its budget to debt payments between 2024 and 2026.

This financial strain is already impacting HIV response spending. In Western and Central Africa, spending on HIV has fallen from 0.3% of GDP in 2017 to just 0.12% in 2022.

The report estimates that Western and Central Africa will require US$ 4.18 billion in 2024 to fully fund its HIV response, a figure that will rise to US$ 7.9 billion by 2030.

Eastern and Southern Africa face similar challenges, with a projected need for almost US$ 12 billion in 2024 and US$ 17 billion by 2030.

Despite the substantial funding gaps, global efforts to end AIDS by 2030 are threatened by a lack of financial resources.

While US$ 20.8 billion was available for the HIV response in 2022 from domestic and international sources, this was insufficient to meet the needs of low- and middle-income countries.

Western and Central Africa alone faced a funding shortfall of 32% in 2022.

UNAIDS Executive Director Winnie Byanyima emphasizes the urgency of the situation, stating, “When countries cannot effectively look after the health care needs of their people because of debt payments, global health security is put at risk.”

She urges immediate action to reduce public debt, strengthen domestic resource mobilization, and increase financial assistance for health and HIV response.

The report calls for a multi-pronged approach to address the financial challenges:

Strengthening tax systems: Sub-Saharan African countries need to improve their tax systems, including closing tax exemptions that currently cost countries an average of 2.6% of GDP in lost revenue.
Scaling up financial assistance: Donors must increase their financial support for health and the HIV response between now and 2030.
Debt relief: Creditors should offer debt relief to heavily indebted countries to alleviate the burden of debt payments.

“World leaders cannot let a resource crunch derail global progress to end AIDS as a public health threat by 2030,” Byanyima warns.

This report serves as a critical reminder of the interconnectedness of global health, economic development, and debt. It emphasises the need for international cooperation to support countries in their efforts to control the HIV epidemic and achieve global health goals.