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U.S.-Based Philanthropies: Their Support and Coverage of HIV/AIDS in the United States and Abroad



December 1st, 2011
by Lee-Lee Prina

On World AIDS Day, GrantWatch Blog looks at what foundations have been saying and doing about HIV/AIDS in the past month or so. In 2011, HIV/AIDS watchers marked thirty years since the first case was reported in the United States, believe it or not! Of course, this post describes just a sampling of recent activity and is not meant to be comprehensive.

Recent reports:

On November 10, Funders Concerned About AIDS (FCAA) released U.S. Philanthropic Support to Address HIV/AIDS in 2010. Supported by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and others, this annual publication says that the total amount disbursed by U.S.-based philanthropies decreased by $33 million from 2009 to 2010. (Funders awarded $492 million in 2009, and $459 million in 2010.) “Philanthropic support” includes that of foundations of various kinds, corporate-giving programs, and public charities.

The report notes that the decline can be largely attributed to a decline in funding by the biggest private AIDS funder, the Bill and Melinda Gates Foundation in part because of the multiyear nature of their funding commitments and in part because Gates was undergoing an HIV/AIDS “strategy review process” in 2010. Not to worry, HIV/AIDS is a “top priority” for Gates, which is forecasting an increase in its funding in this area for 2011, the report says.

Also, in 2010 other U.S.-based funders as a group decreased their HIV/AIDS giving by around 2 percent, part of a ”continuing trend of funders exiting the field of HIV/AIDS-specific funding.”

Most HIV/AIDS funding provided by U.S.-based philanthropies in 2010—that is, 78 percent of all such disbursements—was directed to addressing the international epidemic. Domestic funding  decreased almost 10 percent from 2009. The Northeast region received the lion’s share of that funding (46 percent).

As for new infections, the South has the dubious distinction of having 45 percent of new AIDS diagnoses, the report says. And citing the Henry J. Kaiser Family Foundation and AIDS United, the report says that the state/”dependent area” with the highest diagnosis rate per 100,000 people (in 2009) was Washington, D.C.

See the handy table listing the top U.S. HIV/AIDS funders in 2010 (on page 21).

Projections suggest that total funding for HIV/AIDS–related projects may increase for 2011, the report says.

Interestingly, a footnote in the report states that funding for HIV/AIDS awarded by foundations to the Global Fund to Fight AIDS, Tuberculosis, and Malaria was not counted in this report because “it will be increasingly difficult to accurately determine actual disbursements to the Global Fund from funders each year.” The major reason is that promissory notes are being used by some donors.

FCAA also notes that no data were received from Macy’s Foundation (a top funder in 2008 and 2009) and a few others. Also, grant seekers will be interested to know that the David and Lucile Packard Foundation, Rockefeller Brothers Fund, and the William and Flora Hewlett Foundation are not in the current report because they each “shifted from specifically funding HIV/AIDS towards other health interventions.” The Kaiser Family Foundation, an operating foundation, is omitted from the report because FCAA finds it “increasingly difficult to value financially” its policy research and communications programs. Kaiser has had a long-time interest in funding HIV/AIDS-related projects—going back to when it was a grant-making foundation.

Broadway Cares/Equity Fights AIDS, the Ford Foundation, and the New Venture Fund also funded the FCAA report.

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“Improving Women’s Health in South Africa: Opportunities for PEPFAR [U.S. President’s Emergency Plan for AIDS Relief],” by Janet Fleischman, released October 27 by the Center for Strategic and International Studies. Change is coming to South Africa, which “is decentralizing HIV services to the primary care level, paving the way for greater integration to address women’s health and to reduce maternal mortality,” says Fleischman. Nurses and community health workers will have important roles in this re-engineering. PEPFAR is transitioning from a program of emergency response to sustainable programs within individual countries. The author recommends that PEPFAR show that it can address HIV-related goals by linking HIV services with more comprehensive services for women—family planning, reproductive health, and maternal and child health services—as a cost effective way to help improve health outcomes and a way to reduce maternal mortality.

Although much progress has occurred in South Africa, both in fighting the HIV/AIDS epidemic and improving health services, the country continues to have “unacceptably high levels” of both pregnant women with HIV and maternal mortality, “which are correlated with the high HIV prevalence among women and girls.” Many of South Africa’s key health challenges, Fleischman says, could be addressed by more effectively reaching those populations—for example, through HIV prevention programs that meet the needs of females; integration of health services, such as HIV services with family planning, reproductive health, and maternal and child health services; and strengthening the health care system. Whether the South African government can now adequately address these issues and whether PEPFAR and the U.S. government’s Global Health Initiative will support its efforts are “open questions,” Fleischman comments.

The David and Lucile Packard Foundation funded the report. (Grant seekers: See information on the Packard Foundation above.)

Fact Sheets

The Kaiser Family Foundation announced Nov. 29 that it had updated various resources on HIV/AIDS, including the following fact sheets:

The Global HIV/AIDS Epidemic, November 2011;

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), November 2011;

The HIV/AIDS Epidemic in the United States, October 2011.

For more Kaiser resources on HIV/AIDS, go to: http://globalhealth.kff.org or http://www.kff.org/hivaids/index.cfm.

Foundation Initiative

Read about the Ford Foundation’s Reducing HIV/AIDS Discrimination and Exclusion initiative, which aims to protect and advance the rights of people affected by HIV/AIDS. See this funder’s strategy and grantees.

Foundation Blog Posts:

“Join Presidents Bush, Clinton, plus Bono and Alicia Keys This World AIDS Day on YouTube,” The Official google.org blog, Nov. 23. The philanthropic arm of Google cross-posted this from The Official YouTube Blog.

“Top 10 Myths about HIV Vaccine Research,” Amie Newman of the Bill and Melinda Gates Foundation on the foundation’s Impatient Optimists blog, Nov. 21. The Fred Hutchinson Cancer Research Center, in Seattle, originally came up with this list. It was then picked up by MDNews.com., Newman noted. The first fallacy listed is that HIV vaccines can cause people to contract the virus; read why that is not true.

Related resources:

AIDSVu is an online tool showing high-resolution views of the geography of AIDS in the United States. This Emory University project is funded by Gilead Sciences.

“Global Fund–Supported Programs See Strong Results amid Funding Challenges,” Global Fund press release, Nov. 30. Read here about results from AIDS prevention and treatment programs in countries benefiting from Global Fund to Fight AIDS, Tuberculosis, and Malaria support.

As the Global Fund explained in a November 23 press release, budget problems in some donor countries, plus low interest rates, have markedly affected funds available for its new grants. Thus, this public-private partnership and international financing organization reiterated here “that it will not be in a position to fund additional new grants that would allow a further expansion of its health programs between now and the end of 2013, unless all pledged resources are paid to the Fund during that period.” The Global Fund further explained that it “will ensure that essential treatment and services, covered by grants that expire before that time in countries in need, continue to receive funding.” For details on transitional funding for those countries that already have Global Fund grants, read this December 1 announcement.

That release also noted that the Global Fund’s board approved a “transformation plan” to improve its risk management, fiduciary control, and governance, in response to some problems it had in the past. The fund will use a new model emphasizing funding of projects with “high potential for impact and strong value for money.” It will continue to focus on populations that are most at risk. The fund will also introduce a new way for countries to apply for funding.

• Health Affairs is planning a thematic issue on PEPFAR for July 2012. Watch for it! http://www.healthaffairs.org.

“PEPFAR’s Declining Investment in HIV/AIDS Treatment,” by Matthew Kavanagh, director of US policy and advocacy for Health GAP (Global Access Project), and Marguerite Thorp, a research assistant at Harvard Medical School, on Health Affairs Blog, Nov. 29.

“The Urgency of Providing Comprehensive and Integrated Treatment for Substance Abusers with HIV,” Nora D. Volkow, director of the National Institute on Drug Abuse, and Julio Montaner, clinical director of the British Columbia Centre for Excellence in HIV/AIDS and professor of medicine at the University of British Columbia, Health Affairs, August 2011.

World AIDS Day website, http://www.worldaidsday.org/

“World AIDS Day 2011,” Centers for Disease Control and Prevention (CDC) feature.

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