The recent AIDS 2012 conference included a line-up of speakers to rival most health causes including former President Clinton, current U.S. Secretary of State, Hillary Clinton, World Bank Present Jim Kim, Philanthropist Bill Gates as well as other globally recognizable humanitarians and celebrities. The conference is unlike many other gatherings on this topic in that the speakers, panelists and participants represent a diversity of stakeholders in such a quantity that the conversation is forced to be as dynamic as the people.
But what I found to be especially interesting and relevant for NextBillion readers was an honest and frank debate on financing in a resource constrained environment for HIV/AIDS. Since the global response started nearly 10 years ago, there has been significant investment in building health systems, expansion of services including prevention and new science. At the same time, costs of programs continue to decline along with increased productivity from a decade of lessons learned.
Among the key questions discussed were: Should any sector or disease area be protected during the current economic times and associated financial constraints? What criteria should be used as we allocate resources as a global community?
In the debate, which you can watch below, Roger England, chairman of the Health Systems Workshop, Grenada, and Mead Over, senior fellow, Center for Global Development, are assigned to argue against continued financing. Jeffrey Sachs, economist and director of the Earth Institute at Columbia University and UNAIDS Executive Director, Michel Sidibé are positioned to argue for continued financing.
This financing debate presents good arguments for a balance of priorities within countries, across sectors. While the natural inclination may be to immediately support continued funding for HIV/AIDS, a leveling-off of funding in recent years is forcing country directors and finance ministers to re-evaluate allocation of their resources. In the same way, this debate suggests the global community should think hard about the status quo of donor spending. Today, HIV/AIDS resource allocation is far different than it was ten years ago, largely because it is much more integrated and helps to build systems of healthcare. While this may be true, should all disease areas and/or development challenges be addressed indirectly as a synergistic outcome of HIV/AIDS development? Or, should competing priorities be evaluated with the appropriate weights and evaluation criteria (some of which are suggested during this panel) in a more balanced and direct fashion?
As we think about development in a broad sense, how can we best improve resource allocation? “Aid colonialism” as it was termed in this discussion and prescribing of the use of funds, neglects the flexibility at a country level required in this changing financial market to balance competing priorities. With HIV/AIDS, many lives have been saved and many are left to be saved. Countries must decide based on their circumstances how to act next. As suggested in this debate, country level decision-making and flexibility regarding country-level priority making should be a development approach in and of itself.
As someone who did not attend the conference, but is reflecting on outputs from this event, my perspective is limited. For those of you who did attend and have further thoughts to highlight, please bring your reflections to the comment section below.
For more information on the debate, here are several follow-up articles:
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