Introduction
Despite sub-Saharan Africa [SSA] constituting just 12% of
the world’s population, the region has the
highest burden of HIV with 70% of HIV infection
in general and 80% of new infections among
young people
occuring in the region. Diverse intervention
programmes have been implemented among
young people but with
minimal translation to behavior change.
lobal trends in HIV infection demonstrate an overall
increase in HIV prevalence and substantial
declines in AIDS related
deaths largely attributable to the survival
benefits of antiretroviral treatment. Sub-
Saharan Africa carries a disproportionate burden
of
HIV, accounting for more than 70% of the global
burden of infection. Success in HIV prevention in
sub-Saharan Africa has the
potential to impact on the global burden of HIV.
METHODS
systematic review to identify innovative
financing instruments used for domestic
HIV/AIDS financing in
sub–Saharan Africa, international health
financing and financing in non–health sectors.
analysis on peer–reviewed and grey literature published
between 2002 and 2014.
We examination of the nature
and volume of funds mobilized with innovative
financing, then in
consultation with leading experts, identified
instruments that held
potential for financing the HIV response.
• Conclusion
• A limited number of innovative financing
Discussion instruments
The possibility of an AIDS free generation cannot be realized unless we are able contributed a very modest share of funding
to prevent HIV infection in young women. toward domestic HIV/
he HIV epidemic in this region is generalised but young women, men who have AIDS programs. Several innovative
sex with men, transgender people, sex workers, prisoners and people who financing instruments successfully applied
inject drugs are at an increased vulnerability to infection. in other sectors could be used to augment
Improved availability of provider-initiated and community-based HIV testing domestic financing toward HIV/AIDS
services now means three out of four people living with HIV are aware of their programmes.
status. • Insufficient financial resources, combined
The number of people living with HIV in East and Southern Africa continues to with the lack of strategic information, has
increase, but access to antiretroviral treatment is increasing as well. led to many high-impact HIV prevention
Although laws and cultural traditions vary between Eastern and Southern programmes not being implemented to the
African countries, there are a number of ingrained cultural, structural and legal necessary standard or scale in the region.
barriers that act as barriers to HIV prevention.
SOCIO ENVIRONMENTAL THEORIES OF HIV
East and Southern Africa is the region most affected by HIV in the world and is • Fundamental barriers to treatment,
home to the largest number of people living with HIV. particularly HIV-related stigma and
Structural constraints on ability to navigate prevention and discrimination and HIV-specific criminal
treatment options require particular attention in sub-Saharan legislation, must also be overcome.
Africa. Removing such barriers would encourage
These prevailing challenges— more people to get tested and seek out
treatment, reducing the burden of HIV
most notably poverty, housing, food security, unemployment,
substance abuse, crime, and violence—were sometimes more across the region.
overbearing than HIV.
• Recommendation