We know that in 2009, there were about 18,000 new HIV infections, a total of 50 per day, in the Caribbean. We also know that there was a 14% reduction in the incidence of HIV between 2001 and 2009. In fact, Jamaica, the Dominican Republic, Suriname and Belize recorded reductions by at least 25% during the same period. However, do we know the total spending for HIV and AIDS programmes across the region and in our respective countries? Do we know where our governments and civil society organisations are getting this money? And do we know what it is being spent on?

At the recently held Caribbean HIV Prevention Summit on most-at-risk populations (MARPs) and other vulnerable populations in Nassau, Bahamas, Bilali Camara, UNAIDS Caribbean Senior Monitoring and Evaluation Adviser, highlighted that between 2008 and 2009, US$497 million was spent on HIV and AIDS in the region. Of this total more than half (58% to be exact) of funding for HIV/AIDS Programmes came from outside the region. Only 31% of that spending was from domestic coffers.

This raises a number of questions, as to the level of investment by the region to halt and reverse the spread of HIV by 2015 – a goal our Caribbean leaders committed to achieving in 2000 at the Millennium Summit. Furthermore, with funding mechanisms such as the Global Fund looking to close their operations in the region in the short-term, one can’t help but wonder about the future of AIDS programmes.

A further breakdown of spending by areas was shared and revealed that the Caribbean region is spending very little on research. Immediately, one begins to think that the vast majority of our prevention programmes, which amounts to 32% of the region’s HIV/AIDS budget, are not necessarily evidence-based. While 37% was spent on treatment in the same period, the UNAIDS representative was particularly concerned that 20% was being used to pay salaries.

Let us now look at HIV/AIDS spending in Jamaica.

Unlike most countries in Latin America and the Caribbean, a large portion of Jamaica’s total health expenditure comes from the local budget and not international donors. In 2006, health expenditure was 5.1% of gross domestic product (GDP) and only 1.3% was received from international development partners. However, the expenditure for HIV and AIDS is different.

Funding for Jamaica’s National HIV Strategic Plan comes from donors such as the World Bank and the Global Fund to against AIDS, Tuberculosis and Malaria (GFATM). However, it is impossible to complete all activities in this plan due to a 67.3% shortfall in the amount of money available. Between 2007 and 2009, most of Jamaica’s HIV budget was spent on treatment and care and prevention. According to the Planning Institute of Jamaica the plan costs US$201.2 million but only US$65.7 is available. In fact, Jamaica’s Ministry of Health budget is about J$31 billion, but HIV only J$1.2 billion.

Numbers turns many of us off, but it is important that we begin to pay attention to what is being spent on HIV and AIDS programmes. Understandably, we cannot expect our governments to put all the money for health towards HIV/AIDS but the necessary investments are being made to ensure there is zero new infections, zero AIDS related death, and that all persons have access to treatment and care.