Funding for Key HIV Commodities in PEPFAR Countries
Issue Brief
KFF, “The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)” fact sheet, May 2020. PEPFAR, PEPFAR 2019 Country Operational Plan Guidance for all PEPFAR Countries.
Global HIV funding in LMICs has been largely flat over the years and declined between 2017 and 2019. KFF. Donor Government Funding for HIV in Low- and Middle-Income Countries in 2019, July 2020.
Funding totals represent amounts reported in countries’ PEPFAR 2019 COP/ROPs (“COP19”) for implementation in FY 2020. All references to 2019 throughout this analysis refer to data presented in 2019 COP/ROP documents. The underlying source of these data varies considerably. In some cases, countries used data from previous years, while in others, the data are a result of planning and negotiations with national stakeholders and the Global Fund.
Zimbabwe reports total funding need, which includes the percent covered by each funding source as well as the gap in funding. For the purposes of this analysis, we removed the percent gap in funding; consequently, Zimbabwe’s total expenditure on key commodities is lower than what is reported in its SDS. Eswatini only reports 75% of expenditures for condoms, all of which is supported by PEPFAR. We categorized the remaining 25% as “Other Funder,” as Eswatini’s SDS states “it is not expected that there will be a gap in condom supply because PEPFAR will continue to support the optimization of access to low-cost condoms for clients who can afford to pay for condoms while ensuring that the no-cost condoms are distributed according to mapped need.” Nepal only reports 66% of its expenditures for “Other Drugs.” Given that there were no further details provided about the remaining 33%, the data is considered missing and not included in the analysis.
UNAIDS. AIDSinfo database, accessed May 2021.
Countries whose percentage totals do not sum to 100% include Burma, Cambodia, Eswatini, Jamaica, Lesotho, Nepal, Zambia, and Zimbabwe.
Most PEPFAR countries order condoms through USAID’s Commodity Fund. It is possible that there may be inconsistency among countries on how condoms procured through USAID’s Commodity Fund are accounted for in the SDSs; for instance, some countries may call them PEPFAR-supported procurement and others may categorize them as “Other.” We interpret the funding amounts reported in the SDSs at face value. PEPFAR, 2019 Country Operational Plan Guidance for all PEPFAR Countries.
Numerous countries did not report data for “Other Commodities”. In some cases, the lack of data might indicate $0 expenditures. As it was not clear, we assumed that any data denoted by a “-“ or “N/A” in the SDSs were true “N/A” and noted it as such in this analysis. We applied this assumption to “-“ and “N/A” in other categories as well.
According to the 2019 COP Guidance, PEPFAR concentrates its VMMC programs in 14 priority countries. Also, data for PEPFAR-supported VMMC procedures in these countries for 2019 is included in PEPFAR’s online Panorama Spotlight Dashboard. Twelve of these countries provided VMMC commodity funding data in their 2019 SDSs; two countries, Kenya and Ethiopia, did not provide data on VMMC commodity funding in their 2019 SDSs. According to Ethiopia’s SDS, Ethiopia used non-COP resources for its VMMC program. South Sudan, while not noted as one of the 14 priority countries where PEPFAR concentrated its VMMC efforts in 2019, provided funding data on VMMC in its 2019 COP. We included South Sudan’s data as reported in the analysis.
According to the 2019 COP Guidance, PEPFAR concentrates its VMMC programs in 14 priority countries. Also, data for PEPFAR-supported VMMC procedures in these countries for 2019 is included in PEPFAR’s online Panorama Spotlight Dashboard. Twelve of these countries provided VMMC commodity funding data in their 2019 SDSs; two countries, Kenya and Ethiopia, did not provide data on VMMC commodity funding in their 2019 SDSs. According to Ethiopia’s SDS, Ethiopia used non-COP resources for its VMMC program. South Sudan, while not noted as one of the 14 priority countries where PEPFAR concentrated its VMMC efforts in 2019, provided funding data on VMMC in its 2019 COP. We included South Sudan’s data as reported in the analysis.
Numerous countries did not report data for “Other Commodities”. In some cases, the lack of data might indicate $0 expenditures. As it was not clear, we assumed that any data denoted by a “-“ or “N/A” in the SDSs were true “N/A” and noted it as such in this analysis. We applied this assumption to “-“ and “N/A” in other categories as well.