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HIV/AIDS Expenditures in Sub-Saharan Africa: Observations from Kenya, Rwanda and Zambia. S. Muchiri, Wellington Godo, K Chebet,Ministry of Health, Nairobi, Kenya C. Kabago, P. Kayabotsi, D. Ndushabandi, Government of Rwanda, Kigali, Rwanda F. Phiri, Ministry of Health, Lusaka, Zambia
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HIV/AIDS Expenditures in Sub-Saharan Africa:Observations from Kenya, Rwanda and Zambia S. Muchiri, Wellington Godo, K Chebet,Ministry of Health, Nairobi, Kenya C. Kabago, P. Kayabotsi, D. Ndushabandi, Government of Rwanda, Kigali, Rwanda F. Phiri, Ministry of Health, Lusaka, Zambia T. Dmytraczenko, S. De, C. Chanfreau, M. Tien and G. Kombe, Abt Associates Inc., Bethesda MD USA
Providing HIV/AIDS Prevention, Treatment and Care: A Heavy Toll on the Health Sector • HIV/AIDS is the single largest contributor to the burden of disease in Africa • 19% of the total years of life lost due to disability or premature mortality PPP$ 141 45% PPP$ 433 In percentages 24% PPP$ 306 14% HIV/AIDS as a share of total health expenditures
Household and Donors Finance a Large Share of HIV/AIDS Expenditures Kenya Rwanda Zambia
Treatment and Care Absorb the Majority of Health Funds KENYA 75%
Is HIV/AIDS a Priority in Resource Allocation? Rwanda Kenya Zambia 5% 33% 21% 57% 75% 19%
The Burden on HIV+ Households Is Considerable HIV/AIDS Out-of-pocket spending = $31.62 per HIV+ individual General Out-of-pocket spending =$3.70 per capita A person living with HIV/AIDS spends approximately 9 times more out-of-pocket than the average Zambian on health care Preliminary results
HIV/AIDS Out-of-pocket spending = $60.84 per HIV+ individual General Out-of-pocket Spending =$8.90 per capita The Burden on HIV+ Households Is Considerable A person living with HIV/AIDS spends approximately 7 times more out-of-pocket than the average Kenyan on health care Preliminary results
HIV/AIDS Out-of pocket spending = $4.97 per HIV+ individual General Out-of-pocket Spending =$2.13 per capita The Burden on HIV+ Households Is Considerable A person living with HIV/AIDS spends approximately 2 times more out-of-pocket than the average Rwandan on health care Preliminary results
Meeting basic needs in Rwanda • 58% of HIV+ households received assistance, borrowed or sold assets • 26% received assistance • 33% borrowed • 17% sold assets
Policy Issues • Sustainability of donor funding in view of long-term challenges posed by HIV/AIDS • Equity issues related to substantial household out-of-pocket HIV/AIDS spending • Potential implications of future plans to scale up anti-retroviral therapy (ART)