Feature Aid for Middle Income Countries

Downside of becoming a richer country

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3759 (Published 10 July 2015) Cite this as: BMJ 2015;351:h3759
  1. Esha Chhabra, freelance journalist, USA
  1. ec2440{at}gmail.com

Since Vietnam graduated from low income to middle income status, donors have stopped supporting HIV/AIDS programmes and the government is struggling to fill the gap. Esha Chhabra reports

Getting richer has been a double edged sword for Vietnam. The country moved from low income to middle income status in 2010. Since then, aid it receives from the international community for programmes such as HIV/AIDS treatment has been dropping. That’s troublesome given that Vietnam relies on donor support for about 75% of the budget for HIV services1 and the disease is spreading in its mountainous regions.

The World Bank and UK Department for International Development (DFID) were the first major donors to end existing HIV programmes in the country without making any plans for further support; others are following suit. In 2013, DFID finished a six year project that had provided a total of $36.5m (£24m; €33m), and in 2012 the World Bank wrapped up a $38.5m project that had spanned eight years.2

Now the, US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund are reportedly winding down their contributions as well. Launched in 2004, PEPFAR has given $634m to Vietnam’s HIV response programme. But funding has dropped from $87m in 2010 to $69m in 2013 and $65m in 2014.3 Global Fund’s total budget for HIV programmes in Vietnam is $77m for 2014-17.4 The fund hasn’t announced the budget for after 2017, but local officials say they are not hopeful.

A 2014 report written by the Vietnamese Ministry of Health with UNAIDS and its development partners estimated that the resource gap caused …

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