Are we spending too much on HIV?

doi:10.1136/bmj.39113.402361.94

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ comment articles:

From

Limit by

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Roger England (roger.england@healthsystemsworkshop.org)

Health Systems Workshop, Grenada, West Indies

Billions of pounds are being spent on the fight against AIDS in developing countries. Roger England believes that much of the money could be better used elsewhere, whereas Paul de Lay and colleagues argue that current spending is not enough

HIV is receiving relatively too much money, with much of it used inefficiently and sometimes counterproductively. Data from the Organisation for Economic Cooperation and Development show that 21% of health aid was allocated to HIV in 2004, up from 8% in 2000.1 It could now exceed a quarter. Yet HIV constitutes only 5% of the burden of disease in low and middle income countries as measured by disability adjusted life years lost (DALYs),2 less than that for respiratory infections, perinatal conditions, or ischaemic heart disease. It causes 2.8 million deaths a year worldwide—fewer than the number of stillbirths, and much less than half the number of infant deaths.2 More deaths are attributable to diabetes than to HIV.3

Even within sub-Saharan Africa, HIV funding is out of balance. HIV is the biggest single killer, contributing 17.6% of the …