The Current State of the Epidemic:
Why We Need to Step Up Our Efforts

8. The global epidemic is devastating poorer countries and threatening richer ones

Funding for HIV/AIDS-specific programs and services comes from many sources: provincial and territorial departments of Health and Social Services, federal departments and agencies (e.g., the Public Health Agency of Canada, Health Canada, Correctional Service Canada and the Canadian International Development Agency), federal and provincial research funding organizations, municipal governments, foundations and donations. Funding also comes from other government programs and services that serve populations affected by HIV, such as correctional services, addiction programs, STI programs, and programs for Aboriginal people, recent immigrants and youth.

While other health initiatives and diseases rely on private donations to fund programs and services, HIV programs and services have never received a comparable level of philanthropic support. This is in part because HIV infects a relatively small proportion of the population compared to illnesses such as heart disease or cancer. However, other factors also influence the level of private funding for HIV/AIDS. Since the late 1990s, corporate and individual donations to HIV organizations have dropped dramatically -- a reflection of both the public misconception that HIV is now a treatable disease and the marginalization of many affected by HIV, such as people who use injection drugs.27

Because HIV receives less support from private citizens and companies, there is a stronger imperative for all governments to provide long-term and sustainable funding for HIV initiatives that meet the increase in scope, cost and complexity of the epidemic.

Between 1993 and 2003, HIV/AIDS-related programs and services experienced a 43% increase in demand due to both new infections and people living longer with the disease.28 As a result, "important prevention efforts were not sustained and new prevention programs were not initiated; new policy was not developed and important research was not conducted; organizations were weakened and had to compete rather than cooperate."29 For many organizations -- particularly community-based AIDS organizations -- this has led to an increase in staff and volunteer burnout and turnover.

Organizations and jurisdictions also report increasing problems attracting and retaining people and expertise, including staff for community-based agencies, volunteers, physicians and researchers. While this growing gap is due in part to a lack of resources, it is also due to the increasing complexity of HIV/AIDS care (for physicians), the challenge of working with marginalized populations, the misconception that HIV/AIDS is no longer as large a problem as it once was, and the fact that community-based AIDS organizations cannot compete with the private sector and many other organizations in the public sector in terms of salaries.

Securing long-term and sustainable funding for HIV initiatives is also a global issue. Despite the contributions of additional funding by a number of countries to date, global efforts still fall far short of the estimated US $10 billion a year required to stop the epidemic.30


Martin Spigelman Research Associates. Getting Ahead of the Epidemic: the Federal Government Role in the Canadian Strategy on HIV/AIDS 1998-2008. 2003.



This is the funding requirement identified by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

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