The Lancet: Comparing estimates of spending on health and HIV/AIDS
Jose Antonio Izazola-Licea and Ana Yakusik, both special advisers for strategic information at UNAIDS, and Deepak Mattur, officer for strategic information at UNAIDS

“We commend the Global Burden of Disease (GBD) Health Financing Collaborator Network … for publishing HIV spending estimates. However, we are concerned that some readers could interpret the GBD’s reported estimates to mean that the global HIV-resource needs have been met. The GBD estimate of total spending for HIV responses in low-income and middle-income countries (LMICs) in 2015 … appears to exceed the U.N. General Assembly commitment to fully fund the global HIV response and reach ‘overall financial investments in developing countries of at least 26 billion dollars per year by 2020.’ … However, if the global and regional components of the development assistance for HIV are included in the LMIC aggregates, then the GBD estimate for 2015 and the UNAIDS estimates are remarkably similar. … Both analyses come to similar conclusions: increases in domestic expenditures are being offset by reductions in development assistance. We agree with the authors that more investment is needed to achieve global health and HIV goals, and that investment for in-country HIV resource tracking is also needed” (11/3).

The Lancet: Comparing estimates of spending on health and HIV/AIDS — Authors’ reply
Annie Haakenstad and Mark Moses, both researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and Joseph L. Dieleman, assistant professor at IHME

“We are appreciative of the constructive and helpful comments made to our article by Jose Antonio Izazola-Licea and colleagues and commend UNAIDS on its recently released estimates of domestic and external financing of HIV/AIDS. We agree with the authors’ assertion that the world remains far from realizing global goals for HIV/AIDS investments. Evidence that the decline in HIV incidence is slowing down is particularly concerning in light of the investment gap. … [H]owever, we stress the crucial importance that readers and practitioners always consider the currency in which estimates are being reported in, especially when making comparisons across countries. The appropriate exchange rate information will be particularly important as we investigate further how much domestic resources can be raised for HIV/AIDS…” (11/3).