A New Initiative to Track HIV Resource Allocation and Costs

In early 2020, several global health institutions – including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Joint United Nations Program on HIV/AIDS (UNAIDS); United States Agency for International Development; and Office of the Global AIDS Coordinator at the United States Department of State – aligned behind activity-based costing/management in a multi-country initiative to track resource allocation and funding for human immunodeficiency virus (HIV) services throughout sub-Saharan Africa. The initiative will generate detailed information, down to the patient level, on the costs of delivering HIV care. The initiative recognizes that governments and global institutions need to align and optimize their investments, particularly during a transition in which the governments assume greater fiscal responsibility for service delivery. The initiative will provide detailed information on where current investments are being directed and how this transition is shaping programs in reality. PEPFAR (President’s Emergency Plan for AIDS Relief) and the Global Fund will launch a Secretariat to coordinate the initiative’s activities and support the collaborative learning component across participating countries. The initiative could also serve as a model for examining the cost and delivery of other health services.