PUBLISHED ON 31 Mar 2015



RethinkHIV released a Policy Brief based on a research paper by RethinkHIV researchers Sir Paul Collier, Richard Manning, and Olivier Sterck.

The Policy Brief argues that the moral duty to provide life-long treatment to people diagnosed with HIV, while saving millions of productive lives, creates an enduring liability that is like a debt. This burden is significant for African countries with generalised epidemics. And it has far-reaching implications, requiring a rethink of the way we finance the HIV response and prioritise interventions.

Actions for Policy Makers

Recognise the threat to fiscal sustainability posed by long-term HIV liabilities

Incorporate this liability in national financial projections and into aid planning

Minimise the total fiscal liability through more attention to cost-effective measures of prevention

Spending on prevention should be pursued up to the point at which the marginal dollar spent on prevention reduces the discounted liability of treatment by at least one dollar

Questions for Policy Makers

For national policy-makers: What are the implications of acknowledging the long-term liability posed by HIV treatment for your country? Which synergies and efficiencies can be harnesssed to reduce them? Where can new fiscal space be found to finance the response domestically?

For donors: How will you factor these long term liabilities into your planning? What opportunities are there to rethink the financing architecture of the response?

For all policy-makers: Which prevention methods could help reduce HIV fiscal liabilities? Which blue sky investments are required to change the course of the pandemic? What new commitment technologies should be put in place by donors and affected governments for the long-term effective, responsible financing of the HIV response?

Download the Paper

Policy Brief 2