A call for additional resources

© UNICEF/HQ00-0008/Pirozzi

UNICEF believes that the current incremental improvements in funding and the focus on children and AIDS are inadequate. There is an urgent need to massively scale up the response for children and adolescents affected by HIV/AIDS and mobilize the necessary partnerships and resources. The challenge facing the international community, national governments and key stakeholders is the comprehensive, massive scaling up of interventions and initiatives for prevention, treatment and care.

The last few years have seen a paradigm shift in the amount of resources available for HIV/AIDS, estimated at over US $6 billion in 2004. Yet despite all our efforts, we have not been able to ascertain how much of this funding has been allocated to children. Most funding agencies/mechanisms and governments do not have a dedicated budget line for children and do not currently require that resources be tracked by age and gender.

One of the challenges for UNICEF through the campaign and our other work is to ensure that in the hardest-hit countries, all national HIV/AIDS strategies, budgets and plans of action for children have dedicated resources for children affected by HIV/AIDS. We must also institute mechanisms to track funding by age and gender so as to more effectively monitor better the allocation given to children affected by HIV/AIDS. This was a key recommendation of the second annual Global Partners Forum.

A second major challenge related to resources is to ensure that we "make money work”, and that funds reach families, communities and civil society groups providing services for children. This does not mean simply doing more of the same with an increase in scale. It means mobilizing sufficient resources to make and fund a paradigm shift in the programme response for children affected by HIV/AIDS.
 
The “Making the Money Work” meeting convened jointly by Joint United Nations Programme on HIV/AIDS (UNAIDS), UK Department for International Development (DFID) and USG/France was a pivotal meeting that UNICEF needs to take careful note of. There is increasing concern in both developing countries and donor nations that there is a lack of coherence in the international response to HIV/AIDS in general and the UN agency response in particular.

The latest UNAIDS report (released on 24 June 2005) pointed out that the global response to AIDS has now reached a crucial stage. Awareness of the disease is at an all-time high, and the availability of resources has increased significantly from US $300 million a decade ago to US $6.1 billion in 2004. However, the gap between the financial resources needed and the resources available has not been closed, and the reality that these high levels of funding will have to be maintained for years and even increased in many countries has not been factored into country development frameworks. An even greater challenge is to close the gap between the funding available and the money that is actually being spent effectively, efficiently and transparently on the ground by implementing agencies in the public and private sectors and in civil society.

According to UNAIDS projections, a total of US $8.3 billion is estimated to be available from all sources in 2005, rising to US $8.9 billion and US $10 billion in 2006 and 2007, respectively.

As the response to AIDS is scaled up, funding estimates must be constantly revised and updated. UNAIDS will work with international donors and affected countries to refine the cost estimates, focusing particularly on strengthening health infrastructures.

Although financing for the response to AIDS in low- and middle-income countries has increased significantly, it falls far short of the scale necessary to achieve the Millennium Development Goal of halting and beginning to reverse the epidemic by 2015.

It is therefore all the more imperative that the most effective use is made of whatever funds are available. This, in turn, requires that the many actors in the response to AIDS at the global, national and local levels fully coordinate and harmonize their efforts.

Based on present projections, from 2008 more than US $20 billion will be needed annually to mount a fully comprehensive response to the global AIDS epidemic. However, reaching this goal and ensuring the money can be used to best effect will prove a major challenge for all stakeholders, including the governments of affected and donor countries.

As a synthesis of which resources have been secured for HIV/AIDS and Children, please find below the major funding needs for each of the foor Ps:

Prevention of mother to child transmission (PMTCT)	US $1.5 billion (through 2010)
Providing paediatric treatment	US $1.8 billion (through 2008)
Protection of children affected by AIDS and support	US $4.5 billion a year
Prevention among adolecents and young people	US $10 billion (through 2010)

The global response to AIDS must move from its current levels of implementation to the point where comprehensive strategies incorporating prevention, care and treatment, and services for orphaned and vulnerable children can be rapidly and extensively expanded.

However, without significant increases in funding, current levels of availability from domestic and international sources will peak at a projected US $10 billion by 2007. Financing at this level would raise coverage of HIV prevention initiatives to only 55 per cent; the number of people on antiretroviral treatment would fall far short of internationally agreed targets, and services to orphaned and vulnerable children would continue to lag behind. In many nations, the epidemic’s trajectory would be barely affected, if at all.